Farag A.G.A.Basha M.A.Amin S.A.Elnaidany N.F.Elhelbawy N.G.Mostafa M.M.T.Khodier S.A.Ibrahem R.A.Mahfouz R.Z.DermatologyAndrology and STDsMenoufia UniversityShebin El KomEgypt; Forensic Medicine & Clinical ToxicologyMenoufia UniversityShebin El KomEgypt; Faculty of PharmacyClinical PharmacyMSA University6 October CityEgypt; Faculty of MedicineMedical BiochemistryMenoufia UniversityShebin El KomEgypt; Faculty of MedicineClinical PathologyMenoufia UniversityShebin El KomEgypt; Faculty of MedicinePublic Health and Community MedicineMenoufia UniversityShebin El KomEgypt; Cleveland Clinic Lerner College of MedicineCase Western Reserve UniversityClevelandOHUnited States2020-01-092020-01-0920183034569https://doi.org/10.1111/and.13026PubMed ID 29781510https://t.ly/z5rEZScopusMSA Google ScholarTramadol, one of the most commonly abused drugs in Middle East, impacts spermatogenesis and disturbs reproductive hormones in animal studies. We aimed to investigate tramadol impact on sperm quality and on levels of testosterone, prolactin and gonadotropins, in tramadol abusers (n=30) to age-matched control (n=30). Abusers had significantly low percentages of sperm motility, normal forms and vitality compared with control (95% CI ?40.7 to ?19.3, ?13.5 to ?9.3 and ?31.9 to ?9.7 respectively). Hypoandrogenism (95% CI ?4.5 to ?2.8), hyperprolactinaemia (CI (95%) 4.9 to 9.4) and hypergonadotropinaemia (95% CI 2.9 to 7.2 for FSH and 2.0 to 7.8 for LH) were observed in tramadol abusers vs controls. Smokers (26 of 30), concurrently abusing other drugs (11 of 30) and asymptomatic leucocytospermic (15 of 30) patients subgroups significantly abused tramadol beyond 3years (p=.02, <.001, =.03 respectively) and in excess >450mg/day (p=.02, =.01, =.005 respectively). Progressive motility (a+b%) was significantly low in young men <25years old (p=.03) subgroup. Tramadol abuse is associated with poor sperm quality, hyperprolactinaemia and hypergonadotropic hypogonadism. We recommend semen analysis for tramadol long-intakes, question sperm donors and follow-up studies to prevent and reverse tramadol-induced testicular damage. � 2018 Blackwell Verlag GmbHEnglishopioidsprolactinsperm qualitytesticular functiontramadolfollitropingonadotropinluteinizing hormoneprolactintestosteronetramadolgonadotropinnarcotic analgesic agentprolactintestosteronetramadoladultArticleasymptomatic leucocytospermiaasymptomatic leucocytospermiaclinical articlecontrolled studydisorders of hormone metabolismdrug abusedrug dependencefollow uphumanhypergonadotropic hypogonadismhypergonadotropinemiahypergonadotropinemiahyperprolactinemiahypoandrogenismhypoandrogenismmaleprolactin blood levelsemen analysissmokingsperm donorsperm qualityspermatozoon motilitysubstance abuseadolescentcomplicationdrug effectepidemiologyhyperprolactinemiahypogonadismmetabolismMiddle Eastopiate addictionspermatogenesisspermatozoon motilitytestisAdolescentAdultAnalgesics, OpioidGonadotropinsHumansHyperprolactinemiaHypogonadismMaleMiddle EastOpioid-Related DisordersProlactinSemen AnalysisSmokingSperm MotilitySpermatogenesisTestisTestosteroneTramadolArticlehttps://doi.org/10.1111/and.13026PubMed ID 29781510