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The endocrine system is an extensive network of glands – organs or tissues in the body that create chemicals that control many bodily functions, that secrete hormones, which are chemical messengers that play essential roles in regulating various bodily functions. These hormones are secreted into the bloodstream and travel throughout the body. They require specific receptors to convey signals to cells possessing these corresponding receptors. This complex signaling mechanism ensures that...
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Opioids and endocrine dysfunction.

Oliver Seyfried1, Joan Hester1

  • 1King's College Hospital, London, UK.

British Journal of Pain
|October 31, 2015
PubMed
Summary

Opioid use for persistent pain can disrupt hormone levels, affecting the reproductive, adrenal, and other systems. Patients and clinicians often overlook these endocrine side effects, necessitating monitoring and potential hormone replacement therapy.

Area of Science:

  • Endocrinology
  • Pain Management
  • Pharmacology

Background:

  • Opioid therapy for persistent pain is common, yet its endocrine effects are poorly understood.
  • Clinicians and patients frequently overlook the signs of hormone deficiencies caused by opioids.
  • Opioid-induced endocrine dysfunction impacts the hypothalamic-pituitary-gonadal axis and potentially adrenal hormones, weight, blood pressure, and bone density.

Purpose of the Study:

  • To highlight the under-recognized endocrine effects of long-term opioid therapy.
  • To emphasize the importance of patient education regarding potential hormonal side effects.
  • To recommend monitoring and management strategies for opioid-induced endocrine dysfunction.

Main Methods:

  • Literature review on opioid endocrinopathy.
Keywords:
Opioidsendocrinehormone replacementhypogonadismsex hormonestestosterone

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  • Clinical observation of patients on long-term opioid therapy.
  • Analysis of hormonal pathways affected by opioids.

    • Main Results:

    • Opioids commonly affect the hypothalamic-pituitary-gonadal axis, leading to sex hormone deficiency in both men and women.
    • Symptoms of hormone deficiency are under-reported and often misdiagnosed.
    • Potential effects extend to adrenal hormones, body weight, blood pressure, and bone mineral density.

    Conclusions:

    • Educate patients on potential endocrine effects before initiating long-term opioid therapy.
    • Regular monitoring of sex hormone levels is recommended for patients on chronic opioid treatment.
    • Opioid dose tapering or withdrawal should be considered if deficiencies are found; hormone replacement therapy may be necessary under specialist care.