Systematic review of sex-based differences in opioid-based effects

Andrew S. Huhn, Meredith S. Berry, Kelly E. Dunn

Research output: Contribution to journalReview articlepeer-review

10 Scopus citations


There are several biological factors that might play a role in physiological response to opioids and/or the onset of problematic opioid use; however, sex-based differences in non-analgesic opioid-based effects are poorly understood. The goal of this review is to provide a current analysis of the pre-clinical literature on sex-based differences in response to endogenous and exogenous opioids, including the interplay between sex hormones and opioid receptor-mediated neuronal activity and associated behaviours. A systematic search was performed on the following terms within PubMed between March and April 2018: ‘opioid oestrogen’, ‘opioid progesterone’, ‘opioid oestradiol’, and ‘opioid testosterone’. Pre-clinical research on the non-analgesic, sex-based effects of opioids is disparate, both in terms of methodology and outcomes, which prohibits a cohesive summary of the results. Themes from the pre-clinical literature suggest that opioid receptor binding, coupling, and density vary as a function of hormone exposure. Findings also suggest that interactions between endogenous opioid and stress systems may differ between males and females as a function of ovarian hormones. Given the current opioid-related public health crisis, there is a pressing need to increase systematic pre-clinical and clinical research on sex-based differences in opioid-effects and opioid use disorder.

Original languageEnglish (US)
Pages (from-to)107-116
Number of pages10
JournalInternational Review of Psychiatry
Issue number5
StatePublished - Sep 3 2018


  • Opioid
  • androgen
  • oestrogen
  • sex
  • treatment

ASJC Scopus subject areas

  • Psychiatry and Mental health


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