Effect of tramadol on the male reproductive system and sexual health

Objectives The aim of this study was to review the literature as regards the potential effects of chronic tramadol administration on the male reproductive system and sexual health in humans and experimental animals in vivo and in vitro in published studies. Materials and methods We searched electronic databases from 2006 to 2016, including PubMed MEDLINE, Medscape, EMBASE, EBCSO Academic Search Complete, Cochrane Systematic Reviews Database, and Google-Scholar. Study selection The articles that studied the effect of chronic tramadol administration on the male reproductive system and sexual health in both humans and laboratory animals were selected. The initial search selected articles that met the inclusion criteria. If the studies did not fulfill the inclusion criteria, they were excluded. Data extraction Study quality assessment included the following: whether ethical approval was gained, eligibility criteria specified, appropriate controls, adequate information, and defined assessment measures. Data synthesis Comparisons were made using a structured review with the results tabulated. Conclusion This review demonstrates a significant damage to testicular tissue with chronic tramadol administration. Tramadol was demonstrated to affect male reproductive hormones by decreasing serum testosterone and gonadotrophins and increasing estradiol and prolactin. As regards its effect on sexual function, it was demonstrated that it is neither more effective nor safer compared with other drugs used in the treatment of premature ejaculation. Moreover, it may be associated with erectile dysfunction.