A Case of Hypogonadotropic Hypogonadism Caused by Opioid Treatment for Nonmalignant Chronic Pain

Tabuchi, Yoshikatsu; Yasuda, Tetsuyuki; Kaneto, Hideaki; Kitamura, Tatsuya; Kozawa, Junji; Otsuki, Michio; Imagawa, Akihisa; Nakae, Aya; Matsuda, Youichi; Uematsu, Hiroyuki; Mashimo, Takashi; Shibata, Masahiko; Shimomura, Iichiro

doi:10.1155/2012/740603

Cited by 3 publications

(1 citation statement)

References 40 publications

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“…Despite it is unclear the risk factors for patients to develop OIE, there is an association with a higher dose, time of treatment, and patient's age. Hypogonadal effects are more common in older patients with methadone doses higher than 100mg and long-term treatment at least more than 4-6 weeks [1,3,9].…”

Section: Discussionmentioning

confidence: 99%

A Case of Secondary Hypogonadism with Increased Risk of Fractures in a 57-year-old Male Patient on Methadone Maintenance Therapy

Campana¹,

Riofrio²,

Jadav³

et al. 2022

IJDE

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Oral maintenance opioid agonists have an important role in the management of heroin addiction and chronic pain.Methadone is one of the most popular and effective treatments for opioid dependence, however many patients following methadone's clinics can develop a few metabolic and sexual side effects. Methadone can induce a few hormonal disbalance over time, including hypogonadotropic hypogonadism with sexual dysfunction, muscle weakness, and decreased bone mass density. Most of the side effects are dose-related especially when methadone is above 100 mg daily. Low levels of testosterone increase the risk of erectile dysfunction, loss of libido, sexual unsatisfaction, osteopenia, and osteoporosis, giving a poor quality of life in patients on methadone maintenance therapy. We present a case of a 57 -year-old male patient complaining about erectile dysfunction and loss of libido secondary to central hypogonadism induced by methadone with decreased bone density. The purpose of this case report is to bring these patients to the primary care world and improve their management with a multidisciplinary team including primary care, endocrinologists, and psychologists. Physicians should be aware of opioidinduced endocrinopathies and address properly with early sex hormones work up, bone density screening, and encourage methadone tapering every visit.

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Section: Discussionmentioning

confidence: 99%

A Case of Secondary Hypogonadism with Increased Risk of Fractures in a 57-year-old Male Patient on Methadone Maintenance Therapy

Campana¹,

Riofrio²,

Jadav³

et al. 2022

IJDE

View full text Add to dashboard Cite

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Fentanyl

2013

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Association Between Opioid Use and Risk of Erectile Dysfunction: A Systematic Review and Meta-Analysis

Zhao¹,

Deng²,

Luo³

et al. 2017

The Journal of Sexual Medicine

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Background Opioid analgesics have been widely used to relieve chronic pain conditions; however, a connection between opioid analgesic administration and increased susceptibility to erectile dysfunction (ED) has been hypothesized. Aim To evaluate whether opioid use was a risk factor for ED in a systematic review and meta-analysis. Methods The PubMed, Cochrane Library, and Embase databases were searched to identify eligible studies concerning opioid use and risk of ED from inception to April 2017. The association between opioid use and risk of ED was summarized using the relative risk with 95% CI. Sensitivity analyses were conducted to assess potential bias. The Begg and Egger tests were used for publication bias analysis. The GRADE evidence profile tool was used to assess the quality of the evidence. Outcomes The overall combined risk estimates for the effect of opioid use on ED were calculated using a random-effects model. Results This meta-analysis included 8,829 men (mean age = 41.6 years) from 10 studies, 2,456 of whom received opioid management (duration of intervention = 4 months to 9.5 years). Pooled results demonstrated that the use of opioids was significantly associated with an increased risk of ED (relative risk = 1.96, 95% CI = 1.66–2.32, P < .001). Estimates of the total effects were generally consistent in the sensitivity analysis. No evidence of publication bias was observed. The overall quality of evidence was rated as low. Clinical Implications We found that men with opioid use had a significantly increased prevalence of ED, which suggests that patients and clinicians should be aware of the potential role played by opioid administration in the development of ED. Strengths and Limitations This is the first meta-analysis performed to describe the relation between opioid use and ED risk based on all available epidemiologic studies. However, the direction of causality between opioid use and risk of ED should be interpreted with caution because most included studies used a cross-sectional design. Conclusion Evidence from the included observational studies indicated that men with opioid use had a significantly increased risk of ED. Further randomized controlled trials are still needed to confirm this relation.

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A Case of Hypogonadotropic Hypogonadism Caused by Opioid Treatment for Nonmalignant Chronic Pain

Cited by 3 publications

References 40 publications

A Case of Secondary Hypogonadism with Increased Risk of Fractures in a 57-year-old Male Patient on Methadone Maintenance Therapy

A Case of Secondary Hypogonadism with Increased Risk of Fractures in a 57-year-old Male Patient on Methadone Maintenance Therapy

Fentanyl

Association Between Opioid Use and Risk of Erectile Dysfunction: A Systematic Review and Meta-Analysis

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