Hypogonadism in Males Following Withdrawal From Anabolic Steroids
Written by Ben Bunting: BA(Hons), PGCert. Sport & Exercise Nutrition. British Army Physical Training Instructor (MFT).
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A study has examined the incidence and severity of hypogonadal symptoms in long-term androgenic anabolic steroids (AAS) users.
The study involved 24 former long-term AAS users and 36 non-AAS-using weightlifters. Of the AAS-using participants, five received physiological testosterone replacement therapy, whereas the other 19 were untreated.
The patients underwent a structured clinical interview (DSM-IV), a physical examination, and serum hormone determinations.
Anabolic Androgenic Steroids
Many users of anabolic androgenic steroids incorporate a variety of substances into their regimens.
These substances may include performance enhancing drugs and fat-loss agents. These drugs can enhance muscle mass, as well as the aesthetic appeal of musculature. These substances are often purchased online.
The use of anabolic androgenic steroids is a growing public health problem. They are synthetic derivatives of testosterone that can exert significant effects on the human body.
Although they can be dangerous, short-term use can help improve athletic performance. However, most studies have only been carried out in the laboratory and may not reflect the risks of steroid use in the field.
While short-term use of these substances may increase strength and muscle size, it is important to note that these drugs can also cause fat accumulation.
Anabolic androgenic steroids can alter the process by which men and women express sexual behaviours.
In addition to affecting the male genitalia, these medications can also alter the development of the reproductive organs, including the ovaries.
They can also affect a woman's voice and clitoral size. In addition, anabolic steroids can cause striae, acne, and pituitary atrophy.
The use of anabolic androgenic steroids has increased in high-income countries in the past decade.
The use of these drugs is linked to an elevated risk of developing cholestasis, a condition where the liver is damaged.
This damage usually occurs within one to four months of therapy, but in some patients, it may take up to 24 months before symptoms appear. The symptoms are usually insidious and include fatigue, nausea, and dark urine.
Jaundice may persist even after the use of anabolic steroids is discontinued. Liver enzyme elevations are usually less than three times normal.
Anabolic steroids are extremely dangerous if they are not used in the prescribed doses.
For this reason, health care professionals must supervise the use of anabolic steroids. While anabolic steroids have numerous benefits, they should only be taken by those with a medical condition.
If misused, anabolic steroids can cause irreversible damage to the human body and the hormone system.
Mood disorders are a common side effect of anabolic steroids. Many people may suffer from depression, anxiety, or suicidal thoughts.
Mood disorders and insomnia are also common side effects of withdrawal from anabolic steroids.
Additionally, some people will experience muscle and joint pain, headaches, and trouble concentrating. Lastly, steroid withdrawal can cause a persistent desire to take the drug again.
Aside from these side effects, anabolic androgenic steroids may also cause liver injuries.
Although C-17a alkylated testosterones have been implicated in liver injury, the C-17b esterified testosterones may increase the risk of hepatic tumors and nodular transformation.
While anabolic androgenic steroids have legitimate uses in medical settings, they are also widely used in illegal uses.
Symptoms of steroid withdrawal
Withdrawal from anabolic steroids is not an easy process and it can be accompanied by a range of unpleasant symptoms.
The most important step is to seek treatment. The medical staff at a specialized treatment center can monitor the condition and prescribe medications to relieve withdrawal symptoms.
These professionals can also provide educational and counseling support to help the individual deal with the withdrawal symptoms and to prevent relapse.
While detox is not an easy process, undergoing it with the support of medical professionals can help to increase the likelihood of long-term sobriety.
The most common symptom of anabolic steroid withdrawal is depression, which can be treated with anti-depressants.
The physical changes associated with steroid withdrawal can also be treated with hormone therapy. Nonmedical use of corticosteroids can also cause withdrawal symptoms, as these drugs affect the amount of cortisol available to the brain. In such cases, medications and counseling are essential.
Withdrawal symptoms usually peak two to five days after the last dose of anabolic steroids.
They may also include decreased energy levels and mood swings. The intensity of withdrawal symptoms will vary depending on the type of steroid used.
The first few days may be the most difficult, with nausea, headaches, and irritability being common. In the second week, these symptoms will generally be less severe.
Some testosterone withdrawal symptoms may be life threatening.
While withdrawal from anabolic steroids can be physically uncomfortable, the most frightening symptom is depression.
In addition to being uncomfortable, depression may lead to suicidal thoughts. While these are not life-threatening, they are certainly serious enough to warrant the support of medical professionals.
Although there are many withdrawal symptoms, they can become more severe if abruptly stopped. In order to avoid the unpleasantness, it is best to taper the dosage of anabolic steroids gradually.
