Objective: To detect the possible gonadotoxic effects of tramadol dependence on seminal
fluid parameters, and prolactin and testosterone hormone levels.
Patients, Subjects, and Methods: There were 94 participants who were divided into
a tramadol-dependent group (T-group; 56 patients) and a control group (C-group; 38 healthy
volunteers). The following variables were evaluated: testosterone level, prolactin level, erectile
function, libido, semen parameters, and effect of tramadol dose and dependence duration.
Results: There was a significant increase in erectile dysfunction (ED) and decreased libido
in the T-group vs C-group. Also, the serum testosterone level was lower in the T-group vs
the C-group, while the serum prolactin level was significantly higher in the T-group vs the
C-group. All semen parameters were low in the T-group except for abnormal forms, which
were high. As the dose of tramadol increased there was a more negative effect on the
previous parameter, while ED, libido, semen volume and concentration showed no significant
changes. When comparing tramadol doses of 400–1000 mg/day to >1000 mg/day,
the tramadol blood level increased with high doses, while serum testosterone level
decreased when the dose increased and the prolactin level increased when the dose
increased. Progressive motility of the sperm decreased and abnormal forms increased.
Also increased duration of tramadol administration was also accompanied by a more
negative effect on these parameters
Conclusion: Tramadol administration has a negative effect on hormone levels, libido, erectile
function, and semen characters.