{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:52:46Z","timestamp":1793494366105,"version":"4.5.0"},"reference-count":84,"publisher":"Oxford University Press (OUP)","issue":"6","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate pituitary function, sexual function and quality of life (QoL) in patients on oral or transdermal opioids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and methods<\/jats:title><jats:p>Cross-sectional study comparing pituitary function, QoL and sexual function in people on long-term opioid therapy (<jats:italic>n<\/jats:italic>\u2009=\u200940) vs an age- and sex-matched control group (<jats:italic>n<\/jats:italic>\u2009=\u200925). Baseline pituitary function was assessed on blood samples collected prior to 0900\u2009h. Further testing with corticotropin (250\u2009\u00b5g IV) and metyrapone (30\u2009mg\/kg) stimulation tests was undertaken on participants with serum cortisol &lt;250\u2009nmol\/L. Validated questionnaires completed to assess QoL, fatigue and sexual function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Secondary adrenal insufficiency (SAI) was identified on the basis of a failed stimulation test in 22.5% of opioid users vs no controls (<jats:italic>P<\/jats:italic>\u2009=\u20090.01). Opioid users with SAI had a higher median morphine-equivalent daily dose (MEDD),<jats:italic>P<\/jats:italic>\u2009=\u20090.037 \u2013 50% with MEDD &gt;200\u2009mg and 0% with MEDD &lt;60\u2009mg had SAI. Among male participants, testosterone was inversely associated with BMI (<jats:italic>P<\/jats:italic>\u2009=\u20090.001) but not opioid use. A non-significant trend to low testosterone &lt;8\u2009nmol\/L in male opioid users (11\/24 opioid users vs 2\/14 control,<jats:italic>P<\/jats:italic>\u2009=\u20090.08) suggests a small subgroup with opioid-induced androgen deficiency. Opioid users had greater fatigue, reduced quality of life in all subsections of the SF-36 and impaired sexual function in both males and females (all scores<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001 compared to controls).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Long-term opioid therapy was associated with dose-related SAI in over 20% of chronic pain patients and is associated with poor quality of life, fatigue and sexual dysfunction. Obesity confounds the interpretation of opioid-induced male androgen deficiency.<\/jats:p><\/jats:sec>","DOI":"10.1530\/eje-18-0530","type":"journal-article","created":{"date-parts":[[2018,9,13]],"date-time":"2018-09-13T12:23:00Z","timestamp":1536841380000},"page":"353-362","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":45,"title":["Secondary adrenal insufficiency and pituitary dysfunction in oral\/transdermal opioid users with non-cancer pain"],"prefix":"10.1093","volume":"179","author":[{"given":"Andrea","family":"Lamprecht","sequence":"first","affiliation":[{"name":"1Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Sorbello","sequence":"additional","affiliation":[{"name":"2Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Jang","sequence":"additional","affiliation":[{"name":"1Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia"},{"name":"3Department of Endocrinology and Diabetes, Mater Hospital, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J","family":"Torpy","sequence":"additional","affiliation":[{"name":"4Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia"},{"name":"5University of Adelaide, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warrick J","family":"Inder","sequence":"additional","affiliation":[{"name":"1Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia"},{"name":"2Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, Queensland, 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