Anabolic-androgenic steroids--a double-edged sword?

Trends in male contraception

Methods that are available for male contraception, namely coitus interruptus, condoms, and vasectomy, have been used since the 19th century. With the exceptions of a few improvements of these methods, no major progress has been made with respect to introducing new male contraceptives since then. It is extremely urgent to develop new, safe, effective, and reversible male contraceptive methods. Among all male contraceptive methods that are being investigated, the hormonal approach is the closest to clinical application. Hormonal contraception provides pregnancy protection by means of spermatogenic suppression. Androgen-progestin regimens currently represent the best available hormonal combination for induction of a profound suppression of spermatogenesis. Further development of new steroids is mandatory for increasing the choices of available contraceptive formulations and to optimize long-term safety of these regimens.

Environment, lifestyle and male infertility

Our understanding of the importance of environmental and lifestyle factors on sperm count and fertility is constrained by the extreme variation in sperm count between men and between ejaculates. The factors responsible for this variation provide a key to understanding what factors actually affect the sperm count. The relative importance of the various factors and the pathways via which they affect sperm count are discussed. The most important are Sertoli cell number, ejaculatory frequency, season, factors affecting scrotal heating (e.g. the time spent seated), a past history of reproductive tract disorders and ageing. The possible role of other environmental factors commonly supposed to affect sperm count (exposure to pesticides or endocrine disruptors) is discussed, although the evidence for a major influence of such factors is lacking. It is suggested that lifestyle changes, especially in the time spent seated, will exert an adverse effect on sperm production in a progressively larger group of men over the next decade.

Androgenic--anabolic steroids and body dysmorphia in young men

There has recently been increasing attention focused on the use of androgenic-anabolic steroids (AAS). Some research has suggested that a disturbance in body image in males leads to AAS use. At present, the available literature is sparse and there is little/no discussion on the causal factors for their use. This review gives a historical account of the development and the changing patterns of AAS use. Both the physical and psychological side-effects are presented. The available evidence and theories for external/social and internal, psychological, and developmental influences are discussed in relation to AAS use. The current trends for the treatment of AAS abusers are also presented. Recommendations regarding further research are made in the conclusions.