Dramatic acceleration of reproductive aging, contraction of biochemical fecundity and healthspan-lifespan implications of opioid-induced endocrinopathy-FSH/LH ratio and other interrelationships.
Whilst disturbances of female reproductive hormones and function are commonplace in opioid dependence, their pathophysiological interrelationships are not well understood. Hormonal levels in females were compared in 77 opioid dependent patients (ODP) and 148 medical controls (MC) including 205 and 364 repeat studies. Significant changes in FSH, LH, oestradiol, testosterone and SBG were noted including power functions with age. The FSH/LH was lower in ODP (P=0.0150) and the ratio inversion point occurred at 28.06±9.36v. 46.26±4.76years, implying a 58% reduction in fertility duration. FSH has been shown to induce ovarian failure and GnRH (controlling LH and FSH) has been shown to regulate longevity systemically. This implies that, far from being benign, these findings explicate the adverse experience of female compared to male ODP, exacerbate opioid-dependent aging amongst females, and informs the care of opioid dependent women, particularly relating to the choice, dose and duration of agonist or antagonist therapy.
School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley WA 6009, Australia. Electronic address: sreece@bigpond.net.au.
Albert Stuart
AS
Reece
Emphron Informatics, 88 Jephson St., Toowong, QLD, 4066, Australia.
Mervyn Rees
MR
Thomas
School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley WA 6009, Australia.
Amanda
A
Norman
School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley WA 6009, Australia.
Gary Kenneth
GK
Hulse
D000293:Adolescent; D000328:Adult; D000375:Aging / Q000187:drug effects*; D000701:Analgesics, Opioid / Q000009:adverse effects*; D004958:Estradiol / Q000097:blood; D005260:Female; D005298:Fertility / Q000187:drug effects*; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D008136:Longevity; D007986:Luteinizing Hormone / Q000097:blood; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000097:blood / Q000150:complications*; D011374:Progesterone / Q000097:blood; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood; D055815:Young Adult
D000701:Analgesics, Opioid; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone
Estradiol; FSH; Free androgen index; Free estradiol index; LH; Reproductive endocrinology; Sex hormone binding globulin; Testosterone