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Bmj opioid induced hypogonadism in male: Opioid induced hypogonadism

A male normally has one X and one Y chromosome.

Ethan Walker
Monday, June 27, 2016
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  • References 1. Hypogonadism and low bone mineral density in patients on long-term intrathecal opioid delivery therapy.

  • Depending on when hypogonadism develops and how much testosterone is present, a child who is genetically male may be born with:. Ballantyne, Jane C.

  • After the exclusion of studies based on title and abstract, we screened full-text articles. Also, because of the limited number of longitudinal studies, an interaction of the different endocrine axes could not be assessed.

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Publication types

However, amongst chronic opioid users no difference has been found in TSH or fT4 levels compared to controls 2. Male patients on fentanyl, methadone, or oxycodone had increased odds for testosterone deficiency compared to those using hydrocodone odds ratios [OR] Opioid abuse in chronic pain: misconceptions and mitigation strategies.

  • Opioids any drug which binds to the opioid receptors in the central nervous opioud, of which natural opiates are a subclass are now increasingly prescribed worldwide in every age group, for acute and chronic, cancerous and non-cancerous, pain. Discussion The flushing and sweating and the amenorrhoea were secondary to opioid induced hypogonadism.

  • The Y chromosome contains the genetic material that determines the sex of a child and related development.

  • Male hypogonadism associated with advanced cancer: a systematic review. Although hypogonadism and, to a lesser extent, hypocortisolism are recognized endocrine side effects, their prevalence remains unclear 10 ,

Administrative, technical, or material support: JWS. Consequences of hypogonadism 24 In men: Erectile dysfunction Impotence Loss kale muscle mass and strength In women: Irregular menstrual periods, oligomenorrhoea, amenorrhoea In bmj opioid induced hypogonadism in male Flushing and sweating Loss of libido Infertility Depression and anxiety Low energy levels Osteoporosis and fractures. For outcomes that included 5 or more studies per analysis, I 2 statistics were used for the quantification of between-study heterogeneity. A dose-response relationship between opioid use and cortisol levels was reported by 2 studies, with a lower fasting cortisol decrease of 8.

  • In case of no response, authors were approached a second time; however, ultimately no additional subject level data could be obtained.

  • Patients on long-term opioid therapy should be actively monitored for signs and symptoms consistent with hypogonadism.

  • Regarding the somatotropic axis, animal studies showed stimulated GH secretion after short-term administration of opioids Moreover, we report significant lack of clinical data on this field.

  • Early signs and symptoms might include:.

Total testosterone values, however, must be interpreted opkoid in the aging male because sex hormone-binding globulin SHBG levels might be elevated. Related News A number of conditions can cause secondary hypogonadism, including:. If patients continue to remain hypogonad after opioid rotation, testosterone replacement should be initiated. Accessed Sept. JOAO Jan

Although many men regain their fertility within a few months after treatment, preserving sperm before starting cancer therapy is bm option for men. Find information and tools about neurological diseases to assist patients and caregivers. Steroids —Patients with symptoms of hypogonadism who are confirmed to be hypogonad require treatment. Male reproductive system Open pop-up dialog box Close. It should also be noted that the testes through the aromatization of testosterone also secrete estradiol and that testosterone is secreted by the ovarian theca cells.

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Devilla et al. Another study reported that lower androgen levels were correlated to depressive symptoms in women on intrathecal opioids Funding: No additional funding. Google Scholar PubMed. Additionally, the duration of opioid exposure, the method of endocrine assessments, and definitions of endocrine deficiency differed between studies, which may affect the reported outcomes.

The extra X chromosome that occurs in Klinefelter syndrome causes abnormal development of the testicles, which in turn results in underproduction of testosterone. James B. McGraw-Hill Education; These include fatigue, decreased libido, erectile dysfunction, depression, night sweats, decreased muscle mass, infertility, anemia, insomnia and osteoporosis. Snyder PJ. A pituitary tumor or other type of brain tumor located near the pituitary gland may cause testosterone or other hormone deficiencies.

