Which endocrine or metabolic change is commonly associated with chronic opioid therapy?

• A. Hyperthyroidism
• B. Hypogonadism
• C. Diabetes mellitus
• D. Cushing syndrome

Answer: (B)

Chronic opioid therapy commonly suppresses the hypothalamic-pituitary-gonadal axis, leading to hypogonadism. Opioids act on receptors in the hypothalamus to inhibit gonadotropin-releasing hormone release, which lowers the pituitary’s production of LH and FSH. With less LH and FSH, the gonads produce less testosterone in men and less estrogen in women, causing symptoms like reduced libido, erectile dysfunction, menstrual irregularities, infertility, and, over time, decreased bone density. This endocrine effect is a well-recognized complication of long-term opioid use across various opioids.

The other choices don't fit as typical endocrine/metabolic changes from chronic opioid therapy: hyperthyroidism, diabetes mellitus, and Cushing syndrome are not standard consequences of opioid use.