Long-Acting Daily Opioids Increase Risk of Hypogonadism
In men taking daily opioids, duration of action, but not dose, affects risk of hypogonadism
FRIDAY, Feb. 8 (HealthDay News) -- For men with chronic pain taking opioids on a daily basis, hypogonadism occurs significantly more frequently in those taking long-acting opioids (LAOs) compared with short-acting opioids (SAOs), according to a study published online Jan. 24 in the Clinical Journal of Pain.
To determine whether daily dose, duration of action, and specific opioid affects total serum testosterone levels in men with chronic pain using opioids daily, Andrea L. Rubinstein, M.D., of Kaiser Permanente in Santa Rosa, Calif., and colleagues conducted a retrospective cohort study involving 81 men, aged 26 to 79 years, seen in a chronic pain clinic.
The researchers found that, based on average AM serum testosterone levels, 53 percent of men were hypogonadal, with a total serum testosterone level below 250 ng/dL. Significant differences in the percentage of men considered hypogonadal were seen between men receiving SAOs such as hydrocodone or oxycodone compared with those receiving LAOs (34 versus 74 percent). After accounting for daily dose and body mass index, men taking LAOs were significantly more likely to become hypogonadal (odds ratio, 4.78). Daily dose was not linked to hypogonadism, but there was a significant correlation with body mass index (odds ratio, 1.13).
"Among a contemporary sample of men receiving chronic daily opioids, we found a high prevalence of hypogonadism associated with duration of action, but not with total daily dose of the opioid," the authors write.