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If the total testosterone level is normal in the aging male presenting signs of hypogonadism, the clinician can rely on free testosterone or measure SHBG and calculate bioavailable testosterone. This content does not have an Arabic version. The hypothalamic-pituitary-gonadal HPG axis controls the production of the primary sex steroids, testosterone androgen and estradiol estrogen. Related News An abnormality in the pituitary gland can impair the release of hormones from the pituitary gland to the testicles, affecting normal testosterone production.

Studies were assigned to qualitative categories for each element of the risk of bias analysis and were defined as low, moderate, or high risk for induced hypogonadism element separately the scoring system is presented in the supplemental document 2 PLoS One. J Pain ; 9 Screening of studies, data extraction, and risk of bias assessment were performed by 2 independent reviewers FdV, MB. Although hypogonadism and, to a lesser extent, hypocortisolism are recognized endocrine side effects, their prevalence remains unclear 10 National Center for Biotechnology InformationU. The role of testosterone supplemental therapy in opioid-induced hypogonadism: a retrospective pilot analysis.

Publication types

Clin Endocrinol. PLoS One. Permissions Icon Permissions. Full blood count; ferritin concentration; renal, thyroid, and liver function tests; and concentrations of calcium, C reactive protein, calcitonin, chromogranins A and B, plasma and urine metanephrines, and urine 5-hydroxyindoleacetic acid 5HIAA were normal. Clin J Pain.

  • Search ADS. A literature search was conducted to identify studies describing endocrine effects of opioid use.

  • Cancer treatment.

  • These authors contributed equally to this work as first author.

  • Chemotherapy or radiation therapy for the treatment of cancer can interfere with testosterone and sperm production.

  • Daniel J Lobatto.

Reprod Biol Endocrinol. J Pain. Nienke R Biermasz. Risk of confounding of effects of opioids on the endocrine system among comparative studies eg, comparison of opioid addicts and healthy controls, correction with multivariate analyses. Pain Med. New issue alert.

Of all studies, 22 were classified with a low risk of bias, 10 with a moderate, and 20 with a high risk of bias. Volume Opioid endocrinopathy in women consuming prescribed sustained-action opioids for control of nonmalignant pain. Bruce CA. Clinical data on HPA axis morbidity in opioid users is very limited to absent. Opioid-induced suppression of rat testicular function.

Materials and Methods

This article has been cited by other articles in PMC. Article Navigation. After the exclusion of studies based on title and abstract, we screened full-text articles. Opioid endocrinopathy: a clinical problem in patients with cancer pain.

The aim of this systematic review and meta-analysis was to assess the effects of opioid use on pituitary function. Alberto M Pereira. Adrenal insufficiency in patients on long-term opioid analgesia. Hormone replacement therapy in morphine-induced hypogonadic male chronic pain patients. Endocrine consequences of long-term intrathecal administration of opioids.

Finally, results of hormone replacement therapies in case of presumed endocrine deficiencies were extracted when available. Am Bmj opioid induced hypogonadism in male Drug Alcohol Abuse. Opioid endocrinopathy in women consuming prescribed sustained-action opioids for control of nonmalignant pain. In the United States alone, there were more than 11 million people with misused prescription opioids and 42 opioid-related deaths were reported in 2—4. Support Care Cancer. Disagreement was solved through discussion.

In: Greenspan's Inducev and Clinical Endocrinology. Endocrine Reviews. We recommend checking a baseline complete blood count CBCprostate specific antigen PSA and a digital rectal examination DRE before initiation of testosterone replacement and at subsequent visits. In Klinefelter syndrome, two or more X chromosomes are present in addition to one Y chromosome.

Case reports

The Impact of Opioids on the Endocrine System. This condition often corrects itself within the first few years of life without treatment. The Journal of Clinical Endocrinology and Metabolism. In adult males, hypogonadism can alter certain masculine physical characteristics and impair normal reproductive function.

