Abstract
Iako su mnogi efekti opioida dobro proučeni, efekti na hipogonadalnu osovinu su manje poznati. Opioidi dovode do pada nivoa testosterona izmenom normalnog lučenja gonadotropina ili promenama u odgovoru prednjeg režnja hipofize na ove hormone. Dugodelujući opioidi, kao što su morfin sulfat, metadon, fentanil i oksikodon, koji se koriste u lečenju hroničnog bola često dovode do androgene deficijencije izazvane opioidima (OPIAD- Opioid-Induced Androgen Deficiency). Do značajnog smanjenja nivoa testosterona dolazi već pri primeni 100-200 mg oralne formulacije morfina. Ovaj efekat se ostvaruje izmenom normalnog pulsnog oslobađanja gonadotropina, ali i promenama u odgovoru prednjeg režnja hipofize na hormon koji oslobađa gonadotropine , što skupa dovodi do smanjene sekrecije hormona hipofize, luteostimulirajućeg i folikulostimulirajućeg hormona, a to za posledicu ima smanjenje stimulacije testisa na produkciju testosterona, odnosno nastanka hipogonadizma. Cilj ovog prikaza je da ukaže na nastanak endokrinih poremećaja usled hronične upotrebe opioida i naglasi potrebu za daljim istraživanjem u ovoj oblasti, kako bi se omogućio bolji kvalitet života pacijenata obolelih od maligne bolesti.
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