Der Schmerz
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The intrathecal application of opioids is promoted as a safe and cost-efficient method to treat chronic pain of nonmalignant origin. But the way of application could trigger the appearance of otherwise rare side-effects. One of those side-effects could be the alteration of androgen hormones. Can a long-time-application of intrathecal opioids result in gynecomastia? ⋯ Further research is needed to support the clinical suspicion of a correlation between intrathecal opioids and gynecomastia. In case of a opioid-produced gynecomastia tests of the oestrogen-testosterone-ratio should be performed. An early substitution of testosterone could prevent a full fledged gynecomastia.