Opioids have been used for medicinal and analgesic purposes for millennia, and today remain a critical part of the medical armamentarium against pain, diarrhea, cough, and other symptoms. Unfortunately, although barely discussed in the modern medical lexicon, opioids have negative effects on the endocrine system, which have been observed for at least a century. These effects include decreased testosterone production in men, with loss of libido and other expected effects, and menstrual irregularities and infertility in women. In view of the increased use of opioids for chronic pain, it has become increasingly important to recognize and manage their endocrine complications.

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