Persistent primary hypogonadism associated with anabolic steroid abuse

Boregowda, Kusuma; Joels, Lisa; Stephens, Jeffrey W.; Price, David E.

doi:10.1016/j.fertnstert.2011.04.029

Cited by 37 publications

(33 citation statements)

References 8 publications

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“…Early studies of AAS users have generally suggested that hypogonadism will gradually resolve after AAS use is discontinued, with eventual restoration of normal HPT function within a few weeks to a few months of AAS abstinence . However, a growing literature of case reports and small case‐series has now suggested that some AAS users exhibit HPT suppression that persists for many months after AAS are discontinued , with at least eight reports describing cases of hypogonadism and/or azoospermia persisting for more than a year after last AAS use (Table ) .…”

Section: Introductionmentioning

confidence: 99%

Prolonged hypogonadism in males following withdrawal from anabolic–androgenic steroids: an under‐recognized problem

et al. 2015

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Aims To assess the frequency and severity of hypogonadal symptoms in male long-term anabolic-androgenic steroid (AAS) misusers who have discontinued AAS use. Design Cross-sectional, naturalistic. Setting Outpatient facility. Participants Twenty-four male former long-term AAS users and 36 non-AAS-using weightlifters, recruited by advertisement in Massachusetts, USA. Five of the former users were currently receiving treatment with physiologic testosterone replacement, leaving 19 untreated users for the numerical comparisons below. Measurements The Structured Clinical Interview for DSM-IV, questions regarding history of AAS use, physical examination, serum hormone determinations, and the International Index of Erectile Function (IIEF). Findings Compared with the 36 non-AAS-using weightlifters, the 19 untreated former AAS users displayed significantly smaller testicular volumes (estimated difference [95% confidence interval (CI)]: 2.3 [0.1, 4.5] ml; p = 0.042) and lower serum testosterone levels (estimated difference: 131 [25, 227] dL; p = 0.009), with five users showing testosterone levels below 200 ng/dL despite abstinence from AAS for 3–26 months. Untreated former users also displayed significantly lower scores on the IIEF Sexual Desire subscale (estimated difference: 2.4 [1.3, 3.5] points on a 10-point scale; p < 0.001). In the overall group of 24 treated plus untreated former users, 7 (29%) had experienced major depressive episodes during AAS withdrawal; 4 of these had not experienced major depressive episodes at any other time. Two men (8%) had failed to regain normal libidinal or erectile function despite adequate replacement testosterone treatment. Conclusions Among long-term anabolic-androgenic steroid misusers, anabolic-androgenic steroid-withdrawal hypogonadism appears to be common, frequently prolonged, and associated with substantial morbidity.

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Section: Introductionmentioning

confidence: 99%

Prolonged hypogonadism in males following withdrawal from anabolic–androgenic steroids: an under‐recognized problem

et al. 2015

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“…Although sup- Birzniece pression of pituitary gonadotropin secretion is potentially reversible, largely depending on the duration of AAS abuse, hypogonadism may persist for prolonged periods of time after androgens are discontinued. 20 AAS users may have a reduction in testicular size, sperm count, sexual dysfunction and other symptoms like gynaecomastia, which results from an increase in oestrogen aromatised from testosterone. In women, AAS abuse associates with breast atrophy, hirsutism, clitoral enlargement and menstrual irregularity.…”

Section: Side-effects Of Aasmentioning

confidence: 99%

Doping in sport: effects, harm and misconceptions

Birzniece

2015

Internal Medicine Journal

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Doping in sport is a widespread problem not just among elite athletes, but even more so in recreational sports. In scientific literature, major emphasis is placed on doping detection, whereas detrimental effects of doping agents on athletes' health are seldom discussed. Androgenic anabolic steroids are well known for their positive effects on muscle mass and strength. Human growth hormone also increases muscle mass, although the majority of that is an increase in extracellular fluid and not the functional muscle mass. In recreational athletes, growth hormone does not have major effect on muscle strength, power or aerobic capacity, but stimulates anaerobic exercise capacity. Erythropoietin administration increases oxygen-carrying capacity of blood improving endurance measures, whereas systemic administration of beta-adrenergic agonists may have positive effect on sprint capacity, and beta-adrenergic antagonists reduce muscle tremor. Thus, there are certain drugs that can improve selective aspects of physical performance. However, most of the doping agents exert serious side-effects, especially when used in combination, at high doses and for a long duration. The extent of long-term health consequences is difficult to predict, but likely to be substantial, especially when gene doping is considered. This review summarises the main groups of doping agents used by athletes, with the main focus on their effects on athletic performance and adverse effects.

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“…(e) Brain injury to pituitary gland [15]. (f) Prior exogenous anabolic steroid use [15,49,50] The ARP might plausibly argue that (c), (d), (e), and (f) all constitute illegitimate reasons for an actively competing athlete to take TRT. Reason (c), for instance, might be illegitimate because aging is a natural process and thus taking TRT to curb the effects of aging is unnatural, and therefore should not be permitted.…”

Section: The Arp and The Abuse Of Drugsmentioning

confidence: 99%

On Treating Athletes with Banned Substances: The Relationship Between Mild Traumatic Brain Injury, Hypopituitarism, and Hormone Replacement Therapy

Malanowski

Baima

2014

Neuroethics

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Until recently, the problem of traumatic brain injury in sports and the problem of performance enhancement via hormone replacement have not been seen as related issues. However, recent evidence suggests that these two problems may actually interact in complex and previously underappreciated ways. A body of recent research has shown that traumatic brain injuries (TBI), at all ranges of severity, have a negative effect upon pituitary function, which results in diminished levels of several endogenous hormones, such as growth hormone and gonadotropin. This is a cause for concern for many popular sports that have high rates of concussion, a mild form of TBI. Emerging research suggests that hormone replacement therapy is an effective treatment for TBIrelated hormone deficiency. However, many athletic organizations ban or severely limit the use of hormone replacing substances because many athletes seek to use them solely for the purposes of performance enhancement. Nevertheless, in the light of the research linking traumatic brain injury to hypopituitarism, this paper argues that athletic organizations' policies and attitudes towards hormone replacement therapy should change. We defend two claims. First, because of the connection between TBI and pituitary function, it is likely many more athletes than previously acknowledged suffer from hormone deficiency and thus could benefit from hormone replacement therapy. Second, athletes' hormone levels should be tested more rigorously and frequently with an emphasis on monitoring TBI and TBI-related issues, rather than simply monitoring policy violations.

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Persistent primary hypogonadism associated with anabolic steroid abuse

Cited by 37 publications

References 8 publications

Prolonged hypogonadism in males following withdrawal from anabolic–androgenic steroids: an under‐recognized problem

Prolonged hypogonadism in males following withdrawal from anabolic–androgenic steroids: an under‐recognized problem

Doping in sport: effects, harm and misconceptions

On Treating Athletes with Banned Substances: The Relationship Between Mild Traumatic Brain Injury, Hypopituitarism, and Hormone Replacement Therapy

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