Related Experiment Video
Updated: Apr 12, 2026
Investigating Drivers of Antireward in Addiction Behavior with Anatomically Specific Single-Cell Gene Expression Methods
Published on: August 4, 2022
Hypogonadism associated with long-term opioid therapy: A systematic review
Pravardhan Birthi1, Vittal R Nagar2, Robert Nickerson2
1Pain Management Service, Saint Francis Medical Center, Grand Island, Nebraska.
Background:
Sexual dysfunction and Opioid-Induced Sexual Hormone Deficiency (OPISHD) have been associated with patients on long-term opioid pain therapy. There have been few comprehensive reviews to establish a relation between hypogonadism with chronic opioid pain management. The OPISHD is often not treated and literature guiding this topic is scarce.
Objective:
To investigate hypogonadism associated with long-term opioid therapy based on qualitative data analysis of the available literature.
Study Design:
Systematic review.
Interventions:
The review included relevant literature identified through searches of PubMed, Cochrane, Clinical Trials, US National Guideline Clearinghouse, and EMBASE, for the years 1960 to September 2013. The quality assessment and clinical relevance criteria used were the Cochrane Musculoskeletal Review Group Criteria for randomized control trials and the Newcastle-Ottawa Scale Criteria for observational studies. The level of evidence was classified as good, fair, and poor, based on the quality of evidence.
Main Outcome Measures:
The primary outcome measures were clinical symptoms and laboratory markers of hypogonadism. Secondary outcome measure was management of OPISHD.
Results:
Thirty-one studies were identified, of which 14 studies met inclusion criteria. There were no randomized control trials and eight of 14 studies were of moderate quality. The remaining studies were of poor quality. Four studies report most patients on long-term oral opioid therapy have associated hypogonadism and three studies of patients receiving intrathecal opioid therapy suggest that hypogonadism is common.
Conclusions:
There is lack of high-quality studies to associate chronic opioid pain management with hypogonadism. At present, there is fair evidence to associate hypogonadism with chronic opioid pain management, and only limited evidence for treatment of OPISHD.
Insights
Long-term opioid pain therapy is linked to hypogonadism, a condition causing sexual hormone deficiency. While evidence suggests a connection, high-quality studies and treatment guidelines for opioid-induced sexual hormone deficiency are lacking.
Area of Science:
- Endocrinology
- Pain Management
- Pharmacology
Background:
- Sexual dysfunction is frequently observed in patients undergoing long-term opioid therapy.
- Opioid-Induced Sexual Hormone Deficiency (OPISHD) is a recognized complication, yet comprehensive reviews and treatment guidance remain scarce.
- The relationship between hypogonadism and chronic opioid pain management requires further elucidation.
Purpose of the Study:
- To systematically review and analyze existing literature on hypogonadism associated with long-term opioid therapy.
- To assess the quality of evidence linking chronic opioid use to hormonal imbalances.
- To identify gaps in knowledge regarding the management of Opioid-Induced Sexual Hormone Deficiency.
Main Methods:
- A systematic review of literature was conducted using databases like PubMed, Cochrane, and EMBASE (1960-2013).
- Study quality was assessed using the Cochrane Musculoskeletal Review Group Criteria and the Newcastle-Ottawa Scale.
- Primary outcomes included clinical symptoms and laboratory markers of hypogonadism; secondary outcomes focused on OPISHD management.
Main Results:
- Out of 31 identified studies, 14 met the inclusion criteria; none were randomized controlled trials.
- Eight of the included studies were of moderate quality, while the rest were of poor quality.
- Evidence suggests a common occurrence of hypogonadism in patients on long-term oral or intrathecal opioid therapy.
Conclusions:
- A significant lack of high-quality studies hinders definitive association between chronic opioid therapy and hypogonadism.
- Fair evidence currently supports the link between chronic opioid use and hypogonadism.
- Limited evidence exists for effective treatment strategies for Opioid-Induced Sexual Hormone Deficiency.
More Related Videos
07:23Assessment of Morphine-induced Hyperalgesia and Analgesic Tolerance in Mice Using Thermal and Mechanical Nociceptive Modalities
Published on: July 29, 2014
09:54Combining Laser Capture Microdissection and Microfluidic qPCR to Analyze Transcriptional Profiles of Single Cells: A Systems Biology Approach to Opioid Dependence
Published on: March 8, 2020
Related Concept Videos
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
01:25Analgesia and Pain Management
01:22Opioid Receptors: Overview
01:17Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
01:28Menopause