The Opioid Epidemic and Men's Sexual Health

Abstract The opioid epidemic, one of the worst drug crises in US history, has resulted in detrimental effects on men's sexual health, displayed by the increased incidence of opioid-induced androgen deficiency (OPIAD). OPIAD may present with symptoms such as fatigue, reduced sense of vitality, weight gain, and depressed mood. However, these nonspecific findings may often be overlooked or thought to be unrelated to opioid use, warranting a high clinical suspicion for OPIAD in patients being evaluated for infertility or sexual dysfunction. Symptomatic patients with a history of chronic opioid abuse should have testosterone, LH, and FSH levels obtained. Treatment options include opioid cessation, short-acting opioids, and testosterone replacement therapy. The current review highlights the importance of identifying and treating patients with this condition and further discusses the current opioid epidemic, pathophysiology and diagnosis of OPIAD, and treatment options for this patient population.