Investigating the Impact of Kratom ( Mitragyna speciosa ) Use Upon Male Sexual Health

• Published in: Research and reports in urology 2023-01, Vol.15, p.69-76
• Main Authors: Deebel, Nicholas A, Scarberry, Kyle, O'Connor, Collette A, Dutta, Rahul, Matz, Ethan, Hanlon, Colleen A, Terlecki, Ryan P
• Format: Article
• Language: English
• Subjects: analgesia; Androgens; Chronic pain; Consent; Ejaculation; Ethnicity; Frustration; kratom; Males; Medical screening; Mental disorders; Mitragyna speciosa; Narcotics; Normal distribution; Opioid receptors; Original Research; Participation; Patients; Polls & surveys; Post traumatic stress disorder; premature ejaculation; Questionnaires; Sexual behavior; sexual function; Sexual health; Sexual orientation
• ISSN: 2253-2447; 2253-2447
• DOI: 10.2147/RRU.S390094

Kratom ( ) exhibits μ-receptor agonism and is used as an opioid substitute. While opioids are known to inhibit sexual behavior, less is known regarding kratom. We conducted a pilot study to assess the subjective impact of kratom upon male sexual health including erectile and ejaculatory function. Twitter and Reddit (r/Kratom) were accessed to disseminate our survey featuring validated instruments (the International Index of Erectile Function, IIEF, and the premature ejaculation diagnostic tool, PEDT). Sexual health prior to and after 4 weeks of kratom use was assessed. Most males surveyed (n = 165) were 18-40 years old (84.9%), with 95.8% of respondents using it at least weekly and 82.4% using kratom for ≥1 year. Reasons for use included treating pain (39.4%), and mental health conditions (63.6%). Kratom was associated with a positive (37.7%) and negative (20.5%) impact on sexual health. Kratom subjectively increased time to ejaculation in 104 (66.6%) patients, perceived as positive by 62 (59.6%). Seventy-eight patients answered questions about premature ejaculation. The median (with interquartile range, IQR, following;) pre-kratom and kratom use scores were 13.0; 8.0 and 6.5; 5.0, respectively (p < 0.001). Ejaculation before 5 minutes improved after kratom (51.3% vs 12.8%) (p < 0.0001). Following kratom use, patients reported lack of frustration with ejaculation prior to desire (21.8% vs 61.5%) (p < 0.001). The erectile function domain of the IIEF was statistically significantly different however - clinically similar pre-kratom use (29.0; 5.75) versus 27.0; 6.75 during kratom use (p = 0.037). Clinicians treating male sexual health should be aware of kratom and its potential effect on ejaculatory and erectile function.