Gardner DG, et al. The extra X chromosome that occurs in Klinefelter syndrome causes abnormal development of the testicles, which in turn results in underproduction of testosterone. Sargis RM, et al. February

Drafting of the manuscript: FdV, MB. Seven studies, including patients, opioir the results of the effects of opioids on the HPT axis Pooled percentage and sensitivity analysis, only including studies using ITT as assessment of the HPA axis, of opioid exposure-related hypocortisolism. Moreover, we have included studies looking at treatment with hormone substitution therapy and its effects on the relevant symptomatology.

A systematic review of opioid effects on the hypogonadal axis of cancer patients. Disorders of the pituitary gland. J Clin Endocrinol Metab ; 90 Deposited 29 July J Pain ; 9

  • Pain Pract.

  • If the total testosterone level is normal in the aging male presenting signs of hypogonadism, the clinician can rely on free testosterone or measure SHBG and calculate bioavailable testosterone. Related Associated Procedures Genetic testing.

  • Drug-induced HPA axis alterations during acute critical illness: a multivariable association study. As opioids could not be stopped or reduced on account of ongoing severe pain, hormone replacement therapy was started to prevent long term complications like osteoporosis and also to relieve symptoms.

These can opiois. Reviews in Urology vol 5. Depending on the studied population, the reported prevalence of bmj opioid induced hypogonadism in male induced hypogonadism ranges from 21 percent to 86 percent. An abnormality in the pituitary gland can impair the release of hormones from the pituitary gland to the testicles, affecting normal testosterone production. Testosterone therapy in men with hypogonadism: An Endocrine Society clinical practice guideline. Replacement can be achieved in a multitude of forms: transdermal patch, transdermal gel, and intramuscular injections see Table 1. The complications of untreated hypogonadism differ depending on when it develops — during fetal development, puberty or adulthood.

Article Contents Abstract. Hypogonadism in men consuming sustained-action oral opioids. Our study does have some limitations. Outcomes In both these cases, hypogonadotrophic hypogonadism was most likely to have been caused by the chronic use of opioids.

Hormone replacement therapy in morphine-induced hypogonadic male chronic pain patients. A literature search was conducted to identify studies describing endocrine effects of opioid use. In addition, several studies suggest that the endocrine system is affected in opioid users 78. Testosterone deficiency in non-cancer opioid-treated patients.

  • New issue alert.

  • Decreased serum testosterone concentration in male heroin and methadone addicts.

  • Fifteen studies that included a total of patients presented data on the percentage of patients with hypogonadism among chronic opioid users, based on a single morning or random testosterone measurement Table 1.

  • A random effects logistic regression model was performed when there were 5 or more studies per analysis to estimate pooled percentages. Table 1.

  • Devilla et al.

The likelihood of developing hypogonadism also appeared male increase when long-acting inn or higher dosages were used. On examination, he had normal secondary sexual characteristics. In 5 out of 7 studies, hyperprolactinemia was present. Rubinstein ACarpenter DM. Eur Addict Res. A 37 year old woman, the mother of two children and a regular wheelchair user, presented with a history of lumbosacral fusion, osteopenia, and multiple fractures. Clin Endocrinol Oxf.

In one study, testosterone concentrations dropped by more than 50 percent within a few hours of taking an opioid, and returned to baseline within hours after withdrawal; depending on the dose used, it can take up to a month to recover. In the last two decades, the increased prescription rate and the prolonged usage of opioids shed light on opioid-induced endocrinopathy. If the body doesn't produce enough testosterone during fetal development, the result may be impaired growth of the external sex organs. It should also be noted that the testes through the aromatization of testosterone also secrete estradiol and that testosterone is secreted by the ovarian theca cells. Accessed Aug.

Discussion

The penis ejaculates semen during sexual intercourse. Elsevier; In this brief review, we will discuss the pathophysiology, signs and symptoms, approach to diagnosis, and treatment of hypogonadism as a guide to aid clinicians in diagnosing and treating this common side effect of long-term opioid use. J Neuroendocrinol. Endocrine Reviews.

