How does heroin decrease your libido?

Written by Brandon Okey. Mina Draskovic, B.Psy., reviewed this content for accuracy.

Heroin disrupts the hormonal balance needed for healthy sexual function. This powerful opioid blocks testosterone production and floods your system with artificial pleasure signals that override natural sexual responses. Sexual desire plummets as your body prioritizes the drug’s effects over basic biological drives.

A 2019 study reveals that over 80% of patients in treatment for heroin addiction struggle with sexual dysfunction, including decreased libido, even during their recovery process.

Ardu tackles heroin addiction at its source by targeting physical dependence and psychological patterns that lead to addiction. Our heroin rehab program combines medical therapies with a holistic approach to help you break free from opioids and start your journey toward complete recovery.

Do opioids lower libido?

Heroin belongs to the class of illicit drugs known as opioids. These are powerful substances derived from the opium poppy or synthesized to mimic its effects. Heroin is one of the most addictive opioids. It acts on your brain’s reward system to trigger intense euphoria while disrupting bodily functions.

Any opioid dependence can decrease libido. Heroin users experience severe sexual dysfunction because the drug interferes with the hypothalamic-pituitary-gonadal axis, your body’s hormone production system.

Here’s how all opioids, including heroin, damage your sexual function:

In men, testosterone production plummets, impacting everything from sexual drive to reaching orgasm and fertility.
Blood flow to sexual organs becomes restricted, making erections difficult or impossible.
Women experience vaginal dryness, making sex uncomfortable or painful.
The pathways in your brain that control orgasm shut down, and you may be unable to finish.
Your brain’s reward system shifts toward the drug instead of intimate connections.
Feelings of anxiety and depression creep in. Heroin can kill what little desire remains.
Long-term use shrinks the glands that make hormones, and the effects can last forever.

A 2018 study explains that people who inject full-agonist opioids (like heroin) experience more libido loss than those using partial-agonist opioids (like buprenorphine). A cross-sectional study substantiates this claim and reveals that each additional daily injection reduces sexual activity by 4.6% among heroin users. Users who inject six or more times daily are experiencing a dramatic decrease in sexual function compared to those with lower usage rates.

Even after starting recovery, many individuals continue to struggle with these effects, which can reduce their quality of life and threaten their relationships. Our heroin detox program restores your body’s hormone balance and manages withdrawal symptoms from heroin use.

How does heroin affect your hormone levels?

Heroin disrupts your hormones within hours of use. It hijacks your body’s hormone production system, striking at the root of sexual health and desire.

Disruption of the hormone control center

When heroin floods your bloodstream, it attaches to opioid receptors in the hypothalamic-pituitary-gonadal axis. The drug interferes with the hypothalamus, blocking the release of gonadotropin-releasing hormone (GnRH), the critical signal for hormone production throughout your body. With ongoing heroin exposure, your brain’s hormone regulation system slowly becomes dysfunctional. The longer and heavier the heroin use, the more profound this hormonal imbalance becomes, often persisting even during early recovery.

Testosterone suppression in men

For heroin-dependent men, the most significant impact appears in testosterone production. Plasma testosterone levels can drop by 50–80% with regular heroin use. This testosterone suppression occurs through several mechanisms:

Direct inhibition of the testes’ ability to produce testosterone.
Increased levels of prolactin, which further blocks testosterone production.
Disruption of luteinizing hormone, which normally stimulates testosterone synthesis.

Testosterone decline caused by heroin use affects virtually every aspect of male sexuality. Without sufficient testosterone, your body struggles to maintain muscle mass, energy levels, and sexual function.

Hormonal impact in women

Heroin hijacks a woman’s hormonal balance, triggering severe sexual dysfunction. Here’s how it happens:

Heroin blocks normal estrogen and progesterone cycles, which throws your body’s natural rhythm into chaos.
Your menstrual cycle becomes unpredictable or stops altogether.
Natural vaginal lubrication disappears, turning intercourse into a painful ordeal.
Your body loses its capacity for sexual excitement and climax as hormone signals shut down.

These hormonal attacks leave many women disconnected from their sexuality. Intimate relationships suffer because of the combination of physical discomfort and lack of desire that destroys sexual connection and satisfaction.

Wider endocrine damage

Heroin’s assault on your body damages the entire endocrine system.

Your adrenal glands become hyperactive, pumping out excessive cortisol (the body’s primary stress hormone), which triggers anxiety, weakens immune function, and disrupts sleep patterns.
Thyroid function slows down, sapping your energy and metabolism.
Your body’s insulin response becomes erratic and starts affecting blood glucose levels. If not treated on time, it could lead to metabolic syndrome.
Growth hormone production falls and harms tissue repair and cellular regeneration.

Heroin users experience physical deterioration beyond sexual dysfunction, including accelerated aging, compromised immunity, and chronic fatigue that persists long after the drug is gone.

Injection drug users typically experience more severe hormonal disruption than those who use heroin through other routes, likely due to higher blood concentrations of the drug reaching hormone-producing glands.

Does your sex drive return when you stop heroin use?

Most people see a gradual improvement in sexual functioning after they quit heroin. Your body’s hormone system begins resetting almost immediately, with testosterone levels in men and menstrual cycles in women typically normalizing within months.

Your recovery timeline is influenced by:

How long you used heroin.
The amounts typically consumed.
Your overall physical health.
Presence of other substance use disorders.

A 2014 study found that sexual function in former heroin users improved after they started methadone treatment, with the rate of severe erectile dysfunction decreasing from 65% before treatment to 37% after treatment. Long-term users (five or more years) may experience persistent sexual dysfunction that requires medical intervention. Some people find that buprenorphine treatment causes fewer sexual problems than methadone during recovery.

