title: Opioids and hypogonadism.
abstract: Detailed reports of hypogonadotropic hypogonadism in patients receiving morphine analgesia were published in 2010. Symptoms included flushing and sweating, amenorrhoea, impotence and decreased libido. Epidemiological studies have examined a possible link between hypogonadism and opioid use, in both patients and drug addicts. Statistically significant decreases in plasma hormone concentrations were found, with lower testosterone and LH levels in men, and lower oestradiol, progesterone, LH and FSH levels in women. Animal studies have provided consistent results. It is suspected that opioids affect the hypothalamic-pituitary axis, inhibiting LH secretion. Patients should be warned of this risk. If signs of hypogonadism occur in a patient taking an opioid, the benefits and harms of treatment should be reassessed. If possible, the dose should be reduced or the opioid withdrawn.
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D000818:Animals; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D006065:Gonadotropins, Pituitary / Q000097:blood; D006801:Humans; D007006:Hypogonadism / Q000139:chemically induced* / Q000453:epidemiology; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects / Q000378:metabolism; D008297:Male; D009020:Morphine / Q000009:adverse effects*; D009293:Opioid-Related Disorders / Q000503:physiopathology; D010913:Pituitary-Adrenal System / Q000187:drug effects / Q000378:metabolism
chemical_list: D000701:Analgesics, Opioid; D012739:Gonadal Steroid Hormones; D006065:Gonadotropins, Pituitary; D009020:Morphine