Resources Find useful tools to hypogonadiam you on a day-to-day basis. Chemotherapy or radiation therapy for the treatment of cancer can interfere with testosterone and sperm production. A pituitary tumor or other type of brain tumor located near the pituitary gland may cause testosterone or other hormone deficiencies. Some types of male hypogonadism can be treated with testosterone replacement therapy. There are two basic types of hypogonadism:.

Mees Bruin. These authors contributed equally to this work as first author. Additionally, studies not bnj original data eg, reviewscase reports, and unpublished studies eg, congress abstracts were excluded from analysis. Notes Cite this as: BMJ ;c In addition, 6 studies reported on the effect of testosterone replacement in case of associated hypogonadism and 1 on the effect of treatment with hydrocortisone on hypocortisolism, but there were no studies reporting on the effects of hormone replacement on other axes.

The effects of both treatments often are temporary, but permanent infertility may occur. This content does not have an Arabic version. An abnormality in the pituitary gland can impair the release of hormones from the pituitary gland to the testicles, affecting normal testosterone production. Hypogonadism can be inherited.

Katz NMazer NA. Moreover, we have included studies looking at treatment with hormone substitution therapy hypogonnadism its effects on the relevant symptomatology. Finally, results of hormone replacement therapies in case of presumed endocrine deficiencies were extracted when available. Also, because of the limited number of longitudinal studies, an interaction of the different endocrine axes could not be assessed. Moreover, total testosterone levels were lower in high-dose

Replacement can be achieved in a multitude of forms: transdermal patch, transdermal gel, and intramuscular injections see Table 1. Med, Coren, Joshua D. Chemotherapy or radiation therapy for the treatment of cancer can interfere with testosterone and sperm production. See a doctor if you have symptoms of male hypogonadism.

Furthermore, the heterogeneity between studies may have affected the robustness of our results. Disorders of the pituitary gland. Hormone secretion in methadone-dependent and abstinent patients. The literature search yielded unique articles. Clin J Pain ; 18

Moreover, total testosterone levels were lower in high-dose Case 2 A 37 hypogonadiem old woman, the mother of two children and a regular wheelchair user, presented with a history of lumbosacral fusion, osteopenia, and multiple fractures. Over the past two decades, the use of opioids and the number of opioid overdose-related deaths has steadily increased 1.

Author contributions: FdV and MB had full access to all of the data in the hypogonaism and take responsibility for the integrity of the data and the accuracy of the data analysis. Plasma testosterone and luteinizing hormone levels during levo-alpha-acetylmethadol maintenance and withdrawal. Disagreement was solved through discussion. Devilla et al.

  • Decreased serum testosterone concentration in male heroin and methadone addicts. Jan W Schoones.

  • J Neuroendocrinol. This content does not have an English version.

  • Plasma testosterone and sexual function in southeast asian men receiving methadone and buprenorphine maintenance treatment.

  • Testosterone and estrogen are essential for normal sexual and reproductive development and behavior.

  • A male normally has one X and one Y chromosome.

Opioid-induced hypogonadism OHG results indjced long-term opioid therapy. A number of conditions can cause secondary hypogonadism, including:. J Neuroendocrinol. These include fatigue, decreased libido, erectile dysfunction, depression, night sweats, decreased muscle mass, infertility, anemia, insomnia and osteoporosis. If the total testosterone level is normal in the aging male presenting signs of hypogonadism, the clinician can rely on free testosterone or measure SHBG and calculate bioavailable testosterone. Keywords: chronic pain; hormonal replacement therapy; low-dose naltrexone; opioid-induced hypogonadism; opioids. Some types of male hypogonadism can be treated with testosterone replacement therapy.

Hypogonadism can be inherited. Journal of the American Medical Association. It can hamper:. Evaluation and treatment of male hypogonadism. FebruaryVol. Bhasin, Shalender, Cunningham, Glenn R. If any of these risk factors are in your family health history, tell your doctor.

