Tramadol (opioid) abuse is associated with a dose- and time-dependent poor sperm quality and hyperprolactinaemia in young men

Farag, Azza Gaber Antar; Basha, Mohamed Ahmed; Amin, Safaa; Elnaidany, Nada Farag; Elhelbawy, Nesreen G; Mostafa, Morsy; Khodier, S. A.; Ibrahem, Reda Abdel Latif; Mahfouz, R.

doi:10.1111/and.13026

Cited by 35 publications

(22 citation statements)

References 37 publications

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“…In line with this finding, tramadol has been cited in past studies as a potent drug for its off label effect of increasing intravaginal ejaculatory latency time and for the treatment of premature ejaculation (Abdel‐Hamid et al, ; Kirby, Carson, & Coward, ). While the abuse of tramadol for its off label effect of enhancing sexual performance is widely reported in literature (Abdel‐Hamid et al, ; Kirby et al, ; Wong & Malde, ), a recent study by Farag et al () has also reported low sperm density, motility and vitality among male addicts of tramadol. Future randomized controlled trials would help throw more light on the efficacy and safety of the use of tramadol for it's off label aphrodisiac effect.…”

Section: Discussionmentioning

confidence: 99%

Facilitators to the continuous abuse of tramadol among the youth: A qualitative study in Northern Ghana

et al. 2019

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Study aimConsidering the alarming rate at which young people abuse tramadol, as evidenced by the numerous media reports on the subject, this qualitative study was conducted to explore the facilitators to the abuse of tramadol by young people.Design and methodsA qualitative exploratory descriptive design was employed in conducting the study. A total of 18 participants were purposively sampled. Data for the study were collected through two focused group discussions and three in‐depth‐interviews. Thematic analysis was used to analyse the data.ResultsThe findings of the study revealed four main themes. These themes were initiating factors of abuse; desirable physical effects; desirable psychological effects; and undesirable effects. It was revealed that many young people initially get into tramadol abuse because of peer pressure, curiosity or post‐traumatic addiction. However, they often continue the practice for various physical and psychological gratifications including euphoria, attentiveness, high energy levels, pain relief and improved sexual performance. The study also revealed some unpleasant side effects of tramadol abuse such as severe vomiting, loss of appetite, seizures, emotional aloofness and irritability. Many of the participants in this study also expressed willingness to quit tramadol abuse because of social discrimination and the enormous side effects that come with the abuse of the drug.

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Section: Discussionmentioning

confidence: 99%

Facilitators to the continuous abuse of tramadol among the youth: A qualitative study in Northern Ghana

et al. 2019

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“…This reduction may not be sufficient enough to reach a marked statistical significance but it may be of biological significance. Negative feedback effect may also play a role in this effect as indicated by Farag et al [17]. Opioids are well known to affect sexual drive in male humans and rodents [18].…”

Section: Discussionmentioning

confidence: 96%

Long-term effects of tramadol on the reproductive function of male albino rats: an experimental biochemical and histopathological study

Salah

Wagih

Zaki

et al. 2019

Middle East Fertil Soc J

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Background: Tramadol is a commonly abused erotic drug that recently has gained popularity among young men. It is a centrally acting analgesic used to treat moderate to severe pain. This study aimed to evaluate the chronic toxic effects of tramadol on the reproductive system of male albino rats. It was carried out on 60 rats weighing 130-150 g divided into two groups. The first group (control group) included 30 rats and received normal saline 0.9% 1 ml/day orally for 45 days. The second group (tramadol group) included 30 rats and received tramadol 60 mg/kg subcutaneously three times per week for 45 days. Blood samples were obtained from the animals and analysed for serum testosterone, FSH, LH and prolactin levels. Also, the testes were excised and examined for histopathological changes. Results: The results revealed that there was a decrease in the serum levels of testosterone (P = 0.009), FSH (P = 0.057) and LH (P = 0.002) and an increase in the serum prolactin level (P = 0.166) in animals treated with tramadol. In addition, histopathological examination revealed distinct abnormal changes compared with the corresponding control group. Conclusion: The present study affirms the deleterious chronic toxic effects of tramadol on the reproductive system of male albino rats. It is thus advisable that tramadol should be used with caution with appropriate dose monitoring to avoid its undesirable side effects on male fertility.

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“…63 Adverse effects of opioids on semen quality have also been described. 64,65 In conclusion, opioid use has inhibitory effect on HPG axis, mainly at hypothalamic level. 28 Dose, type and duration of opioid may play a role on the severity of hypogonadism but further studies are needed to elucidate these.…”

Section: Hypothalamo-pituitary-gonadal Axismentioning

confidence: 87%

Opioid-induced endocrinopathies

Fountas

Uum

Karavitaki

2020

The Lancet Diabetes & Endocrinology

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ΤAs the use of opioids is becoming a global epidemic and has led to a rise in expanding, so has the occurrence and recognition of their impact consequences on the endocrine system. Nonetheless, opioid-induced endocrinopathies still remain under-diagnosed, mainly due to symptom under-reporting by patients and lack of awareness in clinicians. Hypogonadism is the most well recognised consequence but These include hypogonadism, inhibitory effects on the hypothalamo-pituitary-adrenal axis and negative impact on bone health also require attention.. Hyperprolactinaemia may also be detected, whereas, clinically relevant thyroid dysfunction has not been identified. EThe effects on other hormones have not been as yet clearly defined. At present, consensus or evidence-based guidelines on how to diagnose and manage these endocrinopathies are lacking. ANonetheless, assessment of gonadal and adrenal function (particularly if in the presence of high index of clinical suspicion), and, as well as evaluation of bone health are advised in these patients. Discontinuation or reduction of the opioid dose and appropriate hormone replacement are management approaches for hypogonadism and hypoadrenalism. Further research is needed to fully elucidate the impact of opioids at all levels of the endocrine system and the optimal management of their consequences.Further research facilitating the development of evidence-based guidelines on the diagnosis and optimal management of opioid-induced endocrinopathies is eagerly awaited.

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Tramadol (opioid) abuse is associated with a dose- and time-dependent poor sperm quality and hyperprolactinaemia in young men

Cited by 35 publications

References 37 publications

Facilitators to the continuous abuse of tramadol among the youth: A qualitative study in Northern Ghana

Facilitators to the continuous abuse of tramadol among the youth: A qualitative study in Northern Ghana

Long-term effects of tramadol on the reproductive function of male albino rats: an experimental biochemical and histopathological study

Opioid-induced endocrinopathies

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