How would you design trials to investigate PCT/ASIH?
Trials of different recovery medication protocols and subsequent expert opinion may remain the only methods to study the treatment of men after nonprescription AAS use. Although the increase in inappropriate TRT might provide a basis for some study.
How a medical provider feels about managing these patients and the consequences of their use from both a fertility and sexual standpoint is difficult to ascertain because the ASIH might be lifelong. This is an area of extreme paranoia for almost ALL physicians. They are afraid to treat or even see these patients. And, when they do they commonly do nothing!
The only analogous studies to investigate the recovery from AAS are the trials that have used T as a male contraceptive agent. The largest and longest study by Gu et al. in 2009 demonstrated that after a loading dose of 1,000 mg of T IM and 500 mg once a month for 30 months, the median recovery time for sperm production to the patient's baseline after cessation of the treatment alone was 182 days (5). All but two of 729 patients recovered spermatogenesis by 15 months. Gu Y, Liang X, Wu W, Liu M, Song S, Cheng L, et al. Multicenter contraceptive efficacy trial of injectable testosterone undecanoate in Chinese men. J Clin Endocrinol Metab 2009;94:1910–5. http://press.endocrine.org/doi/full/10.1210/jc.2008-1846
Tan RS, Scally MC. Anabolic steroid-induced hypogonadism--towards a unified hypothesis of anabolic steroid action. Med Hypotheses 2009;72(6):723-8. http://www.asih.net/ASIH – Towards a unified hypothesis of anabolic steroid action.pdf
Trials of different recovery medication protocols and subsequent expert opinion may remain the only methods to study the treatment of men after nonprescription AAS use. Although the increase in inappropriate TRT might provide a basis for some study.
How a medical provider feels about managing these patients and the consequences of their use from both a fertility and sexual standpoint is difficult to ascertain because the ASIH might be lifelong. This is an area of extreme paranoia for almost ALL physicians. They are afraid to treat or even see these patients. And, when they do they commonly do nothing!
The only analogous studies to investigate the recovery from AAS are the trials that have used T as a male contraceptive agent. The largest and longest study by Gu et al. in 2009 demonstrated that after a loading dose of 1,000 mg of T IM and 500 mg once a month for 30 months, the median recovery time for sperm production to the patient's baseline after cessation of the treatment alone was 182 days (5). All but two of 729 patients recovered spermatogenesis by 15 months. Gu Y, Liang X, Wu W, Liu M, Song S, Cheng L, et al. Multicenter contraceptive efficacy trial of injectable testosterone undecanoate in Chinese men. J Clin Endocrinol Metab 2009;94:1910–5. http://press.endocrine.org/doi/full/10.1210/jc.2008-1846
Tan RS, Scally MC. Anabolic steroid-induced hypogonadism--towards a unified hypothesis of anabolic steroid action. Med Hypotheses 2009;72(6):723-8. http://www.asih.net/ASIH – Towards a unified hypothesis of anabolic steroid action.pdf
