Patients who require opioid painkillers must watch for this important adverse effect

Where Does it Hurt?

If you, or someone you care about, is in constant pain due to surgery or chronic disease, the need for a powerful opioid painkiller may outweigh the risk of adverse side effects.

Most opioid side effects are well known: constipation, dizziness, drowsiness, and confusion.

Less well known–and less obvious–is the effect opioids can have on your testosterone levels.

Fuel to the fire

Opioid use prompts abnormally low testosterone in many patients. And that creates problems–for women as well as men. Typical symptoms include fatigue, depression, osteoporosis, and night sweats. In men, erectile dysfunction and testicular atrophy are also common.

But even worse, animal studies have shown that when your testosterone levels drop, your threshold for pain decreases too, suggesting that testosterone may play a role in reducing pain. So ironically, the painkiller reduces the hormone that may help kill pain, increasing the need for more painkiller.

So the obvious next step is to bring your testosterone levels back up.

A University of California study showed significant benefits when men with opioid-induced low testosterone used a testosterone patch. At a dose of 7.5 mg per day, sexual function, mood, depression, and pain management all improved.

But while the patch might be convenient, it might not be the best choice.

As with hormone replacement therapy for menopause, there are two ways to go with testosterone replacement: synthetic and bio-identical. Synthetic forms are patented and produced by drug companies. The safer bio-identical forms are prepared by compounding pharmacies.

You can search for doctors in your area who have experience in formulating natural hormone replacement in the “Find a Doc” feature on our website at hsionline.com.

If you consult a doctor about testosterone replacement, be sure to also discuss cancer risks. High testosterone levels have been linked to higher rates of prostate cancer and breast cancer.

As I’ve mentioned before, hormones have profound effects on mood, growth, metabolism, the immune system, hunger, and reproduction. Tweak one hormone level, and you’re tweaking a vast web of potential health issues, which is why it’s so important to work with a physician who really knows what they’re doing and monitors your levels regularly.

To Your Good Health,

Jenny Thompson

Sources:
“Open-Label Pilot Study of Testosterone Patch Therapy in Men With Opioid-Induced Androgen Deficiency” The Journal of Pain, Vol. 7, No. 3, March 2006, jpain.org
“Testosterone Replacement Therapy for Men in Pain” Christina Lasich, M.D., Health Central, 6/14/10, healthcentral.com