This is because abruptly stopping the use of anabolic steroids can lead to dangerous side effects, including severe fatigue.
Another way to cope with withdrawal is to consider the use of anabolic steroid alternatives.
These drugs include selective androgen receptor modulators (SARMs) and human growth hormone (HGH). These alternatives offer similar benefits to anabolic steroids without the health risks.
When it comes to steroid withdrawal, the intensity of these symptoms is directly related to the duration of steroid use.
Long-term and heavy users of anabolic steroids are likely to experience severe withdrawal symptoms.
Medically supervised detox programs can provide medication that helps reduce withdrawal symptoms and restore hormonal balance. Additionally, these programs can also help reduce pain and depression symptoms.
Withdrawal symptoms are caused by the effect of anabolic steroids on testosterone levels.
Although AAS drugs do not contain testosterone, they closely mimic the effects of testosterone, which makes the body accustomed to high levels of the hormone and begins to reduce production of it.
Use of AAS is on the rise
In the United States, illicit use of anabolic-androgenic steroids (AAS) has become a major form of substance abuse, with approximately 2.9-4.0 million men reported to have used AAS.
These steroids, which suppress the HPT axis, can cause hypogonadism when used for prolonged periods. Men experiencing this condition typically experience symptoms during the withdrawal phase.
They may also exhibit depressive symptoms, which may lead to suicide attempts.
In men experiencing prolonged hypogonadism following withdrawal from anabolic steroids, many options are available to improve erectile function and testosterone levels.
Male athletes, bodybuilders, and other competitive athletes often use anabolic steroids. While there are several treatments available, the most effective one is determined by the severity of the hypogonadism and the length of use of AAS.
The physical and psychological symptoms of steroid withdrawal can be debilitating.
Most users experience a severe depressive episode, and some have even contemplated suicide. If you experience these symptoms, it is best to seek medical help. Your doctor may prescribe medications to reduce the withdrawal symptoms.
Symptoms of prolonged hypogonadism may persist for up to three months following the last injection of AAS.
If your symptoms persist even after three months, your body has not fully recovered. This recovery period is typically characterized by low testosterone, low gonadotrophins, and low SHBG.
This means that the HPG axis should be partially recovered after this time. If the symptoms persist, your doctor may want to check your history of drug use and current intake of selective oestrogen receptor modulators.
The physical and psychological symptoms of withdrawal are not life-threatening, but they should not be taken lightly.
Proper care can help reduce the symptoms and help you maintain sobriety from steroids. The first few days of withdrawal can be difficult and uncomfortable for the former steroid user. But if you are committed to recovery, there are many treatment options available to you.
While there are several options available for prolonged hypogonadism following AAS use, many clinicians assume the condition will resolve on its own.
As a result, they suggest biochemical monitoring and wait for biochemical improvement. This is a passive approach to treatment, and may be unsuitable for some former AAS users.
Moreover, it does not address the hypogonadal symptoms. Further studies are needed to understand whether 'watchful waiting' approaches are acceptable to former AAS users.
AAS withdrawal is associated with symptoms that range from headaches to fatigue, depression, and insomnia.
These symptoms can affect the psyche of the patient, and they may even result in suicidal ideation. Therefore, it is important to evaluate novel therapies against the effects of withdrawal from AAS.
Treatment for hypogonadism
In the United States, 2.9 to 4.0 million men report using anabolic steroids (AAS). Long-term misuse of AAS can cause prolonged hypogonadism.
Symptoms can include impaired erectile function and decreased libido, and can result in severe depression and suicide attempts.
Low testosterone affects one in 50 men and is often the cause of sexual dysfunction and other issues.
It can cause low libido, problems with erections, low energy, and difficulty sleeping. While the majority of men develop low-T symptoms as they age, some men are diagnosed with low-T as early as their twenties.
Men who suffer from low testosterone may be at a higher risk for other conditions, such as depression and high blood pressure.
An evaluation for low testosterone should begin with a visit to a primary care physician. Blood samples should be obtained at least twice a day, preferably the first thing in the morning.
Blood samples taken at other times of the day will not be reliable. In addition to blood tests, doctors will also use blood tests to assess liver function and lipid levels.
Synthetic hormone replacement treatments (such as testosterone replacement therapy) for low testosterone may cause a variety of side effects, including infertility and an increased risk of cardiovascular disease.
In addition, topical treatments may rub off on nearby skin, which can also affect others.
A more sophisticated treatment for low testosterone may involve a transplant of lab-grown cells that produce testosterone. However, the procedure is labor-intensive and can also have other side effects.
