An unexpected finding: hormone deficiencies seem to be a consequence of long-term opioid use 

By Patrycja Sztachelski

Research has found that many people who use opioid medications for a long time fail to produce enough testosterone or cortisol. Amir Zamanipoor Najafabadi, M.D./Ph.D. student at Leiden University Medical Center, and colleagues observed which hormones opioids may impact and what percentage of patients have a hormone deficit.

A systematic review of 52 studies was published before May 2018, in which patients were receiving opioids to relieve persistent pain in approximately half of the studies. Afterwards, the researchers focused on the number of studies that involved patients dealing with long-term opioid use, which was defined as drug use for longer than six months.

They found evidence of hypogonadism, an insufficient production of testosterone, as well as hypocortisolism, in which the body fails to produce enough cortisol. According to the results of the study, up to 65 percent of men using opioids long-term had hypogonadism, which may lead to erectile dysfunction, infertility, decreased body hair and muscle mass, and the development of breasts. Additionally, researchers discovered that up to 19 percent of 207 men and women who had taken opioids in the long-term had hypocortisolism—this was observed in five studies and is problematic since cortisol is crucial to many functions in the body. With low levels of the hormone, symptoms experienced by the patient can include fatigue, weight loss, and mood changes.

Above all, researchers are trying to raise awareness of the endocrinological issues that can likely result from taking opioid medications long-term, so they suggest regular endocrine checkups for these patients.


The Endocrine Society. (2019, March 23). Another possible consequence of the opioid epidemic: hormone deficiencies. ScienceDaily. Retrieved March 24, 2019 from