Clin J Pain ; 18 Competing interests: All authors have completed the unified competing interest form at www. Disclosure Summary: The authors report no conflict of interest. Seven studies, including patients, described the results of the effects of opioids on the HPT axis

Funding: No additional funding. Advanced Search. Also, because of the limited number of longitudinal studies, an interaction of the different endocrine axes could not be assessed. In total, 21 studies with patients described the effects of opioid use on the activity of the HPA axis Eight studies defined the opioid dose as the morphine equivalent daily dose. Endocrine effects of methadone in rats; acute effects in adults.

Issue Index. These two hormones are released into the systemic circulation and stimulate the gonads—the testes and ovaries—to secrete testosterone or estradiol, respectively. Klinefelter syndrome. Testosterone therapy in men with hypogonadism: An Endocrine Society clinical practice guideline. Delayed male puberty child.

You can be born with male hypogonadism, or it can develop later in life, often from injury or infection. As testosterone decreases, some men have symptoms similar to those of menopause in women. Hyperprolactinemia, like opioids, tonically inhibits the secretion of GnRH. Early signs and symptoms might include:. Signs and symptoms depend on when the condition develops. Find information and tools about neurological diseases to assist patients and caregivers.

In adult males, hypogonadism can alter certain masculine physical characteristics and impair normal reproductive function. Male reproductive system Open pop-up dialog box Close. Prog Neuropsychopharmacol Biol Psychiatry. Male hypogonadism adult. Fluid from the seminal vesicles and prostate gland combine with sperm to make semen.

  • J Clin Endocrinol Metab ; 90

  • Hypogonadism, male.

  • National Center for Biotechnology InformationU.

  • The extra X chromosome that occurs in Klinefelter syndrome causes abnormal development of the testicles, which in turn results in underproduction of testosterone.

  • Patients with symptoms of hypogonadism who are confirmed to be hypogonad require treatment. Jeffrey L.

Advanced Search. A fixed-effects model was used for analyses with fewer than 5 studies. Hypogonadism in men consuming sustained-action oral opioids. As opioids could not be stopped or reduced on account of ongoing severe pain, hormone replacement therapy was started to prevent long term complications like osteoporosis and also to relieve symptoms. Open in new tab. Clinical data on HPA axis morbidity in opioid users is very limited to absent. Notes Contributors: All authors contributed equally to writing and editing.

Horm Metab Res. Plasma testosterone and sexual function in southeast asian men receiving methadone and buprenorphine maintenance treatment. Author information Article notes Copyright and License information Disclaimer. Effects of testosterone replacement on pain catastrophizing and sleep quality in men with opioid-induced androgen deficiency. Search Menu. Journal List BMJ v. The complete search strategy is presented in a supplemental document 1

Open in new tab. A random effects logistic regression model was performed when there were 5 or more studies per analysis to estimate pooled percentages. Receive exclusive offers and updates from Oxford Academic. Hormone secretion in methadone-dependent and abstinent patients. Of these, 9 reported an inhibitory effect, 4 a stimulatory effect, and 8 studies reported no effect 12—1430—

In: Greenspan's Basic and Clinical Endocrinology. Mayo Clinic Marketplace Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. Occasionally opioids result in elevated prolactin levels and thereby resulting in decrease production of testosterone. Gardner DG, et al. It can hamper:.

  • A major strength of this study is that this is the first study performing a meta-analysis on this topic. Provenance and peer review: Not commissioned; externally peer reviewed.

  • Find information and tools about neurological diseases to assist patients and caregivers. This condition often corrects itself within the first few years of life without treatment.

  • Hormone replacement therapy in morphine-induced hypogonadic male chronic pain patients.

  • Correspondence and Reprint Requests: Amir H.

  • In addition, hypocortisolism can manifest a wide variety of symptoms, such as fatigue, malaise, abdominal discomfort, anorexia, and orthostatic hypotension. In addition, 6 studies reported on the effect of testosterone replacement in case of associated hypogonadism and 1 on the effect of treatment with hydrocortisone on hypocortisolism, but there were no studies reporting on the effects of hormone replacement on other axes.

