Long-term opioid use previously has been linked with low testosterone in men.
But what has been unclear is how many men taking opioids had been screened or treated for low testosterone.
In a new study, researchers found a very low rate of screening for low testosterone, a surprising finding given that a link is known.
The research was conducted by a team from The University of Texas Medical Branch at Galveston.
Earlier studies have shown that low testosterone, which is linked to muscle wasting, weight gain, osteoporosis, low libido, and infertility, has been linked with opioid use in 35 to 90% of cases.
This is because opiates inhibit the release of chemicals in the brain that trigger testosterone production in the testis.
Given the dramatic increase in opioid use over the past 20 years, it’s likely that opioid-induced low testosterone is becoming increasingly common.
This situation can have a profound effect on men’s health and quality of life.
In the study, the team conducted the first large-scale, nationally representative study to see how many of the men with extended opioid prescriptions were screened and, if needed, treated for low testosterone.
They tested 53,888 men aged 20 years or older who had 90 or more days of opioid prescriptions in a single 12-month period with no history of low testosterone or testosterone therapy in the year before.
The researchers compared this group of men with 53,888 men who received 14 or fewer days of opioid prescriptions that were otherwise familiar.
They found although more men taking long-term opioids were screened for low testosterone than men who only took opioids for a short period, these rates were surprisingly lower than expected.
This finding suggests a wide underscreening of opioid-induced low-testosterone, but it’s not clear what factors drove this low rate.
It may reflect a lack of awareness among some clinicians or a reluctance to screen for conditions that would require additional medications in patients who already have complex conditions and treatment plans
The team says from a patient’s perspective, it’s possible that men who are struggling with chronic pain and related conditions are less concerned than their peers about low testosterone symptoms and are therefore less likely to bring these symptoms to the attention to their doctor.
One author of the study is Jacques Baillargeon, a UTMB professor.
The study is published in Mayo Clinic Proceedings: Innovations, Quality & Outcomes.
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