OBJECTIVE: To develop an understanding of hypogonadal men with a history of anabolic-androgenic steroid (AAS) use and to outline recommendations for management.
DESIGN: Review of published literature and expert opinions. Intended as a meta-analysis, but no quality studies met the inclusion criteria.
SETTING: Not applicable.
PATIENT(S): Men seeking treatment for symptomatic hypogonadism who have used nonprescribed AAS.
INTERVENTION(S): History and physical examination followed by medical intervention if necessary.
MAIN OUTCOME MEASURES(S): Serum testosterone and gonadotropin levels, symptoms, and fertility restoration.
RESULT(S): Symptomatic hypogonadism is a potential consequence of AAS use and may depend on dose, duration, and type of AAS used. Complete endocrine and metabolic assessment should be conducted. Management strategies for anabolic steroid-associated hypogonadism (ASIH) include judicious use of testosterone replacement therapy, hCG, and selective estrogen receptor modulators.
CONCLUSION(S): Although complications of AAS use are variable and patient specific, they can be successfully managed. Treatment of ASIH depends on the type and duration of AAS use. Specific details regarding a patient's AAS cycle are important in medical management.
Written by:
Rahnema CD, Lipshultz LI, Crosnoe LE, Kovac JR, Kim ED. Are you the author?
University of Tennessee Graduate School of Medicine, Knoxville, Tennessee; Scott Department of Urology, Baylor College of Medicine, Houston, Texas.
Reference: Fertil Steril. 2014 Mar 14. pii: S0015-0282(14)00140-X.
doi: 10.1016/j.fertnstert.2014.02.002
PubMed Abstract
PMID: 24636400
UroToday.com Androgen Deficiency Section
