title: Improvement in sexual function after reduction of chronic high-dose opioid medication in a cancer survivor.
abstract: OBJECTIVE
  To demonstrate improvement in sexual function after reduction of opioids.
  
  
  METHODS
  This was a retrospective examination of a single patient at the cancer pain management clinic at M.D. Anderson Cancer Center in Houston, Texas. The patient was a 58-year-old male, free of cancer for 12 years, with chronic low back pain from a prior retroperitoneal mass. Changes in scores from the Brief Male Sexual Inventory and visual analog scale pain questionnaires were used to evaluate the patient.
  
  
  RESULTS
  In this patient, a decrease in morphine-equivalent daily dose from 690 mg to 20 mg resulted in a significant increase in sexual function. Sexual inventory scores increased from 4 to 43.
  
  
  CONCLUSIONS
  Reduction in opioid consumption can dramatically increase libido and sexual function. A possible mechanism involves opioid-related effects on the hypothalamic-pituitary-gonadal axis.
authors.affiliation: Department of Anesthesiology, University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA. arajagop@mdanderson.org
authors.forename: Arun
authors.initials: A
authors.lastname: Rajagopal
authors.forename: Eduardo D
authors.initials: ED
authors.lastname: Bruera
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D002908:Chronic Disease; D006801:Humans; D007989:Libido / Q000187:drug effects; D017116:Low Back Pain / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012186:Retroperitoneal Neoplasms / Q000150:complications*; D012189:Retrospective Studies; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced*; D011795:Surveys and Questionnaires; D017741:Survivors
chemical_list: D000701:Analgesics, Opioid