Former Abusers of Anabolic Androgenic Steroids Exhibit Decreased Testosterone Levels and Hypogonadal Symptoms Years after Cessation: A Case-Control Study
Open Access
- 17 August 2016
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 11 (8), e0161208
- https://doi.org/10.1371/journal.pone.0161208
Abstract
Abuse of anabolic androgenic steroids (AAS) is highly prevalent among male recreational athletes. The objective of this study was to investigate the impact of AAS abuse on reproductive hormone levels and symptoms suggestive of hypogonadism in current and former AAS abusers. This study had a cross-sectional case-control design and involved 37 current AAS abusers, 33 former AAS abusers (mean (95%CI) elapsed duration since AAS cessation: 2.5 (1.7; 3.7) years) and 30 healthy control participants. All participants were aged 18–50 years and were involved in recreational strength training. Reproductive hormones (FSH, LH, testosterone, inhibin B and anti-Müllerian hormone (AMH)) were measured using morning blood samples. Symptoms of hypogonadism (depressive symptoms, fatigue, decreased libido and erectile dysfunction) were recorded systematically. Former AAS abusers exhibited significantly lower median (25th –75th percentiles) total and free testosterone levels than control participants (total testosterone: 14.4 (11.9–17.7) nmol/l vs. 18.8 (16.6–22.0) nmol/l) (P < 0.01). Overall, 27.2% (13.3; 45.5) of former AAS abusers exhibited plasma total testosterone levels below the lower reference limit (12.1 nmol/l) whereas no control participants exhibited testosterone below this limit (P < 0.01). Gonadotropins were significantly suppressed, and inhibin B and AMH were significantly decreased in current AAS abusers compared with former AAS abusers and control participants (P < 0.01). The group of former AAS abusers had higher proportions of participants with depressive symptoms ((24.2%) (11.1; 42.2)), erectile dysfunction ((27.3%) (13.3; 45.6)) and decreased libido ((40.1%) (23.2; 57.0)) than the other two groups (trend analyses: P < 0.05). Former AAS abusers exhibited significantly lower plasma testosterone levels and higher frequencies of symptoms suggestive of hypogonadism than healthy control participants years after AAS cessation. Current AAS abusers exhibited severely decreased AMH and inhibin B indicative of impaired spermatogenesis.Keywords
Funding Information
- AntiDoping Denmark
- Danish Heart Foundation (15-R99-A5797-22952)
- Herlev Hospital
- Faculty of Health and Medical Sciences, University of Copenhagen
This publication has 37 references indexed in Scilit:
- Reference Ranges for Testosterone in Men Generated Using Liquid Chromatography Tandem Mass Spectrometry in a Community-Based Sample of Healthy Nonobese Young Men in the Framingham Heart Study and Applied to Three Geographically Distinct CohortsJournal of Clinical Endocrinology & Metabolism, 2011
- Persistent primary hypogonadism associated with anabolic steroid abuseFertility and Sterility, 2011
- Serum inhibin-b in fertile men is strongly correlated with low but not high sperm counts: a coordinated study of 1,797 European and US menFertility and Sterility, 2010
- Pilot Study of Serum Inhibin B as a Potential Marker of Testosterone Doping in Weight Lifting MenClinical Journal of Sport Medicine, 2010
- Treatment of anabolic–androgenic steroid dependence: Emerging evidence and its implicationsDrug and Alcohol Dependence, 2010
- Applicability of the SHBG Androgen Sensitivity Test in the Differential Diagnosis of 46,XY Gonadal Dysgenesis, True Hermaphroditism, and Androgen Insensitivity SyndromeExperimental and Clinical Endocrinology & Diabetes, 2004
- Androgenic Anabolic Steroid Use and Severe Hypothalamic-Pituitary Dysfunction: a Case StudyInternational Journal of Sports Medicine, 2003
- The Reversibility of Anabolic Steroid-Induced AzoospermiaJournal of Urology, 1995
- Anabolic steroid-induced hypogonadotropic hypogonadismThe American Journal of Sports Medicine, 1990
- Interrelationships between sex hormone-binding globulin and testosterone, 5α-dihydrotestosterone and oestradiol- 7β in blood of normal menMaturitas, 1980