heroin and Amenorrhea

Changes in sexual function and hormone levels are commonly found in subjects addicted to narcotics. In this study we examined 16 male and 3 female addicts who had been taking heroin (H) in the last year in doses higher than 150 mg/day. In these patients, who presented similar clinical problems, we assayed by RIA the plasma levels of heroin, testosterone, (T), dihydrotestosterone (DHT), androstenedione (A), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) for periods of 150 min, 6 h and 9 h. We found a significant reduction of T and DHT concomitant with higher plasma concentrations of heroin but no relevant changes of A, LH and FSH. T and DHT returned to the initial levels after the decrease of heroin concentration. The GnRH test effectd on a female subject allowed us to make the diagnosis of hypothalamic amenorrhea. In the same patient no circadian rhythms for T, DHT and A were detected.

Topics: Adolescent; Adult; Amenorrhea; Androgens; Androstenedione; Binding, Competitive; Dihydrotestosterone; Female; Follicle Stimulating Hormone; Gonadal Steroid Hormones; Heroin; Heroin Dependence; Humans; Luteinizing Hormone; Male; Pituitary Hormone-Releasing Hormones; Testosterone; Time Factors

The ability of morphine to block ovulation in animals prompted investigation of the frequency and mechanisms of menstrual abnormalities in women addicted to narcotic analgesics. Menstrual histories obtained from 76 former heroin addicts receiving daily methadone maintenance revealed that more than one-half of these women had experienced menstrual abnormalities while taking heroin or methadone. In order to determine the specific physiologic effects of narcotic analgesics on reproductive function, detailed endocrinologic studies were carried out in seven of these patients who complained of amenorrhea or irregular menses while receiving methadone. Four of the seven women manifested abnormalities of the control of gonadotropin secretion. Three of these four failed to exhibit cyclic gonadotropin release, as evidenced by an absence of increased levels of follicular phase follicle-stimulating hormone, midcycle gonadotropin peaks or luteal phase progesterone increments. In the fourth patient a prolonged follicular phase (30 days) of the menstrual cycle was detected. One of these four patients also had low basal gonadotropin levels and failed to exhibit luteinizing hormone increments greater than control levels in response to ethinyl estradiol (positive feedback). The remaining three women exhibited normal patterns of gonadotropin secretion during the observation period. In these women, menstrual bleeding occurred in response to withdrawal from luteal phase (10 to 20 ng/ml) progesterone levels and to exogenous ethinyl estradiol, suggesting normal uterine responsivity to progesterone and estrogen. Although not documented, it is likely that oligo-ovulation was the cause of the irregular menses in these three patients. Amenorrhea is commonly associated with methadone ingestion or heroin addiction and appears to be related to an alteration of the hypothalamic mechanisms controlling gonadotropin secretion. Tolerance to these effects of methadone may develop after chronic ingestion.

Topics: Adult; Amenorrhea; Barbiturates; Central Nervous System; Corpus Luteum; Ethinyl Estradiol; Female; Follicle Stimulating Hormone; Gonadotropins; Heroin; Heroin Dependence; Histamine H1 Antagonists; Humans; Luteinizing Hormone; Menstruation Disturbances; Methadone; Ovulation; Phenothiazines; Pituitary Gland; Pregnancy; Progesterone; Radioimmunoassay; Substance-Related Disorders; Surveys and Questionnaires; Uterus

Topics: Adult; Amenorrhea; Depression, Chemical; Female; Heroin; Heroin Dependence; Humans; Hypothalamo-Hypophyseal System; Lactation Disorders; Pituitary Neoplasms; Pregnancy; Puerperal Disorders

Topics: Adult; Age Factors; Amenorrhea; Endocarditis; Female; France; Gangrene; Hepatitis; Heroin; Humans; Injections; Male; Middle Aged; Morphinans; Pharmaceutic Aids; Sepsis; Sexually Transmitted Diseases; Skin Manifestations; Social Behavior Disorders; Social Conditions; Substance-Related Disorders

Topics: Amenorrhea; Child Abuse; Child Rearing; Female; Heroin; Heroin Dependence; Humans; Libido; Physician-Patient Relations; Pregnancy; Pregnancy Complications; Psychiatry; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Acute Kidney Injury; Administration, Oral; Adolescent; Alkaline Phosphatase; Amenorrhea; Amphetamine; Barbiturates; Cannabis; Child; Cocaine; Eosinophilia; False Positive Reactions; Female; Hepatic Encephalopathy; Hepatitis B; Heroin; Humans; Injections, Intravenous; Injections, Subcutaneous; Juvenile Delinquency; Lysergic Acid Diethylamide; Peptic Ulcer; Pneumonia; Pseudotumor Cerebri; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Adult; Amenorrhea; Diagnosis, Differential; Female; Heroin; Humans; Substance-Related Disorders; Time Factors