Sex Hormones

Diminished sexual drive and performance in opioid users have raised questions about the relationship between such narcotic drug use and disturbances in the levels of sex hormones. Although some reports show no significant differences in serum-testosterone levels between heroin addicts, METHADONE-MAINTAINED patients, and normal controls, other studies have not confirmed these results. Some researchers have reported plasma levels of testosterone to be consistently lower in active heroin addicts, in addicts who self-administer heroin in controlled research settings, and to be within normal range in long-term methadone-maintained patients. Additionally, some evidence shows that plasma testosterone levels that are depressed under circumstances of heroin administration followed by methadone maintenance and then withdrawal gradually returned to preheroin-use levels.

Opioid effects on the estrogens of both males and females may be responsible for the clinical observations of sexual dysfunction. In the male heroin addicts studied, the plasma estradiol concentrations were either low or within normal ranges; in the females, the plasma estrogens are low. A clear explanation of these observed derangements in plasma testosterone and estrogens is unknown. Female heroin addicts frequently experience cessation of or irregular menses. However, most regain normal menstrual funcion when stabilized on metha-done and under these circumstances fertility seems unaffected. The anecdotal reports and, in limited cases, experimental evidence of the influence of MARIJUANA on sexual function and sex-hormone levels are also inconsistent and confusing.

The illicit drug-related disturbances discussed above suggests that the narcotic-related depressions in sex-hormone production of the ovaries and testes may occur because they reduce the pitu itary's stimulation of these sex organs. Still, this has not been a consistent finding.

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