Long-term opioids use associated with reproductive dysfunction in women

Women taking long‐term opioids are at increased risk of abnormal menstruation and menopause, according to a new study in the European Journal of Pain. The study has implications for clinicians as reproductive dysfunction needs to be considered while prescribing long‐term opioids to women with chronic musculoskeletal pain.

Emily Richardson, Research Institute for Primary Care & Health Sciences, Keele University, UK, and colleagues conducted the study to investigate reproductive dysfunction in women prescribed long‐term opioids for musculoskeletal pain.

While many studies have established that long-term opioid therapy can harm the male reproductive system, little has been known about the association between opioid prescription and reproductive dysfunction in women.

For the study, the investigators conducted a matched cohort study of 44,260 women (median age, 43 years) who were prescribed opioids for musculoskeletal pain between 2002 and 2012.

Read Also: Chronic Pain – Alternative Treatment options to opioids

Using data from the Clinical Practice Research Datalink, researchers examined the effects of long-term and short-term opioid therapy on reproductive function. Median follow-up was 39 months, and primary outcomes were altered or absent menstruation, menopause, decreased libido, and infertility.

Key Findings:

• Abnormal menstruation was found to occur at a higher rate in women taking long-term vs short-term opioid therapy (209.5 per 10,000 person-years vs 186.2 per 10,000 person-years, respectively).


• Menopausal symptoms were more common in women on long-term vs short-term opioid therapy (393.7 per 10,000 person-years vs 330.0 per 10,000 person-years).


• Low libido had comparable incidence in women on long-term and short-term opioid therapy (27.7 per 10,000 person-years vs 22.6 per 10,000 person-years, respectively) and infertility (19 per 10,000 person-years vs 16.4 per 10,000 person-years, respectively).

Study limitations include the lack of a group with women not taking opioids.

Based on the study, the authors concluded that it is recommended that clinicians undertake regular reviews of patients prescribed long-term opioids to assess the effectiveness of the medication [and] to raise the possibility of adverse effects including reproductive adverse effects as patients may not volunteer these symptoms.

For further information log on to https://doi.org/10.1002/ejp.1256