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.
Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.