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Updated: Aug 12, 2026

Stereotactic Radiosurgery for Gynecologic Cancer
Published on: April 17, 2012
[Correlation between intrathecal opioids and gynecomastia -- a case report]
1Klinik für Anästhesiologie, Intensiv- und Schmerztherapie, Berufsgenossenschaftliche Kliniken Bergmannsheil Bochum, Universitätsklinikum. hosbach@anaesthesia.de
Introduction:
The intrathecal application of opioids is promoted as a safe and cost-efficient method to treat chronic pain of nonmalignant origin. But the way of application could trigger the appearance of otherwise rare side-effects. One of those side-effects could be the alteration of androgen hormones. Can a long-time-application of intrathecal opioids result in gynecomastia?
Methods:
Case-report of a 49 year old with chronic back and limb pain. Research for publications.
Results:
The close link between the begin of intrathecal application of opioids and the onset of gynecomastia in this patient refers to a causal correlation. Historic publications and new findings from animal research are supporting our hypothesis.
Conclusions:
Further research is needed to support the clinical suspicion of a correlation between intrathecal opioids and gynecomastia. In case of a opioid-produced gynecomastia tests of the oestrogen-testosterone-ratio should be performed. An early substitution of testosterone could prevent a full fledged gynecomastia.
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