Hypogonadal Men Using Opioids: Will Testosterone Replacement Therapy Help with Sexual Function?
Study Comparing Testosterone Levels in Opioid Users and Non-users
Hypogonadism is common in opioid users: in patients with hypogonadism-associated comorbidities, opioid users have the highest incidence of it. Researchers published a study called “Testosterone Replacement Therapy Outcomes Among Opioid Users: The Testim Registry in the United States (TRiUS).” In it, they examined the efficacy of testosterone replacement therapy in opioid users and compared it to testosterone replacement therapy in non-users.
The study was published in the May 2012 issue of Pain Medicine.
This was a prospective, 12-month observational study using the Testim Registry; there were 849 hypogonadal men in the study. As part of the study, they were prescribed Testim (1% testosterone gel [5-10 g/day])—but not necessarily testosterone replacement therapy.
As part of the study, the following were assessed:
- Total testosterone
- Free testosterone
- Sex hormone-binding globulin
- Prostate-specific antigen
- Sexual function
- Anthropometric data
Using repeated measured mixed-effects analysis of variance, changes from baseline were analyzed by the researchers. They also computed—using multiple linear regression—the changes in testosterone levels with sexual function, mood, and opioid use.
At baseline, 90 out of the 849 (10.6%) were using opioids; of those 90, 75 (83%) had been using opioid for ≥ 30 days prior to baseline.
Between the opioid users and non-users, baseline total testosterone and prostate-specific antigen were not statistically different. There was a difference, however, in sex hormone-binding globulin and free testosterone in opioid users: they had higher sex hormone-binding globulin (p = 0.08) and lower free testosterone (p = 0.05).
At 1-month, the opioid and users and non-users had significant increases (p < 0.001) in both total and free testosterone; this remained true throughout the 12-month study. Changes in total testosterone for both groups was significantly correlated with sexual function and mood improvements.
The study researchers concluded that testosterone replacement therapy increased serum testosterone in hypogonadal men—both opioid users and non-users. Therefore, it seems, according to the data, that hypgonadal men who use opioids could see improvements in sexual function and mood with testosterone replacement therapy.