Research and Reports in Urology (Feb 2023)
Investigating the Impact of Kratom (Mitragyna speciosa) Use Upon Male Sexual Health
Abstract
Nicholas A Deebel,1 Kyle Scarberry,2 Collette A O’Connor,1 Rahul Dutta,1 Ethan Matz,1 Colleen A Hanlon,3 Ryan P Terlecki1 1Department of Urology, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, USA; 2Department of Urology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; 3Department of Cancer Biology, Wake Forest University School of Medicine, Winston-Salem, NC, USACorrespondence: Ryan P Terlecki, Department of Urology, Atrium Health Wake Forest Baptist Medical Center, 1 Medical Center Blvd, Winston-Salem, NC, 27157, Tel +1 336 716 4131, Fax +1 336 716 9042, Email [email protected]: Kratom (Mitragyna speciosa) 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.Patients and Methods: 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.Results: 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).Conclusion: Clinicians treating male sexual health should be aware of kratom and its potential effect on ejaculatory and erectile function.Keywords: kratom, Mitragyna speciosa, premature ejaculation, analgesia, sexual function
