- In a systematic review and meta-analysis of opioid users, prevalence of hypogonadism was 63%, and prevalence of hypocortisolism was 15%.
Why this matters
- This study supports the link between opioid use and hypogonadism while clarifying prevalence and examining effects on other hormonal systems.
- The most frequently used opioids in the included studies were methadone (13 studies) and morphine (12 studies).
- The weighted mean prevalence of hypogonadism was 63% (95% CI, 55%-70%; 15 studies, 3250 patients, 99.5% males).
- The weighted mean prevalence of hypocortisolism was 15% (95% CI, 6%-28%; 5 studies, 205 patients, 58% males).
- Further studies were systematically reviewed, without meta-analysis, for effects of opioids on the hypothalamo-pituitary-gonadal axis, the hypothalamic-pituitary-adrenal axis, the hypothalamic-pituitary-thyroid axis, prolactin secretion, the somatotropic axis, and testosterone replacement.
- 52 studies (18,428 subjects) were included in the systematic review, with 15 studies examining the gonadal axis and 5 studies examining the corticotropic axis included in the meta-analysis.
- Funding: None.
- Heterogeneity between included studies.
- Only 22 included studies at low risk for bias.