While the symptoms of low testosterone are most common in older men, there are many causes for it.
Other conditions, such as high blood pressure, diabetes, and depression, may also be responsible. For men with these symptoms, treatment is often necessary.
Time can be a healer
The treatment for this condition varies, depending on the type and duration of AAS use. In symptomatic patients, testosterone levels usually return to pre-AAS levels within six months of discontinuation.
If depressive symptoms persist, an antidepressant may be prescribed to alleviate the symptoms.
In cases where the cause of the condition is substance-dependence, treatment may also include therapy addressing substance-dependence issues.
A significant minority of men who develop hypogonadism after AAS use develop depression.
However, the frequency of such episodes varies among individuals. A few hypogonadal men show severe depressive symptoms. Some men may be attracted to resuming AAS use because of these symptoms.
In addition, repeated AAS use can result in AAS dependence. This phenomenon is known as "hooked-on-hormones syndrome."
The prevalence of AAS use is rising worldwide. It is estimated that 1% to 5% of the adult population uses AAS.
However, there is limited evidence about effective interventions for cessation or for the treatment of the consequences of AAS use.
Nevertheless, the growing evidence indicates that this drug use has an effect on the human body. It has the potential to cause adverse health effects, so the use of AAS has become a major public health issue.
After anabolic steroid use, the symptoms of hypogonadism may persist for at least 3 months. During this time, the HPG axis is expected to be at least partially recovered.
If symptoms persist after three months, the patient should be asked about any previous or current steroid use. Also, he should be questioned about any current use of selective oestrogen receptor modulators or aromatase inhibitors.
The use of AAS has long-term effects on sexual function and hypogonadism in males. In one study of 36 AAS users, researchers found that hypogonadism and decreased libido were common symptoms.
The men had a decrease in testicular volume and reduced serum T levels. Furthermore, two of the subjects failed to regain their normal libido.
The best way to diagnose this condition is to consult a medical doctor or a doctor with expertise in this area.
In addition, the healthcare provider should investigate the underlying cause of the patient's condition, including comorbid mental health conditions or substance abuse disorders.
Synthetic hormones
TRT (trans-resorptive therapy) is a treatment option for central hypogonadism that increases sperm production. It is a synthetic hormone that is injected into the testicles.
While it can increase testosterone and sperm levels, it also has side effects including liver damage and aggression.
Currently, Dr. Kerendian does not recommend this treatment option for most of his patients. Other treatment options for central hypogonadism include gonadotropins. These hormones can induce puberty in prepubertal boys.
Natural options
Men experiencing hypogonadism may have hot flashes, fatigue, and decreased sex drive. After a thorough physical exam, a physician can diagnose the condition and determine a treatment plan.
This treatment option is typically based on testosterone replacement therapy, but some nutritionists may supplements. These supplements may contain fenugreek, Ashwagandha, boron, or antioxidant vitamins.
Hypogonadism is a congenital disorder in which the male and female sex glands don't produce enough testosterone or progesterone.
It can lead to long-term health complications. In addition to impairing sexual ability, untreated hypogonadism can increase the risk of obesity, osteoporosis, and muscle weakness.
Although TRT is considered the standard treatment, it is not recommended for men who wish to preserve their fertility, have severe cardiovascular disease, or polycythemia.
Alternative treatments are available and include lifestyle changes such as optimal nutrition and exercise.
Conclusion
Long-term misuse of anabolic steroids (AAS) is associated with hypogonadism in males. It is also associated with substantial morbidity, particularly during withdrawal.
In this study, we assessed the incidence and severity of hypogonadal symptoms in twenty-four AAS users.
Anabolic steroids are a class of drugs that work by binding to androgen receptors in the brain.
By doing this, they activate the cells in the body that build muscle mass. AAS are available in several forms, including testosterone esters like testosterone enanthate, testosterone cypionate, and testosterone undecanoate. In some cases, they may also be used for medical reasons.
In the United States, about 3% to 4% of males and 1% of females use anabolic steroids. The prevalence of AAS use in males is unknown, but conservative estimates suggest that use is common in between twenty-four and forty-four year-olds.
In addition, AAS use has long-term effects on health, affecting the metabolism and heart. Chronic AAS use increases the risk of cardiovascular disease and abnormal blood lipids.
The mechanisms underlying the onset of hypogonadism following AAS use are not fully understood, but different mechanisms may be at play in different subgroups of AAS users.
Some AAS users show incomplete recovery of gonadotrope function while others develop hypogonadotropic hypogonadism. In some cases, however, men can restore HPT function through treatment with gonadotropin-releasing hormone agonists or drugs mimicking LH and FSH.
