Body Image Disorders and Anabolic Steroid Withdrawal Hypogonadism in Men

Written by Ben Bunting: BA, PGCert. (Sport & Exercise Nutrition) // British Army Physical Training Instructor // S&C Coach.


Body image drugs and body image disorders have been a clinical concern since 20 years ago, but recent attention has focused on a specific class of drugs called anabolic-androgenic steroids (AAS). These drugs are a class of hormones that include testosterone synthetic derivatives.

Anabolic steroids

Athletes across different sports and men with body dysmorphic disorder may be attracted to nonmedical use of anabolic steroids.

These drugs increase the risk of negative health consequences when taken in supratherapeutic doses.

Although these drugs can be obtained legally, illegal use may be associated with psychological dependence and substance abuse disorders.

Understanding these risks and the psychological motivations associated with persistent AAS use will benefit physicians treating nonmedical users.

Symptoms of hypogonadism may persist for up to 3 months after the last injection of AAS.

After this time, gonadal function should have recovered to the pre-AAS level. Patients who show signs of hypogonadism after a recent AAS use should be evaluated for any undisclosed steroid use before blood testing.

In addition, patients should be asked about current use of endocrine therapies such as selective oestrogen receptor modulators or aromatase inhibitors.

Anabolic steroids are associated with increased body size, body image, and self-confidence in men.

These drugs imitate the properties of natural hormones and stimulate testosterone receptors in the body, increasing muscle tissue production.

The difference between anabolic steroids and natural testosterone is that women have lower amounts of testosterone than men.

Anabolic steroids can also cause serious problems in men. The high levels of androgens are known to disrupt the oestrogen-androgen balance, causing mood swings and agitation.

In addition, the disruption of the oestrogen-androgen balance can lead to breast tenderness and gynaecomastia.

Additionally, oral anabolic steroids can cause liver toxicity and an elevation of liver enzymes.

Furthermore, improper injection techniques and contaminated steroids can lead to local inflammation and joint problems.

Moreover, anabolic steroids are widely available and affordable. They are often purchased from friends and gym associates.

In addition to being easily available, they are not associated with violence, dubious dealing, or organised crime.


While anabolic steroids can improve body image and self-confidence, the risks associated with these drugs are considerable.

Some of the side effects can include depression, irritability, roid rage, and low sex drive. Additionally, the body can have trouble ramping up its production of testosterone.

Anabolic steroids are drugs that increase testosterone levels in men. They include Testosterone enanthate, Testosterone propionate, and Testosterone cypionate.

Some anabolic steroids have other effects on the body, such as increasing the body's metabolic rate, enhancing performance, and improving mood.

Since the 1980s, anabolic steroids have become widespread, and several countries have changed their legislation to regulate their use. In 1999, the world anti-doping agency was established.

Anabolic steroids are also associated with an increased risk of insulin resistance. Chronic use of AAS can reduce insulin sensitivity by inhibiting S6K1 and inhibiting the insulin receptor, IRS-1.

Furthermore, aromatisation of testosterone leads to an increase in the hormone Estradiol, which has been linked to insulin resistance.

The symptoms associated with withdrawal from anabolic steroids include headache, fatigue, myalgia, depression, low libido, and suicidal ideation.

The symptoms may persist for months or even years after the last use of an AAS. Treatment with human chorionic gonadotropin (HCG) or clomiphene can restore normal function to the hypothalamic-pituitary-testicular axis and reverse hypogonadism.

However, it is important to note that many endocrinologists are limited in their experience with AAS withdrawal.

Studies on former users of AAS have suggested that their withdrawal experiences may be related to symptoms associated with hypogonadism.

These experiences have also been identified as influencing factors in their decisions to stop taking AAS.


Men who are using anabolic steroids should be monitored for symptoms of body image disorders, including hypogonadism.

Symptoms of hypogonadism often persist for up to three months after the last injection.