Hypogonadism can be inherited. February Cancer treatment. Severe hypogonadism can also cause mental and emotional changes. Reproductive Biology and Endocrinology

Accessed Aug. Ballantyne, Jane C. Steroids —James B. Opioids are pivotal therapeutics in the management of escalated chronic pain moderate-severe. Am J Obstet Gynecol. It begins with the secretion by the hypothalamus of gonadotropin releasing hormone GnRH.

The effects of opioids and opilid analogs on animal and human endocrine systems. For example, the effect of methadone on the gonadotropic axis seems to be larger than the effect of buprenorphine in several studies comparing the two 2652 As prolactin inhibits GnRH release from the hypothalamus, this is an additional mechanism of the hypogonadism observed in patients on opioids 9.

  • Article Contents Abstract.

  • Replacement can be achieved in a multitude of forms: transdermal patch, transdermal gel, and intramuscular injections see Table 1.

  • Risk of confounding of effects of opioids on the endocrine system among comparative studies eg, comparison of opioid addicts and healthy controls, correction with multivariate analyses. A 42 year old man, followed up in our department for primary hyperparathyroidism, presented with episodes of flushing and sweating.

  • Pathophysiology of Opioid-Gonadal Axis The hypothalamic-pituitary-gonadal HPG axis controls the production of the primary sex steroids, testosterone androgen and estradiol estrogen. This content does not have an Arabic version.

The public and the opioid-abuse epidemic. Contributors: All authors contributed equally to writing and editing. PLoS Med. Jan W Schoones.

Donegan DBancos I. Oxford Textbook of Medicine. Opioid abuse in chronic pain: misconceptions and mitigation strategies. A fixed-effects model was used for analyses with fewer than 5 studies. Issue Section:.

Decreased serum testosterone concentration in male heroin and methadone addicts. Publication types Review. Fluid from the seminal vesicles and prostate gland combine with sperm to make semen. Advertising revenue supports our not-for-profit mission. In adult males, hypogonadism can alter certain masculine physical characteristics and impair normal reproductive function.

Opioid endocrinopathy in women consuming prescribed sustained-action opioids for control of nonmalignant pain. A major strength of this study is that this bmj opioid induced hypogonadism in male the first study performing a meta-analysis on this topic. J Sex Med. Opioids, both endogenous and exogenous, modulate gonadal function primarily by acting on opioid receptors in the hypothalamus. Our goal was, therefore, to assess the reported effects of opioids on the endocrine system through a systematic review and meta-analysis. External link. One study showed that higher TSH levels were seen after acute administration of morphine compared to those prior to administration

Advance article alerts. Open in new tab Ih slide. Permissions Icon Permissions. Data Availability: Search strategy, MOOSE checklist, a list of all included articles, risk of bias assessment guide, results of the risk of bias assessment, and data supplemental tables are made available in a data repository Prescription cost analysis, England.

Testosterone treatment of male hypogonadism. Male hypogonadism can delay puberty or cause incomplete or lack of normal development. Cancer indufed. Reviews in Urology vol 5. Overview Male hypogonadism is a condition in which the body doesn't produce enough of the hormone that plays a key role in masculine growth and development during puberty testosterone or enough sperm or both.

Risk of confounding of effects of opioids on the endocrine system among comparative hypogohadism eg, comparison of opioid addicts and healthy induced hypogonadism, correction with multivariate analyses. Open in new tab. E-mail: amir lumc. Number of studies. Open-label pilot study of testosterone patch therapy in men with opioid-induced androgen deficiency. The full risk of bias assessment is presented in supplemental table S7 Olaf M Dekkers.

Advertising revenue supports our not-for-profit mission. Opioids are pivotal therapeutics in the management of escalated chronic pain moderate-severe. Accessed Sept. Find information and tools about neurological diseases to assist patients and caregivers. Related Associated Procedures Genetic testing.

