The effect of heroin addiction on pituitary-testicular function

The effect of heroin addiction on pituitary-testicular function was studied in 54 active and 19 abstinent addicts and their results were compared with those of 43 age-matched controls. Abnormal sexual function was frequently found in heroin addicts and this persisted after drug withdrawal. The mean total (mean +/- SE, 18.1 +/- 1.0 nmol/1) and free (0.17 +/- 0.03 nmol/1) testosterone (T) levels in heroin addicts were significantly lower than those in healthy controls (total T 22.8 +/- 1.1 nmol/1), P less than 0.005; free T 0.30 +/- 0.03 nmol/1, P less than 0.005). The mean sex hormone binding globulin binding capacity was higher in heroin addicts (60.1 +/- 5.2 mM) than in healthy controls (35.5 +/- 2.1 mM). These hormonal changes returned promptly to normal after withdrawal. The basal LH and FSH and the responses to LHRH were comparable in the three groups studied. The finding of significantly lower total and free T together with higher SHBG indicates an abnormal testicular function in heroin addiction. Normal basal and LHRH-stimulated LH and FSH levels suggest that chronic heroin abuse depressed testicular function via the hypothalamus or higher centres.