14 DAY TRIAL // A single shot of morphine has long lasting effects on testosterone levels within the brain and the plasma of male rats, found a new study carried out by Anna Maria Aloisi, MD, of the Department of Physiology – Section of Neuroscience and Applied Physiology at the University of Siena, Italy, the Sbarro Institute for Cancer Research and Molecular Medicine at Temple University in Philadelphia, the University of Siena and the Human Health Foundation in Spoleto, Italy.
The researchers concluded that opioids had a “long lasting genomic effects in body areas which contribute to strong central and peripheral testosterone levels,” which include the brain, the liver and the testis.
What they found was an increase in aromatase – an enzyme responsible for a significant step in the formation of estradiol and the biosynthesis of estrogen, and this is serious, because testosterone is the main substrate of aromatase.
Testosterone and estradiol are two very important hormones, because they are contributing to cognitive functions, but also to motor control, mood and many other functions, like bone structure remodeling for example.
Dr. Aloisi explained that the reason for which they became interested in gonadal hormones, several years back, was because they understood that “there were many differences in pain syndromes between the sexes.
“In looking at differences, it was immediately apparent that these changes were introduced by different treatments, opioids in particular.”
Marco Pappagallo, MD, professor and director of pain research and development, Department of Anesthesiology, Mount Sinai School of Medicine, New York, said that “the research findings are very relevant to the management of patients with chronic pain.
“Today, primary care physicians, pain specialists, and a variety of health care professionals are asked not only to treat pain but how to manage side effects of drugs and to strive for the best possible comprehensive care and wellness of patients who experience chronic pain.”
It's been known for a while now, that patients treated with opioids for short or long periods of time, have low levels of gonadal hormones, and even those treated with newer drugs like fentalyl or tramadol, have a high risk of being hypogonadic – with menopausal symptoms appearing in women and andropausal symptoms in men.
“Opioid induced hypogonadism can cause health complications to which patients with pain can be overly susceptible, including chronic fatigue, loss of stamina, emotional and sexual disturbances, as well painful skeletal and muscular complications,” Dr Pappagallo added.
Dr. Aloisi explains that “the use of opioids puts a 'physiological' block on the reproductive system and can induce a long lasting absence of these essential hormones from the blood and the brain.
“The normal effect of opioids to restrict reproduction in stressed subjects is multiplied by the higher levels/ long duration of opioids in the body.”
“Until a few years ago this condition was completely unrecognized by physicians although some reports clearly showed it in many kinds of patients.
“Today there remains some ignorance on this condition but gonadal hormones are more commonly cited as responsible for many chronic degenerative pathologies.”
The findings are detailed in a new paper published in Molecular Pain.