Long-Term Opioid Use: Research Shows Chronic Low Testosterone Risk

Public awareness of the dangers related to prescription opioid misuse has greatly increased over the years.

However, health concerns exist when these medications are taken exactly as prescribed for an extended period of time, even without behaviors that would indicate significant abuse.

Medical research is finding that long-term use of opioids can impair the production of important hormones such as testosterone and cortisol in men’s bodies, often causing serious hormone imbalances that disrupt a number of critical bodily systems.

A middle-aged man in a dark blue shirt sits in front of his computer, massaging his shoulder and grimacing in pain. It's important that people in pain understand the connection between opioids and chronic low testosterone.

How Opioids Alter Your Hormones

Experts suspect that opioids interfere with hormone production by influencing the hypothalamus, the portion of the brain that links the nervous system to the pituitary gland.

Receptors in the hypothalamus are specifically sensitive to opioids. Their use renders the hypothalamus much less effective at directing the pituitary gland, which is the communication switchboard that sends signals to the body regarding which hormones to produce and how much of them are needed.

Inaccurate messages are sent, the body’s communication network breaks down, and hormone production becomes inefficient. The result is an increased likelihood of hormone imbalance.

Opiates and Hormone Imbalance— What Medical Research Concludes

A team of researchers led by Amir Zamanipoor of Leiden University Medical Center in the Netherlands compiled an exhaustive review of studies conducted prior to May 2018, and their results were presented at ENDO 2019, the Endocrine Society’s annual meeting in New Orleans, LA.

The team’s comprehensive findings, which covered 15 separate studies, revealed that as many as 65 percent of the 3,250 men who used opioids long term (defined as a period exceeding 6 months) developed chronic low testosterone.

Researchers also discovered that almost 20% of the subjects also suffered from low levels of the hormone cortisol, a stress hormone that contributes to the body’s fight-or-flight response and also serves a critical function in the regulation of metabolism.

The subjects experienced symptoms consistent with chronic male hormone imbalance, including:

  • Fatigue
  • Weight loss and loss of muscle mass
  • Mood changes
  • Erectile dysfunction
  • Reduced fertility

Click to learn more about the symptoms of low testosterone and other chronic hormone imbalances.

Excessive use of or addiction to narcotic painkillers has been long recognized as harmful, but the medical community is learning more about the specific dangers involved in their long-term use.

The Greater Lesson

“Our study creates awareness of the frequent endocrinological issues in long-term opioid users and their need for regular endocrine checkups, which are not commonly being done,” Najafabadi said.

That’s a lesson that everyone should be paying attention to—the need for awareness and information goes well beyond prescription opiates and low testosterone.

As a patient, you should be asking your medical provider about the risks for hormone changes and imbalances related to any medical treatment that’s recommended.

You should be made thoroughly aware of the potential side effects related to any medications, as well what methods are available to minimize any threat to your quality of life.

In other words, whatever medical issue you’re dealing with and whatever treatment is proposed, the potential repercussions on your overall health and wellbeing should be an important component of the discussion you’re having with your health provider.

That includes Testosterone Replacement Therapy (TRT).

Like any medical treatment, there are possible side effects with TRT.

At Testosterone Centers of Texas, we’re entirely up front about any risks, and we are thoroughly prepared to explain exactly how we attempt to reduce the probability of negative side effects—learn more in our comprehensive guide which provides exhaustive information on all things TRT.

Read the Guide


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(Augie) Juan Augustine Galindo Jr. MPAS, PA-C

(Augie) Juan Augustine Galindo Jr. MPAS, PA-C started his career in healthcare as a fireman/paramedic in West Texas where he served on the Midland Fire Department from 1998-2004.   He became interested in testosterone treatment after seeing how hormone replacement doctors helped those suffering from low testosterone.   After graduating from the Texas Tech Health Sciences Center Physician Assistant Program, he moved to DFW where he currently lives with his wife and three children.

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