Gender Differences in Depression and Sex Hormones among Patients Receiving Long-Term Opioid Treatment for Chronic Noncancer Pain in Taiwan—A Multicenter Cross-Sectional Study

Shung-Tai Ho, Tso-Chou Lin, Chun-Chang Yeh, Kuang-I Cheng, Wei-Zen Sun, Chun-Sung Sung, Yeong-Ray Wen, Yi-Jer Hsieh, Po-Kai Wang, Yen-Chin Liu and Yu-Chuan Tsai
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Shung-Tai Ho: Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
Tso-Chou Lin: National Defense Medical Center, Department of Anesthesiology, Tri-Service General Hospital, Taipei 11490, Taiwan
Chun-Chang Yeh: National Defense Medical Center, Department of Anesthesiology, Tri-Service General Hospital, Taipei 11490, Taiwan
Kuang-I Cheng: Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
Wei-Zen Sun: Health Science & Wellness Center, Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University, Taipei 10617, Taiwan
Chun-Sung Sung: Department of Anesthesiology, Taipei Veterans General Hospital, Taipei 11217, Taiwan
Yeong-Ray Wen: Department of Anesthesiology, China Medical University Hospital, China Medical University, Taichung 40447, Taiwan
Yi-Jer Hsieh: Department of Anesthesiology, Changhua Christian Hospital, Changhua 500209, Taiwan
Po-Kai Wang: Department of Anesthesiology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
Yen-Chin Liu: Department of Anesthesiology, National Cheng Kung University Hospital, National Cheng Kung University, Tainan 70403, Taiwan
Yu-Chuan Tsai: Center of Pain Management, Department of Anesthesiology E-Da Cancer Hospital, School of Medicine, I-Shou University College of Medicine, Kaohsiung 82445, Taiwan

IJERPH, 2021, vol. 18, issue 15, 1-10

Abstract: Background: Long-term use of opioids for chronic noncancer pain is associated with sex hormone disturbances. The interferences with sex hormones, sexual function, and depression were investigated in patients with chronic noncancer pain. Methods: A cross-sectional multicenter survey was conducted on 170 officially registered outpatients receiving long-term opioid treatment in nine medical centers in Taiwan between October 2018 and July 2019. Serum sex hormone levels were examined after the collection of self-administered questionnaires containing the Taiwanese version of the Brief Pain Inventory, depressive status, and sexual function interference. Results: Among 117 (68.8%) questionnaire responses from 170 enrolled outpatients, 38 women and 62 men completed the sex hormone tests, among whom only 23 (23%) had previously received blood hormone tests. Low serum total testosterone levels were detected in 34 (89.5%) women (<30 ng/dL) and 31 (50%) men (<300 ng/dL). Over 60% of women and men reported reduced sexual desire and function despite a nearly 50% reduction in pain intensity and daily function interference over the previous week after opioid treatment. Women generally had higher risks of a depression diagnosis ( p = 0.034) and severe depressive symptoms ( p = 0.003) and nonsignificantly lower opioid treatment duration (median 81 vs. 120 months) and morphine milligram equivalent (median 134 vs. 165 mg/day) compared with men. Conclusions: This survey demonstrated the high prevalence of depression diagnosis, low sex hormone levels, and reduced sexual function among Taiwanese patients with chronic noncancer pain receiving prolonged opioid therapy. Regular hypogonadal screenings are recommended for further management.

Keywords: chronic pain; opioid; gender difference; depression; sex hormone (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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