Anabolic steroid-induced hypogonadotropic hypogonadism

The reversibility of sperm quality after discontinuing nandrolone decanoate in adult male rats

AIM

To investigate the reversibility of the effect of nandrolone decanoate (ND) on sperm parameters after discontinuing the drug.

METHODS

Three groups of rats received peanut oil (control), low and high doses of ND for 14 weeks, respectively. Each group was divided into subgroups A and B, in which rats were killed 14 and 28 weeks after initiating the injection, respectively.

RESULTS

Sperm count and motile sperm fraction were decreased in the subgroups A and B that received low and high doses of ND in comparison with the controls A and B, respectively. The sperm count and motile sperm fraction increased in the subgroups B that received low and high doses of ND in comparison with their corresponding subgroups A. The number of normal morphology sperm was decreased significantly in subgroups A receiving low and high doses of ND in comparison with the control subgroup A. However, this parameter was not decreased in subgroups B receiving low and high doses in comparison with the control subgroup B. The normal sperm morphology did not show any significant differences in the subgroups B in comparison with their corresponding subgroups A.

CONCLUSION

The 14-week injection of low and high doses of ND decreases sperm quality and quantity in rats. These parameters were improved after discontinuing ND, but not recovered completely even when they are left untreated for 14 weeks.

Stacking anabolic androgenic steroids (AAS) during puberty in rats: A neuroendocrine and behavioral assessment

Anabolic androgenic steroid (AAS) abuse is increasing in teenagers. We examined the effects of stacked AAS in adolescent male rats. Stacking, in which multiple AAS are taken simultaneously, is commonly employed by humans. Beginning at puberty gonadally intact male rats received testosterone, nandrolone, or stanozolol. Additional groups received stacked AAS: testosterone + stanozolol, nandrolone + stanozolol, or nandrolone + testosterone. Injections continued during tests for sexual behavior, vocalizations, scent marking, partner preference, aggression and fertility. Body and reproductive tissue weights were taken. Sexual and aggressive behaviors were increased by testosterone yet inhibited by stanozolol; nandrolone had no effect. Stacking testosterone with stanozolol prevented the inhibitory effects of stanozolol. Body weight was decreased by testosterone and all stacked AAS. Cell nuclear androgen receptor binding in brain was significantly increased in nandrolone males and decreased in stanozolol males; testosterone males were slightly higher than controls. Androgen receptors in stacked groups were intermediate between individual AAS suggesting that stanozolol competed with other AAS for androgen receptors despite its low affinity. The results indicate that stacking AAS influences the effects of individual AAS on behavioral and endocrine measures, and levels of androgen receptor occupation are not directly correlated with AAS effects on behavior.

Anabolic steroids: what should the emergency physician know?

Anabolic steroids have not currently made their way into the daily practice of emergency physicians. The patients that use and abuse them have. In addition, those patients that are suffering from the consequences of illnesses that have excess levels of androgens are commonly evaluated in the emergency department. Clinicians should familiarize themselves with the practices of anabolic steroid users, so they can provide more beneficial council to their patients. As research continues, the emergency physician may find uses for androgens within the emergency department.

Current concepts in anabolic-androgenic steroids

Anabolic-androgenic steroids (AAS) are synthetic derivatives of testosterone. According to surveys and media reports, the legal and illegal use of these drugs is gaining popularity. Testosterone restores sex drive and boosts muscle mass, making it central to 2 of society's rising preoccupations: perfecting the male body and sustaining the male libido. The anabolic effects of AAS have been questioned for decades, but recent scientific investigation of supraphysiologic doses supports the efficacy of these regimens. Testosterone has potent anabolic effects on the musculoskeletal system, including an increase in lean body mass, a dose-related hypertrophy of muscle fibers, and an increase in muscle strength. For athletes requiring speed and strength and men desiring a cosmetic muscle makeover, illegal steroids are a powerful lure, despite the risk of subjective side effects. Recent clinical studies have discovered novel therapeutic uses for physiologic doses of AAS, without any significant adverse effects in the short term. In the wake of important scientific advances during the past decade, the positive and negative effects of AAS warrant reevaluation. Guidelines for the clinical evaluation of AAS users will be presented for sports medicine practitioners.

