Endocrine Abstracts

Background: Anabolic androgenic steroids (AAS) are widely used to improve performance and/or enhance appearance. The aim of this study was to assess the impact of AAS on the reproductive system of athletes.

Methods: An electronic literature search was conducted, using the databases MEDLINE, CENTRAL, Scopus and Google Scholar. Studies including AAS use in any type, dose, form or duration of intake were included in the review. Main outcomes were AAS effects on the reproductive system of athletes, as assessed by medical history, clinical examination, hormone analysis and/or semen analysis.

Results: Twenty-six studies were included in the review, involving 963 participants, with the median (25th-75th percentile) duration of AAS intake being 16 (8–100.8) weeks. Most studies showed that gonadotropin and testosterone levels decreased during the period of AAS intake, whereas following AAS cessation, they gradually returned to normal levels. The majority of AAS users demonstrated prolonged hypogonadism with persistently low gonadotropin and testosterone levels, lasting for several weeks to months after AAS withdrawal. Most studies have also shown that AAS use results in structural and functional sperm changes, reduction of testicular volume, as well as clitoromegaly and menstrual irregularities. Only 2 out of 26 studies determined AAS effects on fertility and only 2 studies involved female athletes.

Conclusion: AAS use results in profound and lasting effects on the reproductive system of athletes and potentially on fertility. Targeted education about AAS abuse and thorough monitoring are needed to prevent negative long-term effects.