Substance guides

Opioids and testosterone: How painkillers affect hormones

Published August 15, 2025 · 6 min read · Updated April 2026

Reviewed for accuracy by licensed clinical professionals.

Opioids suppress testosterone production in both men and women. This opioid-induced androgen deficiency (OPIAD) affects 50-90% of men on chronic opioid therapy.

How it happens

Opioids suppress gonadotropin-releasing hormone in the hypothalamus, reducing LH and FSH, which reduces testosterone production. This occurs with all opioids including buprenorphine and methadone.

Symptoms in men

Fatigue, reduced libido, erectile dysfunction, depression, decreased muscle mass, increased body fat, and reduced bone density.

Symptoms in women

Menstrual irregularities, reduced libido, fatigue, and depression.

In recovery

Testosterone often recovers within 3-6 months of opioid cessation. For patients on long-term MAT, testosterone deficiency may persist and require monitoring. Testosterone replacement therapy may be appropriate for symptomatic patients who remain on MAT.

Authoritative sources

This article references guidelines from: NIDA · SAMHSA · CDC

Frequently asked questions

Do opioids lower testosterone?

Yes. 50-90% of men on chronic opioids develop testosterone deficiency.

Does testosterone recover after quitting opioids?

Usually within 3-6 months. Patients on long-term MAT may need monitoring and potentially testosterone replacement.

Can low testosterone from opioids cause depression?

Yes. Testosterone deficiency contributes to the depression, fatigue, and low motivation seen in chronic opioid use and early recovery.

Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.