Correction of male hypogonadism caused by anabolic steroid use
K. E. Gaidaichuk,
R. V. Rozhivanov,
E. R. Rozhivanova,
E. N. Andreeva,
G. A. Mel’nichenko,
N. G. Mokrysheva https://doi.org/10.14341/brh12784
Abstract
The widespread use of anabolic steroids (AS) in sports and recreational fitness has led to an increase in the frequency of iatrogenic hypogonadotropic hypogonadism among men. This condition, characterized by the suppression of the hypothalamic-pituitary-gonadal (HPG) axis via negative feedback, manifests as severe testosterone deficiency, impaired spermatogenesis, and a wide range of negative clinical symptoms. This review systematizes current data on the methods for correcting AAS induced hypogonadism. Unlike similar works, the emphasis is placed on the pathogenetic rationale for choosing a therapeutic strategy based on clearly defined clinical goals: rapid relief of symptoms versus restoration of fertility. It provides a detailed analysis not only of classical testosterone replacement therapy but also of methods aimed at restoring endogenous steroidogenesis and spermatogenesis: therapy with gonadotropins and selective estrogen receptor modulators. Particular attention is paid to prognostic factors for treatment success, including the duration and nature of prior AAS use. Based on the analyzed data, a systematic approach to patient management is proposed, emphasizing the need for treatment individualization. The review also contains a assessment of the potential role of selective androgen receptor modulators (SARM) and an analysis of the likelihood of spontaneous recovery of HPG axis function.
About the Authors
K. E. Gaidaichuk
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Konstantin E. Gaidaichuk - MD.
11 Dm. Ulyanova street, 117036 Moscow
Competing Interests:
none
R. V. Rozhivanov
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Roman V. Rozhivanov - MD, PhD.
11 Dm. Ulyanova street, 117036 Moscow
Competing Interests:
none
E. R. Rozhivanova
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Ekaterina R. Rozhivanova - MD.
11 Dm. Ulyanova street, 117036 Moscow
Competing Interests:
none
E. N. Andreeva
Endocrinology Research Centre; Russian University of Medicine
Russian Federation
Competing Interests:
Russian Federation
Elena N. Andreeva - MD, PhD, Professor.
Moscow
Competing Interests:
none
G. A. Mel’nichenko
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Galina A. Mel’nichenko - MD, PhD, Professor.
11 Dm. Ulyanova street, 117036 Moscow
Competing Interests:
none
N. G. Mokrysheva
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Natalya G. Mokrysheva - MD, PhD, Professor.
11 Dm. Ulyanova street, 117036 Moscow
Competing Interests:
none
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Gaidaichuk K.E., Rozhivanov R.V., Rozhivanova E.R., Andreeva E.N., Mel’nichenko G.A., Mokrysheva N.G. Correction of male hypogonadism caused by anabolic steroid use. Bulletin of Reproductive Health. 2026;(1):18-25. (In Russ.) https://doi.org/10.14341/brh12784
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