[6] Hypogonadism is induced through direct inhibitory action of opioids on receptors within the hypothalamic–pituitary–gonadal (HPG) and hypothalamic–pituitary–adrenal (HPA) axes as well as testosterone production within the testes.
[1] The opioid effect on adrenal hormone production, somatostatin and thyroid levels is less common, but should be considered as well due to the serious impact on the patients' total health.
[1] Opioid-induced defect of hypothalamic–pituitary–somatotropic axis leads to growth hormone deficiency which in adults results in cognitive dysfunction, mainly affecting visuospatial memory and orientation.
[7] Testosterone deficit at men leads to erectile problems, infertility, depression, anxiety, night sweat and hot flushes.
Premenopausal women due to the low estrogen levels struggle of irregular menstruation, infertility or complete menopause.