After this time, the HPG axis should be partially recovered. If symptoms persist beyond three months, patients should be asked about any undisclosed steroid use prior to blood testing.

They should also be asked whether they are currently using selective oestrogen receptor modulators or aromatase inhibitors.

While symptoms of body image disorders associated with AAS withdrawal can be treated by pharmacotherapy, there are some cases in which psychiatric intervention is necessary.

Although most men suffering from AAS withdrawal do not suffer from depression, up to 10-20% may suffer from serious depressive symptoms.

While psychiatric intervention is not necessary for most AAS withdrawal patients, electroconvulsive therapy and fluoxetine are recommended for those who suffer from serious depressive symptoms.

Anabolic-androgenic steroids have been recognized as a significant clinical problem for more than 20 years, and have gained increased attention in recent years.

In particular, testosterone and its synthetic derivatives are of great concern. The most common forms of AAS use in men are illegal and easily obtained over the internet.

Anabolic-androgenic steroids have also been linked to a number of other health problems, including gynecomastia, hirsutism, left ventricular dysfunction, and coronary artery disease.

Oftentimes, healthcare providers must also assess whether an individual has a comorbid mental health disorder or a substance use disorder.

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Body image disorders

There is a growing body of evidence that suggests a widespread use of anabolic androgenic steroids by a wide range of population groups.

However, despite the large number of users, there is relatively little evidence to support interventions to help people reduce their use or recover from the negative effects of anabolic androgenic steroid use.

There is an important need for more research to understand the effects of anabolic androgenic steroids and the psychological and physical problems that can arise from them.

One of the most disturbing consequences of anabolic steroids is the fact that they can lead to a range of psychological disorders, including depression, anxiety, and psychotic symptoms.

These symptoms can persist for several months or even years following AAS use. In some cases, men with this condition can be cured through the use of a hormone called human chorionic gonadotropin or clomiphene.

These two hormones are widely used by AAS users as postcycle therapy and can restore the hypothalamic-pituitary-testicular axis function.

The majority of studies on steroid withdrawal and side effects involve post-adolescent males. However, studies on females have been a neglected area of research, and the lack of such research may perpetuate the myth that anabolic steroids are safe.

Long-term AAS use can cause hypogonadism by suppressing pituitary gonadotropin levels and testicular function.

Symptoms of AAS withdrawal include low mood, insomnia, and restlessness. Occasionally, men experience suicidal ideas. It is important to seek out a medical professional who can provide individualized care.

Cardiovascular risk

Anabolic steroid use is associated with cardiovascular disease and mood and anxiety disorders. It has also been linked with a high risk of mortality. Men who use anabolic steroids are likely to engage in an unhealthy lifestyle.

Anabolic steroids are steroidal androgens that promote growth and regulate constructive metabolism in the body.

They are now a major public health concern as their use has expanded from strictly sporting activities to the general population. Approximately 1% to 5% of men use anabolic-androgenic steroids at some time in their life.


A recent study aimed to determine the frequency and severity of hypogonadal symptoms in male AAS misusers.

It involved participants with a history of long-term AAS use as well as non-AAS weightlifters. The study included 24 former long-term AAS users and 36 non-users.

A database search was conducted using search terms that included androgen, anabolic steroids, performance enhancing drugs, and androgen withdrawal symptoms.

The search included studies with males, anaerobic activity, and substance abuse. Studies that were not published in English, of non-human species, or of non-androgenic steroids were excluded.

The use of AAS can lead to hypogonadism, which persists for months after AAS withdrawal.

This is a result of the suppression of natural testosterone and spermatozoa production by AAS. The effects of AAS withdrawal hypogonadism can include decreased libido, erectile dysfunction, and infertility.

Furthermore, the withdrawal process may also lead to major depressive disorder.

During AAS withdrawal, men may experience symptoms such as headache, palpitations, and restlessness.

Some patients also experience decreased mood, low libido, and suicidal thoughts. These symptoms, as well as others, should be carefully monitored.

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