Endocrine causes of male infertility

Although endocrinopathies are not often seen in infertile men, these disorders are clinically significant; they often have potentially serious medical significance, regardless of fertility issues. Correction of these disorders represents a possible way to restore normal fertility for the male partner. Male fertility is critically dependent upon a normal hormonal milieu. The hypothalamic-pituitary-gonadal axis is quite sensitive to disruption by endocrine disorders and other generalized medical disorders. Thus, male infertility is occasionally the presenting sign for significant underlying medical disease; it is important to properly evaluate these patients.

Anabolic steroids: a review for the clinician

The number of athletes self-administering ergogenic pharmacological agents to increase their competitive edge continues to be a problem. Most athletes using anabolic steroids (AS) have acquired a crude pharmacological database regarding these drugs. Their opinions regarding steroids have been derived from their subjective experiences and anecdotal information. For this reason, traditional warnings regarding the lack of efficacy and potential dangers of steroid misuse are disregarded. A common widely held opinion among bodybuilders is that the anabolic steroid experts are the athletic gurus who for years have utilised themselves as the experimental participants and then dispensed their empirical findings. This review will address the common anabolic steroid misconceptions held by many of today's athletes by providing an evaluation of the scientific literature related to AS in athletic performance.

Effects of withdrawal from anabolic androgenic steroids on aggression in adult male rats

In gonadally intact male rats, chronic exposure to high levels of testosterone propionate (TP) increases aggression, nandrolone (ND) has little effect and stanozolol (ST) suppresses aggression. The present experiment tested whether the effects of TP, ND and ST on aggression and reproductive tissues are reversed following anabolic androgenic steroid (AAS) withdrawal. Gonadally intact males received TP, ND, ST or vehicle for 12 weeks. Injections were then discontinued. Aggression was tested 3 weeks (short term) and 12 weeks (long term) after withdrawal of AAS treatment, with either a gonadally intact or a castrated opponent in three different environments (home, opponent's and neutral cage). After short-term withdrawal, some parameters of aggression were significantly above control levels in TP males. There were no significant differences between ND or ST males and controls, though ST males showed the lowest levels of aggression. No significant differences between any of the groups were found after long-term withdrawal. Eighteen weeks after AAS withdrawal, serum testosterone (T) and LH levels were comparable to controls in all groups. Testes weights were at control levels in ST males, but significantly higher than controls in TP and ND males. Seminal vesicle weights were significantly elevated in TP males, but similar to controls in both ND and ST males. None of the prostate weights were significantly different from controls. These results suggest that aggression gradually returns to normal following withdrawal from AAS. Some, if not all, hormone levels and tissue weights return to normal, suggesting possible long-lasting effects of chronic AAS exposure.

Clinical review 138: Anabolic-androgenic steroid therapy in the treatment of chronic diseases

The purpose of this study was to review the preclinical and clinical literature relevant to the efficacy and safety of anabolic androgen steroid therapy for palliative treatment of severe weight loss associated with chronic diseases. Data sources were published literature identified from the Medline database from January 1966 to December 2000, bibliographic references, and textbooks. Reports from preclinical and clinical trials were selected. Study designs and results were extracted from trial reports. Statistical evaluation or meta-analysis of combined results was not attempted. Androgenic anabolic steroids (AAS) are widely prescribed for the treatment of male hypogonadism; however, they may play a significant role in the treatment of other conditions as well, such as cachexia associated with human immunodeficiency virus, cancer, burns, renal and hepatic failure, and anemia associated with leukemia or kidney failure. A review of the anabolic effects of androgens and their efficacy in the treatment of these conditions is provided. In addition, the numerous and sometimes serious side effects that have been known to occur with androgen use are reviewed. Although the threat of various side effects is present, AAS therapy appears to have a favorable anabolic effect on patients with chronic diseases and muscle catabolism. We recommend that AAS can be used for the treatment of patients with acquired immunodeficiency syndrome wasting and in severely catabolic patients with severe burns. Preliminary data in renal failure-associated wasting are also positive. Advantages and disadvantages should be weighed carefully when comparing AAS therapy to other weight-gaining measures. Although a conservative approach to the use of AAS in patients with chronic diseases is still recommended, the utility of AAS therapy in the attenuation of severe weight loss associated with disease states such as cancer, postoperative recovery, and wasting due to pulmonary and hepatic disease should be more thoroughly investigated.