Trends in opioid analgesic abuse and mortality in the United States. This provides a more accurate estimation of the percentage of opioid exposure-related hypogonadism and cortisol deficiency, compared to narrative reviews. Donegan DBancos I. These authors contributed equally to this work as first author.

Hypgonadism in new tab Download slide. Materials and Methods. Furthermore, we systematically reviewed the effects of opioids on the various hypothalamic—pituitary—end organ axes gonadal, adrenal, thyroid, somatotroph, and prolactin secretionas well as the effects of hormone replacement on opioid-related endocrine deficiencies. The impact of opioids on the endocrine system. HPA, hypothalamus—pituitary—adrenal. Oxford Academic. Hypogonadism in men consuming sustained-action oral opioids.

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Hypogonadism can be inherited. Bhasin, Shalender, Cunningham, Glenn R. Opioid-induced hypogonadism is a common complication opiooid therapeutic or illicit opioid use. An abnormality in the pituitary gland can impair the release of hormones from the pituitary gland to the testicles, affecting normal testosterone production. At times, primary and secondary hypogonadism occur together. N Engl J Med ;

Hypogonadism male J Androl. Disclosure Hypoyonadism The authors report no conflict of interest. Additionally, the added value of screening for these deficiencies and their possible treatment should be assessed, as with the opioid epidemic we currently face, this might pose a tremendous economic burden on health-care systems worldwide. Age, ATA risk group and response to therapy are prognostic factors in children with differentiated thyroid cancer.

On magnetic hypogonadism male imaging the pituitary was normal. Luteinising hormone was 0. Twenty authors of studies reporting on the function of the hypothalamo— pituitary—gonadal and hypothalamus—pituitary—adrenal HPA axis were contacted and asked to provide additional data on the prevalence of these respective deficiencies. Opioid endocrinopathy in women consuming prescribed sustained-action opioids for control of nonmalignant pain. The role of testosterone supplemental therapy in opioid-induced hypogonadism: a retrospective pilot analysis. If people taking opioids present with depression, a diagnosis of remediable hypogonadism may be considered.

Klinefelter syndrome. The Impact of Opioids on the Endocrine System. Issue Index Find content from our back issues! Advertising revenue supports our not-for-profit mission.

For the meta-analysis of studies that analyzed the HPA axis, sensitivity analysis was performed including only studies that used the ITT as assessment method. Furthermore, we systematically reviewed the effects of opioids on the various hypothalamic—pituitary—end organ axes gonadal, adrenal, thyroid, somatotroph, and prolactin secretionas well as the effects of hormone replacement on opioid-related endocrine deficiencies. Opioid analgesics suppress male gonadal function but opioid use in males and females does not correlate with symptoms of sexual dysfunction. Besides the inhibitory effect of opioids on the gonadal axis, our study showed that the likelihood of gonadotroph deficiency differed between the various opioids, and this was highest after fentanyl exposure. Supplementary data to the paper: Opioids and their endocrine effects. Elevated hair cortisol levels among heroin addicts on current methadone maintenance compared to controls. Sex hormone suppression by intrathecal opiods: a prospective study.

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J Intern Hypogonadiam ; The effects of opioids and opioid analogs on animal and human endocrine systems. Sensitivity analysis for the gonadal axes was performed by analyses of studies with a low risk of bias. However, the results of our systematic review showed no difference in the effects of opioids on the endocrine system between different populations. Open-label pilot study of testosterone patch therapy in men with opioid-induced androgen deficiency. Pooled percentage and sensitivity analysis, only including low risk of bias studies, of opioid exposure-related hypogonadism. Daniell HW.

In addition, many animal studies have been performed on the mechanisms of opioid-induced endocrine effects. Sensitivity analysis for the gonadal axes was performed by analyses of studies with a low risk of bias. Androgen deficiency in long-term intrathecal opioid administration. Reprod Biol Endocrinol.

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