The relationship of salivary testosterone and male sexual dysfunction in opioid-associated androgen deficiency (OPIAD) |
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Authors: | Raquel Ajo Ana Segura Laura Mira María-del-Mar Inda Rocío Alfayate Angel Sánchez-Barbie |
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Institution: | 1. Research Unit, Foundation for the Promotion of Health Research and Biomedicine of Valencia (FISABIO), Alicante, Spain,;2. Andrology Unit, University General Hospital of Alicante (HGUA), Alicante, Spain,;3. Occupational Observatory, University Miguel Hernández of Elche (UMH), Alicante, Spain,;4. Hormones Laboratory, HGUA, Alicante, Spain,;5. Computational Research Center, UMH, Alicante, Spain, |
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Abstract: | Background: Opioids are an effective treatment for chronic non-malignant pain (CNP). Long-term use risks and side effects such as opioid-induced androgen deficiency (OPIAD) exist. This could be measured by saliva testosterone (Sal-T).Objectives: To evaluate OPIAD in long-term opioid use in CNP patients.Methods: A cross-sectional study included CNP male outpatients under opioid treatment. Total-Testosterone (Total-T), Free-Testosterone (Free-T), Bio-Testosterone (Bio-T) and Sal-T were measured. Correlations were calculated by Spearman’s rho (SPSS 20).Results: From 2012 to 2014, 134 from 249 (54%) consecutive male outpatients reported erectile dysfunction (ED), 37% of them related to opioids and 19% evidenced OPIAD. A total of 120 subjects (94 cases and 26 matched-controls) were included. A significantly lower luteinizing hormone, Total-T and Free-T were found, as well as, a significant correlation between Sal-T and Total-T (r?=?0.234, p?=?0.039), Bio-T (r?=?0.241, p?=?0.039), IIEF (r?=?0.363, p?=?0.003) and HAD-anxiety (r =??0.414, p?=?0.012) in OPIAD patients. Sal-T levels were significantly lower in patients with severe–moderate ED versus mild ED (p?=?0.045) and in patients with severe ED versus moderate–mild ED (p?=?0.036).Conclusions: These data demonstrate the high prevalence of ED in long-term use of opioids, part of this is associated to OPIAD, which can be tested by Sal-T as a non-invasive approach. |
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Keywords: | Salivary testosterone sexual dysfunction erectile dysfunction opioids chronic pain OPIAD |
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