Risk factors for anabolic steroid use in college students and the role of expectancy

Anabolic steroids are now recognized as a widespread addictive and dangerous substance, no longer exclusively used as an aid to muscle size and strength in world-class athletes. Psychologists have neglected prevention programs for steroid abuse, in part because of a lack of knowledge of the precipitants of abuse. This study examined demographics, personality factors, and steroid expectancies as risk factors for future steroid use. Older subjects, extraversion, global-positive expectancies for steroid use, and identification with peers who advocated health-risk behaviors predicted higher steroid use, whereas specific social-behavioral negative expectancies for steroid use significantly predicted lowered risk of steroid use. These findings are discussed in the context of past research, and implications for preventive intervention are described.

Uso de esteróides anabolizantes em praticantes de musculação e/ou fisioculturismo

Os hormônios andrógeno-anabolizantes têm seu uso difundido entre os esportistas, usualmente para aumentar a massa e a potência musculares. Assim, através do uso de questionários auto-aplicáveis em um estudo transversal, foram entrevistados 305 atletas (escolhidos aleatoriamente) das academias de Santa Maria, RS, a fim de quantificar diversas variáveis relacionadas ao uso de esteróides anabolizantes (EA). A maioria dos participantes era de homens (81,1%) e a média de idade foi de 22 anos (DP ± 7). Enquanto 29% usavam aditivos alimentares, apenas 2% dos indivíduos admitiram ter usado EA (apesar de 46% dos entrevistados conhecerem algum usuário de EA). Dois terços dos usuários adquiriram a droga em farmácias (sem prescrição médica) e 35,1% desconheciam seus paraefeitos. Dos entrevistados, 28,4% acreditam que doses "adequadas" de EA não causam dano à saúde. Dessa forma, conclui-se que a principal medida preventiva à iniciação ao uso de EA é a educação dos atletas.

Anabolic steroid induced hypogonadism treated with human chorionic gonadotropin

A case is presented of a young competitive body-builder who abused anabolic steroid drugs and developed profound symptomatic hypogonadotrophic hypogonadism. With the help of prescribed testosterone (Sustanon) he stopped taking anabolic drugs, and later stopped Sustanon also. Hypogonadism returned, but was successfully treated with weekly injections of human chorionic gonadotropin for three months. Testicular function remained normal thereafter on no treatment. The use of human chorionic gonadotropin should be considered in prolonged hypogonadotrophic hypogonadism due to anabolic steroid abuse.

The effects of 17 alpha-methyltestosterone, methandrostenolone, and nandrolone decanoate on the rat estrous cycle

In a series of four separate experiments, the effects of anabolic-androgenic steroid (AAS) compounds on the estrous cycle of adult Long-Evans rats were examined. Sexual receptivity, vaginal cytology, and body weight were monitored throughout a 2-week baseline, AAS treatment, and recovery periods. In Experiments 1-3, subjects were administered 17 alpha-methyltestosterone, methandrostenolone, or nandrolone decanoate at doses selected to mimic the human abuse levels of each compound. In these studies, the highest doses of 17 alpha-methyltestosterone (7.5 mg/kg) and nandrolone decanoate (5.6 mg/kg) disrupted behavioral and vaginal cyclicity, whereas the highest dose of methandrostenolone (3.75 mg/kg) appeared to have slightly less robust effects. To compare effects on estrous cyclicity across AAS compounds, subjects in Experiment 4 received a single high dose (7.5 mg/kg) of each compound for 2 weeks. At this dose, all AAS compounds interfered with vaginal cyclicity, although effects on behavioral cyclicity and uterine weight were not uniform. Across all 4 experiments, AAS effects on body weight were minimal. The short-term administration of AAS compounds at levels commonly used by humans disrupts female neuroendocrine function in a dose-dependent manner.

