Hormone Replacement Therapy for Restoring the HPG Axis in Pain Patients Treated with Long-Term Opioid Analgesics

Opioids are a treatment option for a variety ofchronic pain conditions. But long-term opioid use can be associated with sideeffects, including hypogonadism. Opioid-induced hypogonadism (OIhG) isassociated with the alteration of the hypothalamic-pituitary-gonadal axis(HPG). In males, hypogonadism can result in erectile dysfunction, reducedlibido, fatigue, worsening mood, and increased risk of osteoporosis; infemales, it can result in changes in the menstrual cycle and reduced libido,among other effects. A current treatment option for these patients is hormonereplacement therapy. In this report, we discuss the problem of opioid-induced hypogonadism, and the therapeutic approachand the potential complications of treating pain patients using hormonereplacement therapy.