To the Editor: Could Handelsman comment on whether he considered opioid-associated hypoandrogenism when describing the increasing prescribing of testosterone?1 Opioid-induced androgen deficiency has become more recognised, and is one of the most common causes of testosterone deficiency among men in many communities.2,3 It may be that the increase in opioid prescribing4 has complemented the promotion of testosterone therapy.
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- 1. Handelsman DJ. Pharmacoepidemiology of testosterone prescribing in Australia, 1992–2010. Med J Aust 2012; 196: 642-645.
- 2. Daniell H. Opioid-induced androgen deficiency. Curr Opin Endocrinol Diabetes 2006; 13: 262-266.
- 3. Bhasin S, Cunningham GR, Hayes FJ, et al. Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2010; 95: 2536-2559.
- 4. Roxburgh A, Bruno R, Larance B, Burns L. Prescription of opioid analgesia and related harms in Australia. Med J Aust 2011; 195: 280-284.
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