For men with chronic pain taking opioids on a daily basis, hypogonadism occurs significantly more frequently in those taking long-acting opioids (LAOs) compared with short-acting opioids (SAOs), according to a study published online in the Clinical Journal of Pain.

To determine whether daily dose, duration of action, and specific opioid affects total serum testosterone levels in men with chronic pain using opioids daily, Andrea L. Rubinstein, MD, of Kaiser Permanente in Santa Rosa, Calif., and colleagues conducted a retrospective cohort study involving 81 men, aged 26 to 79 years, seen in a chronic pain clinic.

Based on average AM serum testosterone levels, 53% of men were hypogonadal, with a total serum testosterone level below 250 ng/dL, according to the researchers. Significant differences in the percentage of men considered hypogonadal were seen between men receiving SAOs such as hydrocodone or oxycodone compared with those receiving LAOs (34% vs. 74%). After accounting for daily dose and body mass index, men taking LAOs were nearly 4.8 times as likely to become hypogonadal. Daily dose was not linked to hypogonadism, but there was a significant correlation with body mass index.

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“Among a contemporary sample of men receiving chronic daily opioids, we found a high prevalence of hypogonadism associated with duration of action, but not with total daily dose of the opioid,” the investigators concluded.