Hypogonadism and sexual dysfunction in male cancer survivors receiving chronic opioid therapy.
The purpose of this study was to determine the prevalence of central hypogonadism and sexual dysfunction in male cancer survivors exposed to chronic high-dose oral opioid therapy. We studied 20 male patients with cancer-related chronic pain who were disease-free for at least one year. All patients consumed at least 200 mg-equivalent of morphine on a daily basis for at least one year. Participants completed the Sexual Desire Inventory questionnaire and serum levels of testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were assessed. Serum testosterone levels were reduced in these patients. The median value was 140 ng/dL (normal 241-827). There was no compensatory increase in FSH and LH. The median FSH level was 3.5 mIU/mL (normal 1.4-18.1). The median LH level was 2.1 mIU/mL (normal 1.5-9.3). The mean dyadic sexual desire score was 23.9+/-15.7 (normal value, 42.8+/-8.9). The mean solitary sexual desire score was 1.3+/-1.9 (normal value, 10.6+/-1.9). Our data suggest that chronic exposure to high-dose oral opioid therapy may result in marked central hypogonadism and sexual dysfunction. Given the increasing use of long-term opioid therapy for chronic pain syndromes, further investigation into these findings is warranted.
Department of Anesthesiology, University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Arun
A
Rajagopal
Rena
R
Vassilopoulou-Sellin
J Lynn
JL
Palmer
Guddi
G
Kaur
Eduardo
E
Bruera
D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use; D002908:Chronic Disease; D018592:Cross-Over Studies; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D007006:Hypogonadism / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000150:complications* / Q000188:drug therapy / Q000209:etiology; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced*; D011795:Surveys and Questionnaires; D017741:Survivors
D000701:Analgesics, Opioid; D012739:Gonadal Steroid Hormones