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  • Title: [Correlation between intrathecal opioids and gynecomastia -- a case report].
    Author: Hosbach I, Zenz M.
    Journal: Schmerz; 2003 Jan; 17(1):60-2. PubMed ID: 12579390.
    Abstract:
    INTRODUCTION: The intrathecal application of opioids is promoted as a safe and cost-efficient method to treat chronic pain of nonmalignant origin. But the way of application could trigger the appearance of otherwise rare side-effects. One of those side-effects could be the alteration of androgen hormones. Can a long-time-application of intrathecal opioids result in gynecomastia? METHODS: Case-report of a 49 year old with chronic back and limb pain. Research for publications. RESULTS: The close link between the begin of intrathecal application of opioids and the onset of gynecomastia in this patient refers to a causal correlation. Historic publications and new findings from animal research are supporting our hypothesis. CONCLUSIONS: Further research is needed to support the clinical suspicion of a correlation between intrathecal opioids and gynecomastia. In case of a opioid-produced gynecomastia tests of the oestrogen-testosterone-ratio should be performed. An early substitution of testosterone could prevent a full fledged gynecomastia.
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