The effects of illicit drug use and HIV infection on sex hormone levels in women
ABSTRACT Drug use and HIV infection may affect sex hormone levels in women. One hundred and ninety-six women with and without a history of illicit drug use (50 HIV-negative and 148 HIV-infected), with regular menses, who never used antiretrovirals, were evaluated. Luteinizing hormone levels were significantly higher in women with a CD4 cell count <200/microl (p < 0.002). Current methadone use was associated with lower levels of total testosterone (p = 0.03) and higher levels of prolactin (p = 0.002); mean estradiol levels were 43% lower in women who used intravenous drugs (p < 0.001). Alcohol and crack cocaine use was not associated with sex hormone levels. Age, race, body mass index and degree of HIV immunosuppression were also associated with differences in sex hormone levels.
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ABSTRACT: Summary Opioid pharmacotherapy can provide the stability necessary to initiate lifestyle changes, obtain steady employment and function in society. Thus, a critical question is the extent to which pharmacotherapy is associated with impairment in psychomotor and cognitive performance that might affect functioning. In this article, I review human laboratory studies of the effects of the most com- mon opioid pharmacotherapies, methadone and buprenorphine, on psychomotor and cognitive performance (both observational group comparison and experi- mental drug administration studies) and the effects of withdrawal from opioid pharmacotherapy on performance. I then outline some recommendations for further study in this area.
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ABSTRACT: Summary Opioid substitution is the most widespread and well-researched treatment mo- dality for opioid dependence. Methadone and buprenorphine are currently the most commonly used pharmacotherapeutic agents. Sexual dysfunction has been reported as an adverse effect of opioids including methadone and buprenorphine. The current article describes proposed mechanisms for sexual dysfunction as an adverse effect of methadone and buprenorphine, summarizes research conducted on subjects on these agents, and explores appropriate evaluation and intervention in the management of the types of sexual dysfunction most commonly encountered during opioid substitution treatment (libido, erectile, and orgasm dysfunction).
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ABSTRACT: OBJECTIVE: This article aims to review currently available evidence for women infected with human immunodeficiency virus (HIV) and menopause and to propose clinical management algorithms. METHODS: Key studies addressing HIV and menopause have been reviewed, specifically age of menopause onset in HIV-infected women, frequency of menopausal symptoms, comorbidities associated with HIV and aging (including cardiovascular disease and bone disease), treatment of menopausal symptoms, and prevention of comorbidities in HIV-infected women. RESULTS: Studies suggest an earlier onset of menopause in HIV-infected women, with increased frequency of symptoms. Cardiovascular disease risk may be increased in this population, with combination antiretroviral therapy (cART) and chronic inflammation associated with HIV, contributing to increased risk. Chronic inflammation and cART have been independently implicated in bone disease. No published data have assessed the safety and efficacy of hormone therapy in relation to symptoms of menopause, cardiovascular risk, and bone disease among HIV-infected women. CONCLUSIONS: Few studies on menopause have been conducted in HIV-infected women compared with HIV-uninfected women. Many questions regarding age of menopause onset, frequency of menopausal symptoms and associated complications such as bone disease and cardiovascular disease, and efficacy of treatment among HIV-infected women remain. The incidence and severity of some of these factors may be increased in the setting of HIV and cART.Menopause (New York, N.Y.) 03/2013; DOI:10.1097/GME.0b013e318282aa57 · 2.81 Impact Factor