The role of testosterone in joint repair | The role of opioids in low testosterone syndrome

The role of testosterone in joint repair

Ross Hauser, MD

Can low testosterone levels cause chronic joint and pain? If so how? Research has shown that Testosterone has a direct effect on cartilage growth. If the testosterone levels are low, so is the body’s ability to regrow damaged cartilage.

What about opioids, do they impact testosterone levels? In this article we will see how opioids not only cause joint destruction, they also cause a vicious cycle of non-healing and erectile dysfunction by impacting testosterone levels.

Testosterone is an anabolic hormone. An anabolic hormone is a “builder upper,” its characteristics are well known as a hormone that promotes repair and growth of soft tissue, including muscle and cartilage growth.

Many people believe that testosterone is only a male hormone, research over the years shows testosterone also plays a pivotal role in the female body chemistry. Male or female, if one has a low testosterone level, then he/she will likely experience more difficulty healing.

In 2014, a paper with the long descriptive title: ” Long-term testosterone treatment in elderly men with hypogonadism and erectile dysfunction reduces obesity parameters and improves metabolic syndrome and health-related quality of life”, was published in the Journal of Sexual Medicine.(1)

It is a long title because the paper has a lot to say:

It is not what many men want to hear but painkillers cause erectile dysfunction

Men do not like to go to the doctor, this is well documented. Men will finally go to the doctor when erectile dysfunction is involved. This was documented by researchers at Brown University who wrote in the Asian Journal of Andrology:

“Erectile dysfunction is estimated to affect more than 30% of men between the ages of 40 and 70. As a result of an improved understanding of the disorder and improved treatment options, an increasing number of men are going to the doctor with Erectile dysfunction concerns. In fact, many of these men are visiting their health care professional for the first time with ED as their primary complaint.”(2)

But what is causing their erectile dysfunction? While there are many causes of erectile dysfunction, this article we will concentrate on the relationship between low testosterone, joint pain, and opioid or painkiller use.

A recent study from Tegore Medical College in India  begins with this statement: “The relationship between opioid use and sexual problems among males is a complex one, as some are using opioids to increase their sexual performance while others are suffering from sexual problems due to its use.” 

Men are using painkillers to help them have joint or back pain-free sex. But the painkillers are causing Erectile Dysfunction. Now the men are taking medicine for their pain and for their erectile dysfunction

The problem is that this research from Tegore Medical College is suggesting that 53.3% to 81.7%  of patients who were opioid dependent (addicted) had problems of sexual dysfunction.(3)

Listen to what researches in the Journal of Sex Medicine had to say. “Long-term opioid therapy has been found to have a strong impact on the hypothalamic-pituitary-gonadal axis that can be manifested clinically by sexual dysfunction. This event is rarely reported and thus unnoticed and undertreated.”(4)

The management of patients with pain should include a review of their sexual health history

In a second study, published in February 2017 by the same team of researchers, this time appearing in the journal Clinical Medicine, made these findings:

The use of testosterone gel should be discussed with your health care provider.

Testosterone does repair joint damage. Low levels of testosterone make joint repair more challenging

The answer is not a balance of painkillers and erectile dysfunction medications: the answer is to fix the joint and get rid of the painkillers and the need for Viagra

Your journey to alleviate your joint pain and the need for “enhancement” formulas begins with an email. Let’s discuss your case:

You can get help and information from our Caring Medical Staff

Prolotherapy Specialists


1 Yassin DJ, Doros G, Hammerer PG, Yassin AA. Long‐term testosterone treatment in elderly men with hypogonadism and erectile dysfunction reduces obesity parameters and improves metabolic syndrome and health‐related quality of life. The journal of sexual medicine. 2014 Jun;11(6):1567-76. [Google Scholar]

2 Miner M, Kim ED. Cardiovascular disease and male sexual dysfunction. Asian Journal of Andrology. 2015 Jan;17(1):3. [Google Scholar]

3 Aggarwal N, Kherada S, Gocher S, Sohu M. A study of assessment of sexual dysfunction in male subjects with opioid dependence. Asian journal of psychiatry. 2016 Oct;23:17. [Google Scholar]

4 Ajo R, Segura A, Inda MM, Planelles B, Martínez L, Ferrández G, Sánchez A, Margarit C, Peiró AM. Opioids increase sexual dysfunction in patients with non-cancer pain. The journal of sexual medicine. 2016 Sep 1;13(9):1377-86. [Google Scholar]

5 Ajo R, Segura A, Margarit C, Ballester P, Martínez E, Ferrández G, Sánchez-Barbie Á, Peiró AM. Erectile dysfunction in patients with chronic pain treated with opioids. Medicina Clínica (English Edition). 2017 Jul 21;149(2):49-54. [Google Scholar]

6 Lorentzon M, Swanson C, Andersson N, Mellström D, Ohlsson C. Free testosterone is a positive, whereas free estradiol is a negative, predictor of cortical bone size in young Swedish men: the GOOD study. Journal of Bone and Mineral Research. 2005 Aug;20(8):1334-41.[Google Scholar]

Hanna F, Ebeling PR, Wang Y, O’Sullivan R, Davis S, Wluka AE, Cicuttini FM. Factors influencing longitudinal change in knee cartilage volume measured from magnetic resonance imaging in healthy men. Ann Rheum Dis. 2005 Jul;64(7):1038-42. [Google Scholar]

8 Da Silva JA, Larbre JP, Spector TD, Perry LA, Scott DL, Willoughby DA. Protective effect of androgens against inflammation induced cartilage degradation in male rodents. Ann Rheum Dis. 1993 Apr;52(4):285-91. [Google Scholar]

9 Basaria S, Travison TG, Alford D, Knapp PE, Teeter K, Cahalan C, Eder R, Lakshman K, Bachman E, Mensing G, Martel MO, Le D, Stroh H, Bhasin S, Wasan AD, Edwards RR. Effects of testosterone replacement in men with opioid-induced androgen deficiency: a randomized controlled trial. Pain. 2015 Feb;156(2):280-8.[Google Scholar]


 

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