Opioid-induced androgen deficiency in males (OPIAD syndrome)

Abstract

Although many of the effects of opioids are well studied, their activity on the hypogonadal axis is less known. Opioids lead to a decreased level in testosterone by changing the normal excretion of gonadotropins or as a result of changes in the anterior pituitary gland response to these hormones. Long-acting opioids, such as morphine sulfate, methadone, oxycodone and fentanyl, which are used in the treatment of chronic pain, often lead to androgen deficiency induced by opioids (OPIAD-Opioid-Induced Androgen Deficiency). A significant decrease in testosterone levels already occurs during application of 100 to 200 mg of morphine oral formulation. This effect is realized by modifying the normal pulsatile release of the gonadotropins, but also by changing in the response of the anterior pituitary gland up gonadotropin-releasing hormone, which altogether lead to reduced secretion of pituitary hormones, follicle-stimulating hormone and luteinizing hormone. As a result, the reduction in the stimulation of testosterone production in the testes occurs and it leads to hypogonadism. The aim of this review to point out to the occurrence of endocrine disorder caused by chronic use of opioids, as well as to emphasize the need for further research in this area in order to provide a better quality of life for patients with malignant diseases.