Anabolic steroid induced hypogonadism Diagnosis and treatment

A profile of the user with anabolic steroid–induced hypogonadism is provided, and management strategies are proposed.

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Authors

Cyrus Rahnema, B.S., Larry Lipshultz, M.D., Lindsey Crosnoe, B.S., Jason Kovac, M.D., Ph.D., Edward Kim, M.D.

Volume 101, Issue 5, Pages 1271–1279

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.

Read the full text at: http://www.fertstert.org/article/S0015-0282(14)00140-X/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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