Endocrine Abstracts

This is a 38-year-old male, a regular user of a gym with the sole purpose of improving his physical performance and muscular strength and habitual consumer of hyperproteic dietary supplements. Among his PAs he denies toxic habits, and highlights the removal of the right testicle in childhood. Consultation for decreased desire and sexual potency, together with pain and turgor in the left breast; hair loss at the frontal level, in analytic carried out by the Primary Care Physician, the level of Testosterone decreased (0.21 ng/ml) is the normal units, reason for which it is derived to Endocrinology Consultations. In the history acknowledges that from 2005 to 2009 has been a consumer of anabolic (Decarbolin, Sustanol 5HT, Histrol) cyclically and by different routes of administration, with the sole purpose of increasing physical power to exercise, denies such consumption in the last year and a half. In the physical examination gynecomastia draws attention being the rest of the normal exploration. In the complementary study performed, testosterone levels 0.21 ng/dl, with rest of hormonal profile within normality (FSH 1.5 mU/ml, LH 0.7 mU/ml, PRL 17.9 ng/ml, ACTH 20 IU/ml, Basal cortisol 16.40, TSH 2.29 μUI/ml, HCG <0.05 ng/ml, 17 beta-estradiol 21 pg/ml), high CPK levels. Abdominal, mammary and testicular ultrasound, normal except absence of right testis. Incidentaloma pituitary MRI scan (4 mm). Given the findings of complementary tests and history of consumption of anabolics, hypogonadotropic hypogonadism was diagnosed secondary to taking anabolic steroids, without consumption at present for a year and a half. Testosterone treatment is started, and reviewing literature, there are cases in which patients benefit from adjuvant treatment with human chorionic gonadotrophin (hCG) at doses 500 IU, after testosterone for three months. He has always shown a demanding attitude, questioning the diagnosis, so he asks for a second medical opinion. Anabolic androgenic steroids are synthetic androgens derived from testosterone, widely used in athletes, especially in bodybuilders and athletes of high competition, the administration of doses far superior to physiological induce the appearance of side effects, highlighting alterations in sexual function and reproductive.