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Fertil Steril. 2014 May;101(5):1271-9. doi: 10.1016/j.fertnstert.2014.02.002. Epub 2014 Mar 14.

Anabolic steroid-induced hypogonadism: diagnosis and treatment.

Author information

1
University of Tennessee Graduate School of Medicine, Knoxville, Tennessee.
2
Scott Department of Urology, Baylor College of Medicine, Houston, Texas.
3
University of Tennessee Graduate School of Medicine, Knoxville, Tennessee. Electronic address: ekim@utmck.edu.

Abstract

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.

KEYWORDS:

Anabolic-androgenic steroids; androgens; clomiphene citrate; erectile dysfunction; gynecomastia; human chorionic gonadotropin; hypogonadotropic hypogonadism; tamoxifen; testicular atrophy

[Indexed for MEDLINE]

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