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Improvement in sexual function after reduction of chronic high-dose opioid medication in a cancer survivor.

Pain Medicine 2003 December
OBJECTIVE: To demonstrate improvement in sexual function after reduction of opioids.

METHODS: This was a retrospective examination of a single patient at the cancer pain management clinic at M.D. Anderson Cancer Center in Houston, Texas. The patient was a 58-year-old male, free of cancer for 12 years, with chronic low back pain from a prior retroperitoneal mass. Changes in scores from the Brief Male Sexual Inventory and visual analog scale pain questionnaires were used to evaluate the patient.

RESULTS: In this patient, a decrease in morphine-equivalent daily dose from 690 mg to 20 mg resulted in a significant increase in sexual function. Sexual inventory scores increased from 4 to 43.

CONCLUSIONS: Reduction in opioid consumption can dramatically increase libido and sexual function. A possible mechanism involves opioid-related effects on the hypothalamic-pituitary-gonadal axis.

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