BACKGROUND Opioid abuse is a public health crisis. As opioid misuse worsens, efforts are being made to increase access to medication-assisted treatments. Methadone is a medication-assisted treatment used to treat opioid dependence and chronic pain. While methadone is beneficial in the treatment of opiate abuse and chronic pain, side effects of the medication include hormonal and sexual function changes. The purpose of this report is to review the effects of methadone on the hypothalamic pituitary gonadal axis hormones and sexual functioning in males and females. METHODS A search of PubMed was conducted using pre-defined criteria, resulting in the evaluation of 295 articles. A total of 72 articles, including 52 human studies and 20 animal studies, met the selection criteria and were reviewed. The included studies examined the effects of methadone on the hypothalamic pituitary gonadal axis and/or sexual function. RESULTS There was evidence of methadone-induced hormonal changes, disruptions in the hypothalamic pituitary gonadal axis, and sexual dysfunction, although there was some variability in the results of the reviewed studies. Differences in methadone dose and length of exposure to treatment appears to influence the variability in the results. Much of the literature examines the effects of methadone in males, with very limited research examining the effects in females. CONCLUSIONS Despite its effectiveness for opiate abuse and chronic pain treatment, methadone has disruptive effects on the hypothalamic pituitary gonadal axis and sexual function. Further research is warranted to better define potential methadone-induced endocrine consequences and to further examine the effects of methadone in females.

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美沙酮对下丘脑垂体性腺轴和性功能的影响：系统评价。

背景技术阿片类药物滥用是一种公共卫生危机。随着阿片类药物滥用的加剧，人们正在努力增加获得药物辅助治疗的机会。美沙酮是一种药物辅助疗法，用于治疗阿片类药物依赖性和慢性疼痛。美沙酮对阿片类药物滥用和慢性疼痛的治疗有益，但药物的副作用包括荷尔蒙和性功能的改变。本报告的目的是审查美沙酮对男性和女性的下丘脑垂体性腺轴激素和性功能的影响。方法使用预先定义的标准对PubMed进行搜索，从而对295篇文章进行了评估。共有72篇文章符合入选标准，其中包括52项人体研究和20项动物研究，并进行了审查。纳入的研究检查了美沙酮对下丘脑垂体性腺轴和/或性功能的影响。结果有证据表明美沙酮可引起激素变化，下丘脑垂体性腺轴破坏和性功能障碍，尽管所研究的结果存在一定差异。美沙酮剂量和治疗时间的差异似乎会影响结果的变异性。许多文献研究了美沙酮在男性中的作用，而研究在女性中的作用的研究非常有限。结论尽管美沙酮对鸦片类药物滥用和慢性疼痛治疗有效，但对下丘脑垂体性腺轴和性功能却具有破坏性作用。