Anabolic androgenic steroids are frequently employed substances to enhance muscle strength, mass, and athletic performance. A considerable portion of users comprises non-professional athletes, including numerous teenagers. This trend has become prevalent among everyday amateur athletes, including those engaging in personal fitness at the gym.

Users of steroids aim to maximize the anabolic effect, promoting muscle mass, while minimizing the androgenic effect responsible for male sexual characteristic development. While the anabolic and androgenic effects of testosterone maintain a 1:1 ratio, other steroids can exhibit ratios exceeding 30. Steroids can be modified to achieve specific effects, with not all drugs focused solely on muscle mass gain.

The side effects stemming from androgenic effects hinge on dosage and usage duration. Additional hormonal medications are often employed to maximize desired effects and mitigate side effects. Maintaining an unstable androgen-estrogen balance in tissues prompts the use of other drugs to prevent side effects. Websites selling anabolic steroids commonly offer kits that include medications to counteract the side effects of androgenic steroids, though these medications may also have adverse health effects.

Anabolic androgenic steroids significantly impact gonadal activity, suppressing androgen and sperm production in the testicles. These effects vary among individuals and are unpredictable.

Testicular Function and Associated Disorders

The testicles function to produce sperm and sex hormones, primarily testosterone. Normal testosterone production ensures the development of male sexual characteristics and sustains high testosterone levels in the testicles, crucial for proper sperm production.

The pituitary gland regulates testicular function. Externally administered anabolic androgenic steroids disrupt the normal regulation of the pituitary gland, leading to a decrease in the testicles’ own testosterone production and subsequently reducing sperm production, potentially to the point of complete cessation. Anabolic steroids induce dose-dependent dysfunction of the pituitary-testicular axis by inhibiting the secretion of pituitary-derived testicular gonadotropins, which stimulate testosterone production. This results in lowered testosterone production, reduced testicle size, and impaired sperm production, potentially leading to infertility. Externally administered testosterone fails to elevate testicular testosterone levels due to reduced gonadotropin secretion from the pituitary gland.

Infertility specialists are well-acquainted with the impact of anabolic androgenic steroids on sperm production. Studies indicate that approximately one in four steroid users experience no sperm production, around half face decreased sperm production compared to normal values, and only a quarter maintain normal sperm production. Anabolic steroids also affect sperm structure, with irreversible damage possible during adolescence.

The Impact of Anabolic Steroids (Androgens) on Sexual Desire

Testosterone plays a crucial role in regulating sexual desire, commonly referred to as libido. Anabolic steroids have the potential to increase libido, but this enhancement can pose challenges due to the propensity of high androgen doses to also elevate the risk of aggressive behavior.

A prevalent issue arises post-steroid use when the body ceases to produce testosterone for an extended period. Users of steroids often encounter this scenario. However, the testosterone concentration in the bloodstream becomes insufficient to sustain a normal libido, leading to hormonal imbalances and a subsequent loss of sexual desire. Moreover, testosterone deficiency is associated with various symptoms and health risks.

A significant decline in testosterone levels can also contribute to erectile dysfunction and mental health issues. For instance, weightlifters may experience a notable decline in performance coupled with an increased susceptibility to embark on a new androgen cycle.

Additional Side Effects of Anabolic Steroids

Recent findings have uncovered extensive side effects of anabolic steroid doping that indirectly impact reproductive health. Some users report psychiatric symptoms and severe mood disorders, including hyperactivity, irritability, aggressiveness, heightened excitability, impaired concentration, reckless behavior, and other symptoms of a psychotic nature. Suicidal thoughts and actions have also been documented, though these symptoms are experienced by a minority, and there is limited information on the mental state of individuals before steroid use. Compelling evidence points to a negative impact on the heart, with steroid users diagnosed with heart muscle pathology linked to compromised cardiac function. While some heart changes may be reversible upon discontinuation of steroids, irreversible damage may occur if the steroids have led to the destruction of heart muscle cells. Pathological liver changes associated with steroid use can be fatal or necessitate a liver transplant.

Exploration of Effects and Treatment

Individuals who engage in the use of anabolic steroids may possess some awareness of associated issues, yet they often fail to disclose this information during medical consultations. Consequently, side effects stemming from steroid usage might go unnoticed, leading to suboptimal treatment. Additionally, general practitioners may possess only a superficial understanding of the impact of steroids on the body.

During a medical examination, indicators of prolonged androgen use, such as acne, skin stretch marks, breast enlargement, and potential injection marks, may be observed. Laboratory tests could reveal elevated hemoglobin levels, low levels of HDL cholesterol (referred to as “good cholesterol”), and abnormal liver function tests. Prolonged use of androgens may result in a significant reduction in testicle size.

The impact of anabolic androgenic steroids on reproductive function is contingent on factors such as the specific drugs used, dosages, and timing of usage. Hormonal studies reflecting testicular function may reveal typical abnormalities. Semen studies indicate that a considerable proportion of steroid users may experience a complete absence of sperm. It is crucial to note that anabolic steroid use does not preclude other potential causes of male infertility. While reversible effects were previously presumed, certain side effects evidently defy reversal. Severe consequences, such as cardiac and hepatic effects, can lead to chronic conditions like heart failure, sudden death, and the need for liver transplantation due to severe liver impairment.

Recovery of normal sperm production after the cessation of steroid use can be prolonged, and not all individuals fully regain these functions. The most effective approach often involves a straightforward action: complete cessation of anabolic androgenic steroid use. Successful therapy hinges on the individual’s understanding of the link between androgen use and the development of disorders, coupled with the recognition that recovery is a time-consuming process.

In cases of severe and prolonged hypofunction, maintaining physiological testosterone concentrations (testosterone replacement therapy) might be necessary during the recovery phase. However, the potential for abuse must be considered, and substitution therapy should be conducted confidentially. It’s important to acknowledge that physiological replacement therapy may slow down the restoration of sperm production. Therefore, a delicate balance must be struck during treatment, weighing the subjectively unpleasant symptoms of testosterone deficiency against the positive impact on future health.