Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2022 Dec;54(11):e14576.
doi: 10.1111/and.14576. Epub 2022 Sep 5.

The deleterious effects of anabolic androgenic steroid abuse on sexual and reproductive health and comparison of recovery between treated and untreated patients: Single-center prospective randomized study

Manaf Al Hashimi  1   2
Affiliations
Randomized Controlled Trial

The deleterious effects of anabolic androgenic steroid abuse on sexual and reproductive health and comparison of recovery between treated and untreated patients: Single-center prospective randomized study

Manaf Al Hashimi. Andrologia. 2022 Dec.

Abstract

Anabolic androgenic steroids (AAS) abuse is a global health-related concern, as most of the related studies showed increasing trends and deleterious effects, mostly on sexual and fertility health. Unfortunately, there are no consensuses about the management pathways due to the lack of specific guidelines. We aimed to confirm the deleterious effects of AAS abuse, monitor the spontaneous recovery, and demonstrate the effects of treatment regimens on recovery. We enrolled 520 patients with a confirmed history of AAS intake within 1 year of presentation and evaluated their symptoms, hormones levels, and semen every 3 months until 12 months. All patients were monitored for spontaneous recovery in the first 3 months; if they showed no recovery, they were randomized to undergo either continued observation or commence medications. The most common presentation (84%) was a combination of sexual symptoms while some patients (18%) were infertile. Most patients (90%) reported low levels of luteinizing hormone, follicle-stimulating hormone, and total testosterone. After the 3-month observation, most patients (89%) started treatment, but some (11%) continued observation only. Treated patients showed faster improvement regarding the International Index of Erectile Function (IIEF) values, hormone levels, testicular size and semen parameters compared to non-treated patients (p < 0.005). Among the 94 patients who presented with infertility (18%), 61 had oligospermia and 33 had azoospermia. All received treatment, but only 14 (15%) achieved successful pregnancy at 12 months while all azoospermic's patients continued to have infertility at the end of the follow-up period. These findings demonstrated the significant negative impact of AAS abuse on sexual health and fertility, and the need for medical treatment to have faster recovery from their adverse effect.

Keywords: anabolic steroid-induced hypogonadism; androgenic anabolic steroids; body building; infertility.

PubMed Disclaimer

Conflict of interest statement

The author have norelevant conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Flowchart of total patients, included and excluded patients and treated and untreated patients
See this image and copyright information in PMC

References

    1. Abram McBride, J. , & Coward, R. M. (2016). Recovery of spermatogenesis following testosterone replacement therapy or anabolic‐androgenic steroid use. Asian Journal of Andrology, 18, 373–380. - PMC - PubMed
    1. Boregowda, K. , Joels, L. , Stephens, J. W. , & Price, D. E. (2011). Persistent primary hypogonadism associated with anabolic steroid abuse. Fertility and Sterility Journal, 96, e7–e8. - PubMed
    1. Cohen, J. , Collins, R. , Darkes, J. , & Gwartney, D. (2007). A league of their own: Demographics, motivations and patterns of use of 1,955 male adult non‐medical anabolic steroid users in the United States. Journal of the International Society of Sports Nutrition, 4, 12. - PMC - PubMed
    1. Corona, G. , Rastrelli, G. , Marchiani, S. , Filippi, S. , Morelli, A. , Sarchielli, E. , Sforza, A. , Vignozzi, L. , & Maggi, M. (2022). Consequences of anabolic‐androgenic steroid abuse in males; sexual and reproductive perspective. The World Journal of Men's Health, 40(2), 165–178. - PMC - PubMed
    1. Coward, R. M. , Rajanahally, S. , Kovac, J. R. , Smith, R. P. , Pastuszak, A. W. , & Lipshultz, L. I. (2013). Anabolic steroid–induced hypogonadism in young men. Journal of Urology, 190, 2200–2205. - PubMed

Publication types