Anabolic steroid abuse by body builders and male subfertility

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The reversibility of anabolic steroid-induced azoospermia

Anabolic steroid associated male infertility is a little known but potentially treatable form of drug related infertility. We report on a bodybuilder with a 5-year history of steroid use who was azoospermic. He underwent successful gonadotropin replacement and conception was achieved 3 months after therapy was initiated. Important diagnostic and therapeutic considerations in steroid-induced infertility are discussed.

Anabolic-androgenic steroids. Current issues

The use of drugs to enhance physical performance has been observed for thousands of years. Today, individuals continue to use a variety of substances, including anabolic-androgenic steroids, in the hope of enhancing their performance and appearance. Rumours persist regarding the incidence of the nonmedical use of anabolic steroids by athletes and nonathletes: however, true estimates are now available based on the results of systematic surveys. Although the vast majority of the athletic community accepts that anabolic steroids enhance performance and appearance, the extent to which this occurs and the factors influencing such effects remain incompletely understood and documented. Refinement of our knowledge of the ergogenic effects of anabolic steroids is not without merit; however, the existing scientific evidence coupled with an overwhelming number of anecdotal accounts argues against devoting significant resources to this area of investigation at present. The short term health effects of anabolic steroids have been increasingly studied and reviewed, and while anabolic steroid use has been associated with several adverse and even fatal effects, the incidence of serious effects thus far reported has been extremely low. The long term effects of anabolic steroid use are generally unknown. Unfortunately, the lack of scientific information on long term health effects has impeded, if not precluded, the formation of effective health education and drug abuse prevention strategies. Consequently, efforts should be expanded in the areas of prevention and education.

Effect of obesity and fertility status on sex steroid levels in men

Endocrine studies were performed on fertile and infertile obese men and compared with fertile and infertile nonobese men in order to determine the independent and codependent effects of obesity and fertility status on the male hypothalamic-pituitary gonadal axis. The obese infertile group exhibited significant endocrinologic changes as compared with fertile nonobese control group which was not observed in any of the other three groups. Serum testosterone was significantly lower. The testosterone/estradiol ratio was significantly lower despite a lack of significant change in serum estradiol levels. Serum steroid hormone binding globulin (SHBG) was significantly lower which correlated with elevated bioavailability of both testosterone and estradiol in the obese infertile group. Serum luteinizing hormone levels were no different, suggesting that free testosterone levels were unchanged. Obese infertile men exhibit endocrinologic changes that are not observed in men with either obesity or infertility alone. Reduction of serum SHBG, total testosterone, and testosterone/estradiol ratio appear to be a marker of infertility among obese men.

The efficacy of ergogenic agents in athletic competition. Part I: Androgenic-anabolic steroids

OBJECTIVE

To summarize the literature describing the epidemiology, pharmacology, efficacy, and adverse effects associated with androgenic-anabolic steroid (AAS) use among athletes.

DATA SOURCES

Relevant articles were identified from a MEDLINE search using the search terms "Doping in Sports," "Anabolic Steroids (exploded)," and "Androgens (exploded)." Additional references were found in the bibliographies of these articles.

STUDY SELECTION/DATA EXTRACTION

We reviewed studies of AAS use among professional athletes. Interpretation of these studies is difficult because of poor research design. The efficacy studies lacked adequate placebo control. Much of the literature describing adverse effects consists of anecdotal reports. All of this literature was considered for review.

DATA SYNTHESIS

Of all ergogenic drugs, AASs are the most widely abused. Abuse of AASs among high school students is estimated at five to ten percent. AASs are hypothesized to produce ergogenic effects during periods of concomitant positive nitrogen balance via antagonism of the catabolic effect of glucocorticoids released during intense exercise. Despite years of study, the extent of the ergogenic effects associated with AASs remains unclear. This may be because most studies have failed to approximate athletes' AAS usage patterns. The primary toxic effects of AASs are divided into four areas: hepatic, reproductive, cardiovascular, and psychiatric. Athletes do not consider these effects severe enough to refrain from using these drugs.

CONCLUSIONS

Athletes view AASs as an essential component for success. Without adequate intervention measures, AAS abuse is likely to continue unchecked.