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Endocrine consequences of opioid therapy
Anna Maria Aloisi1, Caterina Aurilio, Valeria Bachiocco
1University of Siena, Department of Physiology, Neuroscience and Applied Physiology Section, via Aldo Moro 2, 53100 Siena, Italy. aloisi@unisi.it
Psychoneuroendocrinology
|June 23, 2009
Summary
Opioids like morphine can decrease crucial hormones such as testosterone and cortisol, affecting both males and females. These opioid-induced hormone changes are reversible and warrant consideration during pain management.
Area of Science:
- Endocrinology
- Neuroscience
- Pharmacology
Background:
- Gonadal hormones are significantly influenced by opioid medications.
- Opioid effects on steroid hormones vary based on the specific opioid and subject's sex.
Purpose of the Study:
- To review recent data on opioid-induced effects on gonadal and adrenal hormones.
- To highlight the impact of morphine on testosterone and cortisol levels.
Main Methods:
- Review of collected data on opioid effects on hormone levels.
- Examination of in vivo (animal) and in vitro (glial cell) studies.
- Analysis of hormonal responses during surgical pain treatment.
Main Results:
- Morphine rapidly reduces testosterone and cortisol in both sexes, likely via peripheral glands.
- These depressant effects are observed in surgical pain management and are reversible upon opioid cessation.
- Experimental and in vitro studies confirm morphine's reduction of cellular testosterone content.
Conclusions:
- Opioid use, particularly morphine, impacts key hormones like testosterone and cortisol.
- Consideration of hypothalamo-pituitary-gonadal and hypothalamo-pituitary-adrenal axes is crucial in opioid pain management.
- Hormone replacement therapy may be beneficial where opioid-induced hormonal suppression occurs.
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