SFEBES2023 Oral Communications Reproductive Endocrinology (6 abstracts)
Self-administering post-cycle therapy is associated with biochemical gonadal recovery in men stopping anabolic-androgenic steroid use
Bonnie Grant 1 , John Campbell 2 , Anjali Pradeep 1 , Angela D. Burns 3 , Paul Bassett 4 , Ali Abbara 1 , Priyadarshi Saket 2 , Sukhbinder Minhas 5 , Waljit S. Dhillo 1 , James McVeigh 6 , Shalender Bhasin 7 & Channa N. Jayasena 1
1Imperial College London, London, United Kingdom. 2Glasgow Alcohol & Drug Recovery Services, Glasgow, United Kingdom. 3Queen Elizabeth University Hospital, Glasgow, United Kingdom. 4Statsconsultancy Ltd, Amersham, United Kingdom. 5Charing Cross Hospital, London, United Kingdom. 6Manchester Metropolitan University, Manchester, United Kingdom. 7Brigham and Women’s Hospital, Boston, USA
Background: Millions of men worldwide take anabolic-androgenic steroids (AAS) to boost muscle growth, but risk psychosis, cardiomyopathy, stroke and death. Users avoid stopping AAS because they are fearful of low testosterone symptoms including sexual dysfunction, depression and suicidality. To avoid these symptoms, men often illicitly self-medicate a 2–12-week course of drugs including selective oestrogen receptor modulators to boost testicular function when stopping AAS (post-cycle therapy; PCT). The endocrine consequences of PCT have not been studied previously, but are important since PCT might paradoxically impair AAS recovery.
Methods: Multivariable analysis of 641 men attending a single addiction clinic in Glasgow between 2015-2022. Men ceasing AAS within 36 months, with or without PCT, underwent assessment including a single, non-fasting random blood test. Normalised reproductive hormones (combination of reference range serum luteinising hormone, follicle-stimulating hormone, and total testosterone levels) was used as a surrogate of biochemical gonadal recovery.
Results: Seventy-three-percent of men illicitly administered PCT during AAS cessation. Odds of biochemical recovery during multivariable analysis were: (1) higher with PCT (OR=3.80) vs no-PCT (P=0.001), in men stopping AAS 3 months previously; (2) reduced when two (OR=0.55), three (OR=0.46) or four (OR=0.25) AAS were administered vs one drug (P=0.009); (3) lower with AAS >6 vs ≤3 months previously (OR=0.34, P=0.01); (4) higher with last reported AAS >3 months (OR=5.68) vs ≤3 months (P=0.001). PCT use was not associated with biochemical recovery in men stopping AAS >3 months previously.
Conclusions: This is the largest endocrine study of AAS cessation, revealing for the first-time independent factors associated with recovery from AAS-induced hypogonadism. Surprisingly, we observed that self-administered PCT is associated with gonadal recovery in men stopping AAS <3 months. PCT remains illicit, potentially dangerous and unproven. Interventional studies are needed to determine whether PCT modulates gonadal recovery in men motivated to stop their AAS addiction.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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