Question

Opioid abuse is a major health concern that has surged over the decade of the 2010s, affecting both rural and urban populations. Other health concerns, such as the spread of HIV and other infectious diseases, has followed. A lesser-known complication of opioid use and abuse, however, is opioid-induced hypogonadism due to endocrine axis disruption. There were only a handful of case reports in the 2000s, with this number increasing greatly by the early 2010s.

In your response, describe the endocrine axis that is most affected by opioid use and explain how it affects both sexual development and function over the lifespan. Which hormone(s) and pathways are the most affected, and why? What other associated comorbidities have followed?

Answer 1

Opioids acts on the central nervous system and suppress its activity.
Opioid overuse results in disruption of hypothalamus-pituitary-gonadal axis which results in hypogonadism. This endocrine axis consists of three endocrine organs : hypothalamus, pituitary and gonads.
Release of gonadotropin releasing hormone from hypothalamus stimulates the anterior pituitary to release follicular stimulating hormone and leutinizing hormone. These two hormones are responsible for maturation of male and female reproductive organs and reproductive processes such as spermatogenesis and ovulation. They also stimulates release of oestrogen from female ovaries and testosterone from male gonads. The oestrogen helps in ovulation and sustaining pregnancy while testosterone helps in development of secondary male sexual characteristics and male gamete production.
The disruption of hypothalamus-pituitary-gonadal axis also results in other comorbid conditions such as stunted growth, weak bones, menstrual cycle disturbances and mood disorders such as anxiety, aggression.