Endocrine Effects of Chronic Opioid Therapy: Implications for Clinical Management

Abstract

SUMMARYOver the past few decades, the use of opioids in the management of chronic pain conditions has greatly increased. As opioid utilization has expanded, so has the recognition of associated hormonal derangements. These hormonal disturbances involve disruption, predominantly of the hypothalamic–pituitary–gonadal axis, and can affect both men and women treated with opioids. The best recognized of these hormonal disorders is opioid-associated androgen deficiency. Opioid-associated androgen deficiency is most likely to occur with prolonged, high-dose opioid therapy and may be associated with the development of other conditions such as depression, osteoporosis and possible hyperalgesia. Once identified, opioid-associated androgen deficiency should be managed with appropriate hormonal replacement therapy and patients should be closely monitored for adequacy of treatment and treatment-associated adverse events.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.