Andrologie-Open Access
Libre accès
ISSN: 2167-0250
ISSN: 2167-0250
Manaf Al Hashimi
Objective: Androgenic Anabolic Steroids (AAS) abuse has increased among adult men and has a negative impact on sexual and reproductive health. Studies or guidelines outlining the management pathways for AAS abuse are currently unavailable. We aimed to confirm the deleterious effects of AAS abuse on sexual health and fertility, monitor the spontaneous recovery, and demonstrate the effects of treatment regimens on recovery.
Methods: We enrolled 520 patients with a confirmed history of AAS intake within 1 year of presentation and evaluated their symptoms, hormones levels, and semen every 3 months till 12 months. All patients ceased using AAS and were monitored for spontaneous recovery in the first 3 months; if they showed no recovery, they were randomized to undergo either continued observation or commence medications. The International Index of Erectile Function (IIEF), hormone levels, and semen at presentation and at each 3 months visit were measured and compared between the treated and untreated patients.
Results: The most common presentation (84%) was a combination of sexual symptoms. Some patients (18%) were infertile. Most patients (90%) reported low levels of luteinizing hormone, follicle-stimulating hormone, and total testosterone. After the 3-month observation, most patients (89%) started treatment, but some (11%) continued observation only. IIEF values and hormone levels in the treated group showed significant improvements (p<0.005). Semen analysis was abnormal in 79% of patients, and 85% of who presented with infertility failed to conceive despite treatment.
Conclusion: AAS abuse negatively impacts sexual activity and fertility. Treatment yields a faster recovery than nontreatment. Infertility may persist despite treatment. It is an urgent call for andrology and men health scientific bodies to work on guidelines for specific treatment AAS abuse adverse effects.