The return of sexual desire often lags behind physical recovery, especially when psychological factors or relationship issues are not addressed. At Ardu, we monitor hormonal recovery as part of our comprehensive approach to drug addiction treatment.

Ardu's approach to heroin addiction recovery

Our treatment programs address heroin dependence through evidence-based therapies while providing comprehensive support for lasting sobriety.

Our medical detox program helps you safely navigate the challenging physical aspects of heroin withdrawal. During this initial phase, your body purges the drug’s toxins while our medical team manages your symptoms with FDA-approved medications that prevent dangerous complications. Clinical staff monitors you 24/7 throughout this process for your comfort and safety as your body readjusts to functioning without heroin.

IV hydration therapy accelerates neurochemical rebalancing through direct nutrient delivery to your depleted system. Our nutrition therapy works alongside medical treatment to strengthen your recovering body and boost natural healing processes during detox.

Following detox, our rehab programs target the psychological aspects of heroin addiction.

Cognitive behavioral therapy identifies thought patterns driving addiction.
Dialectical behavior therapy builds distress tolerance and emotional regulation.
Individual therapy addresses personal risk factors and psychological distress.
Group sessions provide peer support and reduce social isolation.
Family therapy helps repair relationships damaged by heroin dependence.

Many heroin users struggle with underlying psychiatric disorders, like depression or anxiety, that fuel their addiction cycle. Our dual diagnosis approach tackles addiction and mental health at once, breaking destructive patterns and improving your chances for successful long-term recovery from heroin dependence.

To enroll in an Ardu heroin treatment program, contact us online or via phone (801-872-8480). We will work with you to find a recovery path that works for you during the detox process and beyond.

Read our admissions process page for more information.

Brandon Okey is the co-founder of Ardu Recovery Center and is dedicated to empowering people on their journey to sobriety.

Heroin and libido FAQ

Does testosterone come back after opioid use?

Testosterone levels begin to recover within days after you stop using heroin. Heroin-dependent men see significant improvement within 1–3 months of sustained abstinence, but long-term heroin use may cause more lasting hormonal disruption requiring longer recovery periods. Your age, overall health, and history of drug use all affect how quickly your body restores normal testosterone production.

Some people, particularly those with five or more years of heroin dependence, might need medical intervention to restore hormone balance. Laboratory investigations can determine if your testosterone levels require additional treatment beyond abstinence from opioids.

Can painkillers affect libido?

Prescription painkillers containing opioids impact sexual desire through their pharmacological effects on hormone regulation. These drugs of abuse disrupt the same hormone pathways as heroin, reducing testosterone in men and altering estrogen cycles in women. Even short-term use of prescription opioids can diminish sexual arousal and satisfaction.

The stronger the painkiller and the longer you use it, the more pronounced these sexual side effects become. Painkillers also affect psychological aspects of sexuality by dulling emotional responses and creating psychological distress that further reduces interest in sexual intimacy.

Does codeine cause low libido?

Codeine can reduce sexual desire, but less severely than heroin or oxycodone. As a mild opioid, codeine affects the same hormone systems that regulate sexual function, and may decrease libido, cause erectile dysfunction in males, and reduce sexual satisfaction. The risk factors increase with higher doses and regular use. Even over-the-counter codeine products used long-term impacted sexual arousal.

If you notice sexual side effects while taking codeine-containing medications, discuss this with your healthcare provider. They will give you alternative medication options with fewer sexual side effects.

What are the side effects of opioids?

Opioids cause many side effects beyond decreased libido that impact virtually every body system. Common immediate effects include:

Severe constipation and digestive problems.
Nausea and vomiting.
Extreme drowsiness and sedation.
Dangerous respiratory depression.
Itching and skin reactions.

Long-term physical effects include:

Blood vessel damage and cardiovascular problems.
Compromised immune function.
Disrupted hormone production.
Impaired liver function.
Sleep disturbances.

Users also experience a wide range of mental and psychological effects, such as:

Depression and anxiety.
Cognitive impairment and memory problems.
Increased pain sensitivity over time.
Social isolation and relationship breakdown.

The most dangerous side effect is an overdose, which can quickly become fatal without immediate medical intervention.

Resources

Llanes C, Álvarez AI, Pastor MT, Garzón MÁ, González-García N, Montejo ÁL. Sexual Dysfunction and Quality of Life in Chronic Heroin-Dependent Individuals on Methadone Maintenance Treatment. J Clin Med. 2019 Mar 7;8(3):321. doi: 10.3390/jcm8030321. PMID: 30866482; PMCID: PMC6463066.

Laélia Briand Madrid, Stéphane Morel, Khadim Ndiaye, Salim Mezaache, Daniela Rojas Castro, Marion Mora, Fabrice Olivet, Virginie Laporte, Camelia Protopopescu, Patrizia Carrieri, Perrine Roux, Factors associated with perceived loss of libido in people who inject opioids: Results from a community-based survey in France, Drug and Alcohol Dependence, Volume 190, 2018, Pages 121-127, ISSN 0376-8716, https://doi.org/10.1016/j.drugalcdep.2018.05.030.

Zhang M, Zhang H, Shi CX, McGoogan JM, Zhang B, Zhao L, Zhang M, Rou K, Wu Z. Sexual dysfunction improved in heroin-dependent men after methadone maintenance treatment in Tianjin, China. PLoS One. 2014 Feb 10;9(2):e88289. doi: 10.1371/journal.pone.0088289. PMID: 24520361; PMCID: PMC3919724.