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Hormone Molecular Biology and Clinical Investigation

Editor-in-Chief: Chetrite, Gérard S.

Editorial Board: Alexis, Michael N. / Baniahmad, Aria / Beato, Miguel / Bouillon, Roger / Brodie, Angela / Carruba, Giuseppe / Chen, Shiuan / Cidlowski, John A. / Clarke, Robert / Coelingh Bennink, Herjan J.T. / Darbre, Philippa D. / Drouin, Jacques / Dufau, Maria L. / Edwards, Dean P. / Falany, Charles N. / Fernandez-Perez, Leandro / Ferroud, Clotilde / Feve, Bruno / Flores-Morales, Amilcar / Foster, Michelle T. / Garcia-Segura, Luis M. / Gastaldelli, Amalia / Gee, Julia M.W. / Genazzani, Andrea R. / Greene, Geoffrey L. / Groner, Bernd / Hampl, Richard / Hilakivi-Clarke, Leena / Hubalek, Michael / Iwase, Hirotaka / Jordan, V. Craig / Klocker, Helmut / Kloet, Ronald / Labrie, Fernand / Mendelson, Carole R. / Mück, Alfred O. / Nicola, Alejandro F. / O'Malley, Bert W. / Raynaud, Jean-Pierre / Ruan, Xiangyan / Russo, Jose / Saad, Farid / Sanchez, Edwin R. / Schally, Andrew V. / Schillaci, Roxana / Schindler, Adolf E. / Söderqvist, Gunnar / Speirs, Valerie / Stanczyk, Frank Z. / Starka, Luboslav / Sutter, Thomas R. / Tresguerres, Jesús A. / Wahli, Walter / Wildt, Ludwig / Yang, Kaiping / Yu, Qi

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Volume 36, Issue 2


Impact of opioid therapy on gonadal hormones: focus on buprenorphine

Anjali Varma
  • Corresponding author
  • Mental Health Clinic, Lead Psychiatrist Buprenorphine Clinic, Veterans Affairs Medical Centre, 1970 Roanoke Blvd., Salem, VA, USA, Phone: +5409822463, ext 3555, Fax: +540-855-3452
  • Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
  • Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Roanoke, VA, USA
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Mamta Sapra
  • Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
  • Memory Assessment Clinic, Chair, IRB, Veterans Affairs Medical Centre, 1970 Roanoke Blvd., Salem, VA, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Ali Iranmanesh
  • Veterans Affairs Medical Centre, Salem, VA, USA
  • Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2018-02-17 | DOI: https://doi.org/10.1515/hmbci-2017-0080



The USA is in the midst of an opioid crisis. Understanding the impact of opioids and commonly used treatments for opioid dependence is essential for clinicians and researchers in order to educate and treat the nation’s growing population with opioid use disorders. As a relatively new treatment for opioid dependence, buprenorphine is gaining popularity to the extent of becoming not only a preferred approach to the maintenance of opiate addiction, but also an option for chronic pain management. The purpose of this report is to review the available evidence on the endocrine effects of buprenorphine, particularly as it relates to the hypothalamic-pituitary-gonadal (HPG) axis, which is controversial and not fully defined.


We conducted a Pubmed search (2000–2017) for human studies in the English language for articles that were available as full length regarding buprenorphine, endocrinopathy, hypogonadism, bone density, opioids. Case reports were also reviewed, although prospective studies and randomized controlled trials received more weight.


Opioid induced hypogonadism is well established. Most studies report that buprenorphine being a partial agonist/antagonist may not be impacting the pituitary trophic hormones as much. There are reports of sexual dysfunction in subjects maintained on buprenorphine, some without hormonal correlation. Thus with the understanding that pertinent clinical studies are limited in number, varied in methodology, mostly cross sectional, predominantly in men and small number of participants, more research in this area is warranted.


Based on a comprehensive review of the available literature, we conclude that despite its increasing popularity, buprenorphine has not been adequately studied in respect to its long-term effects on the hypothalamic-pituitary-adrenal (HPA) axis. There is a great need for longitudinal systematic trials to define the potential buprenorphine-induced endocrine consequences.

Keywords: buprenorphine; endocrinopathy; HPG; hypogonadism; LH; opioids; testosterone


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About the article

Received: 2017-12-01

Accepted: 2018-01-12

Published Online: 2018-02-17

Author Statement

Research funding: Authors state no funding involved.

Conflict of interest: Authors state no conflict of interest.

Informed consent: Informed consent is not applicable.

Ethical approval: The conducted research is not related to either human or animals use.

Citation Information: Hormone Molecular Biology and Clinical Investigation, Volume 36, Issue 2, 20170080, ISSN (Online) 1868-1891, DOI: https://doi.org/10.1515/hmbci-2017-0080.

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