[Russian] Peculiarity of Recovery of The Hypothalamic-Pituitary-Gonadal (HPG) Axis, In Men After Using Androgenic Anabolic Steroids
RATIONALE . Spontaneous restoration of the pituitary-gonadal system after the use of testosterone preparations for the purpose of hormone replacement therapy or for male contraception occurs from several months to 2 years. There is insufficient data on the timing of the restoration of the pituitary-gonadal system after abuse of androgenic anabolic steroids. Testosterone users use post-cycle therapy to restore the pituitary-gonadal system, the effectiveness of which is unknown and requires study.
TARGET. To evaluate the restoration of the pituitary-gonadal system in male users of androgenic anabolic steroids against the background of a 3-month refusal to administer them and the use of post-cycle therapy.
METHODS . An observational, single-center, prospective, selective, open-label, uncontrolled study among male users of androgenic anabolic steroids. While taking the drugs and 3 months after refusing them and conducting post-cycle therapy, the clinical symptoms of hypogonadism were taken into account, the concentrations of luteinizing (LH) and follicle-stimulating (FSH) hormones, total testosterone ( Ttot ), prolactin, estradiol, inhibin B, thyroid stimulating hormone were determined (TSH). The post-cycle therapy regimen was the same and did not change throughout the study. Recovery criteria: T total> 3.4 ng / ml and LH> 1.24 mIU / ml.
The study was conducted from January to August 2019. We used Fisher's exact test, Mann-Whitney U-test, Spearman's rank correlation coefficient. Differences were considered statistically significant at p <0.05.
RESULTS . The study was completed by 44 men, average age 29 [27.75; 34] years, the duration of use of androgenic anabolic steroids 6 [3.52; 7] months. Against the background of steroid use: LH 0.2 [0.04; 0.47] mIU / ml, T total 4.34 [1.05; 8.81] ng / ml.
In this group, there were 84% ( n = 37) men with LH levels <1.24 mIU / ml and 47.7% ( n = 21) participants with T total <3.4 ng / ml. After 3 months, the LH index reached 4.12 [2.58; 5.84] mIU / ml, Ttot - 4.55 [3.76; 6.24] ng / ml, while the level of T commonly <3.4 ng / ml% remained at 20.5 ( n = 9) and LH <1.24 mIU / ml -% y 4.5 ( n = 2) men.
According to the level of recovery of production of LH and T total the surveyed were divided into two groups: with sufficient ( n = 35; 79.5%) and insufficient ( n = 9; 20.5%) recovery.
A significant correlation was established between the duration of use (-0.857; p <0.0001), the amount (-0.443; p = 0.003), dose (-0.7825; p <0.0001), the type of steroid used (-0.698; p <0.0001) and restoration of the concentration of T total . A correlation between the inhibin B and T Society (0.418; p = 0.005).
CONCLUSION . A three-month refusal to use androgenic anabolic steroids against the background of post-cycle therapy restored the pituitary-gonadal system in 79.5% of volunteers. A negative effect on the restoration of the pituitary-gonadal system of the type of androgenic anabolic steroids, the duration and dose of their use, as well as the amount of simultaneously administered drugs, was established. Inhibin B level can serve as a marker of spermatogenic epithelium restoration.
Lykhonosov MP, Babenko AY, Makarin VA, Fedotov YN. [Peculiarity of recovery of the hypothalamic-pituitary-gonadal (hpg) axis, in men after using androgenic anabolic steroids]. Probl Endokrinol (Mosk). 2020 Aug 4;66(1):104-112. Russian. doi: 10.14341/probl12223. PMID: 33351319. https://www.probl-endojournals.ru/jour/article/view/12223 (Особенности восстановления системы гипофиз-гонады у мужчин после использования андрогенных анаболических стероидов | Лихоносов | Проблемы Эндокринологии)
RATIONALE . Spontaneous restoration of the pituitary-gonadal system after the use of testosterone preparations for the purpose of hormone replacement therapy or for male contraception occurs from several months to 2 years. There is insufficient data on the timing of the restoration of the pituitary-gonadal system after abuse of androgenic anabolic steroids. Testosterone users use post-cycle therapy to restore the pituitary-gonadal system, the effectiveness of which is unknown and requires study.
TARGET. To evaluate the restoration of the pituitary-gonadal system in male users of androgenic anabolic steroids against the background of a 3-month refusal to administer them and the use of post-cycle therapy.
METHODS . An observational, single-center, prospective, selective, open-label, uncontrolled study among male users of androgenic anabolic steroids. While taking the drugs and 3 months after refusing them and conducting post-cycle therapy, the clinical symptoms of hypogonadism were taken into account, the concentrations of luteinizing (LH) and follicle-stimulating (FSH) hormones, total testosterone ( Ttot ), prolactin, estradiol, inhibin B, thyroid stimulating hormone were determined (TSH). The post-cycle therapy regimen was the same and did not change throughout the study. Recovery criteria: T total> 3.4 ng / ml and LH> 1.24 mIU / ml.
The study was conducted from January to August 2019. We used Fisher's exact test, Mann-Whitney U-test, Spearman's rank correlation coefficient. Differences were considered statistically significant at p <0.05.
RESULTS . The study was completed by 44 men, average age 29 [27.75; 34] years, the duration of use of androgenic anabolic steroids 6 [3.52; 7] months. Against the background of steroid use: LH 0.2 [0.04; 0.47] mIU / ml, T total 4.34 [1.05; 8.81] ng / ml.
In this group, there were 84% ( n = 37) men with LH levels <1.24 mIU / ml and 47.7% ( n = 21) participants with T total <3.4 ng / ml. After 3 months, the LH index reached 4.12 [2.58; 5.84] mIU / ml, Ttot - 4.55 [3.76; 6.24] ng / ml, while the level of T commonly <3.4 ng / ml% remained at 20.5 ( n = 9) and LH <1.24 mIU / ml -% y 4.5 ( n = 2) men.
According to the level of recovery of production of LH and T total the surveyed were divided into two groups: with sufficient ( n = 35; 79.5%) and insufficient ( n = 9; 20.5%) recovery.
A significant correlation was established between the duration of use (-0.857; p <0.0001), the amount (-0.443; p = 0.003), dose (-0.7825; p <0.0001), the type of steroid used (-0.698; p <0.0001) and restoration of the concentration of T total . A correlation between the inhibin B and T Society (0.418; p = 0.005).
CONCLUSION . A three-month refusal to use androgenic anabolic steroids against the background of post-cycle therapy restored the pituitary-gonadal system in 79.5% of volunteers. A negative effect on the restoration of the pituitary-gonadal system of the type of androgenic anabolic steroids, the duration and dose of their use, as well as the amount of simultaneously administered drugs, was established. Inhibin B level can serve as a marker of spermatogenic epithelium restoration.
Lykhonosov MP, Babenko AY, Makarin VA, Fedotov YN. [Peculiarity of recovery of the hypothalamic-pituitary-gonadal (hpg) axis, in men after using androgenic anabolic steroids]. Probl Endokrinol (Mosk). 2020 Aug 4;66(1):104-112. Russian. doi: 10.14341/probl12223. PMID: 33351319. https://www.probl-endojournals.ru/jour/article/view/12223 (Особенности восстановления системы гипофиз-гонады у мужчин после использования андрогенных анаболических стероидов | Лихоносов | Проблемы Эндокринологии)
