The World Health Organization (WHO) recently funded and designed a study evaluating the effect of a 30-month cycle of injectable testosterone undecanoate as a male contraceptive in over 1,000 Chinese men. Results from the June 2009 issue of Journal of Clinical Endocrinology & Metabolism were published online ahead of print. Monthly injections of 500mg of testosterone undecanoate were shown to be a “safe, effective, reversible and reliable contraception in a high proportion of [participants]”. Interestingly, the same side effects have been considered dangerous and deadly when they involve the non-medical use of steroids for performance enhancement (“Multicenter Contraceptive Efficacy Trial of Injectable Testosterone Undecanoate in Chinese Men,” March 17).
[The] present study results show that monthly 500 mg TU injections can provide effective, reversible, acceptable and readily delivered contraception for most healthy Chinese men without serious short-term adverse effects. While further regimen optimization to achieve uniform azoospermia and long-term safety studies are still required, these promising findings provide encouragement that male hormonal contraceptive regimens may offer a novel and workable alternative to existing family planning options for couples who can not or prefer not to use only female-oriented contraception throughout their reproductive years.
The study participants experienced the usual side effects most commonly associated with anabolic steroid use. Anti-steroid crusaders typically use these adverse reactions as the basis for the overstated and exaggerated steroid scare tactic campaigns. But scientists dispassionately researching the therapeutic applications of steroids consider the short-term use of steroids relatively safe.
Some of the reported steroid-related side effects in the study included “tenderness or discomfort at the injection sites “, “acne“, “severe coughing lasting minutes after injection“, “changes in mood or behavior” , “facial swelling or skin rash“, and mostly increases in libido.
Testosterone levels increased significantly above normal. The HPT axis was also disrupted.
As expected, mean serum T increased by 34% and serum LH and FSH were suppressed by 97% and 94% respectively at the end of the treatment.
Participants gained body weight and their testicles atrophied.
Body weight increases (0.4“1.6 kg) and total testis volume decreases (1.3“5.6 ml as 4“16% of testis volume) were significant during the exposure period.
There hemoglobin/hematocrit increased. And blood lipids were adversely affected.
The mean hemoglobin increased by 7%, mean total cholesterol decrease by 21%, HDL cholesterol by 23% and LDL cholesterol by 29% at the end of the efficacy phase.
Most of the adverse effects were completely reversible within a 12-month recovery period after the discontinuation of the 30-month cycle of testosterone. NO post cycle therapy utilized.
Body weight returned to pre-entry baseline value after recovery but testis volume recovery was incomplete for some men at the end of the recovery period. The mean total testis volume at the end of the recovery phase was decreased approximately 4%, compared to the baseline values; 28% of the participants demonstrated smaller total testis volume at the end of the recovery period, versus pre-entry baseline value.
Treatment protocols designed to normalize the HPTA axis after anabolic steroid cessation, such as those designed by Dr. Michael Scally, clearly would have enhanced and expedited recovery. The use of post-cycle therapy (PCT) by athletes and bodybuilders would have minimized the period of anabolic steroid-induced hypogonadism (ASIH).
The study concludes that side effects from the medical use of steroids are relatively minor; however apparently when the same side effects result from the non-medical use of steroids, they are potentially life-threatening.
About the author
Millard writes about anabolic steroids and performance enhancing drugs and their use and impact in sport and society. He discusses the medical and non-medical uses of anabolic-androgenic steroids while advocating a harm reduction approach to steroid education.
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