Hypogonadism in patients treated with intrathecal morphine.
OBJECTIVE
The objective of this study was to investigate the hypothalamic-pituitary-gonadal response to intrathecal opioids.


METHODS
Thirty patients receiving intrathecal morphine for chronic nonmalignant pain were studied for clinical and biochemical evidence of hypogonadism. Ten men and 10 postmenopausal women with chronic pain of similar duration but who were not receiving any form of opioid therapy acted as control subjects.


RESULTS
Men and both premenopausal and postmenopausal women had evidence of hypogonadism with low levels of serum testosterone or estrogen coupled with low levels of pituitary gonadotrophins. Control subjects had hormone levels in the expected range for their sex and age. Two men demonstrated recovery after ceasing intrathecal opioid therapy.


CONCLUSIONS
Hypogonadotrophic hypogonadism is a common complication of intrathecal opioid therapy in both men and women.
Finch
P M
PM
Perth Pain Management Centre, South Perth, Western Australia. pfinch@iinet.net.au
Roberts
L J
LJ
Price
L
L
Hadlow
N C
NC
Pullan
P T
PT
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002908:Chronic Disease; D004967:Estrogens / Q000097:blood; D005260:Female; D006062:Gonadotropins / Q000097:blood; D006066:Gonads / Q000187:drug effects; D006801:Humans; D007006:Hypogonadism / Q000139:chemically induced* / Q000473:pathology; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects; D007278:Injections, Spinal; D007989:Libido / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D010146:Pain / Q000150:complications / Q000188:drug therapy; D012727:Sex Characteristics; D013739:Testosterone / Q000097:blood
D000701:Analgesics, Opioid; D004967:Estrogens; D006062:Gonadotropins; D013739:Testosterone; D009020:Morphine