Effects of Opium Dependency on Hypothalamic Pituitary Gonadal Axis

Abstract

The aim of this study was to determine the effect of opium on hypothalamic pituitary gonad function. Fifty-six opium dependent (28 men and 28 women; mean age, 25±5 year) were enrolled for hypothalamic pituitary gonadal axis. The control group considered of 56 non-opium dependent subject (28 men and 28 women; mean age 25±5 year). Decreased libido or impotency was present in 26 of 28 opium dependent men. The serum testosterone level was below 9 nmol L-1 in 24 of 28 men and was significantly lower than that in the control group (p<0.001). The free androgen index was below normal in 16 of 28 men and was significantly lower than that in the control group (p<0.001). The serum LH level was less than 2 U L-1 in 17 of 28 men significantly lower than that in the control group (p<0.001). Serum FSH was normal in both groups. Decreased libido was present in 16 of 28 women opium dependent. Serum LH, estradiol and progesterone levels were lower in opium group. In conclusion, of all opium addicts the large majority of men and all of women developed hypogonadotropic hypogonadism. The results reveal that opium can extract deleterious actions upon male and female hypothalamic pituitary gonadal axis and these findings suggested that further investigations are required to determine the need for endocrine work-up in opium dependent and the important substitutive therapy.