Clomiphene citrate and optional human chorionic gonadotropin for treating male hypogonadism arising from long-term anabolic-androgenic steroid use—A pilot study DOI Creative Commons
Hans Christian Bordado Henriksen, Anders Palmstrøm Jørgensen, Astrid Bjørnebekk

et al.

Performance Enhancement & Health, Journal Year: 2024, Volume and Issue: 12(3), P. 100283 - 100283

Published: May 18, 2024

Long-term anabolic-androgenic steroid (AAS) use poses several health risks, including secondary hypogonadism. There is a knowledge gap on treatment targeting the hypothalamic-pituitary-gonadal (HPG) axis among men with anabolic steroid-induced hypogonadism (ASIH). This study aims to gain insights into potential utility of endocrine therapy restore endogenous testosterone levels and alleviate ASIH symptoms in AAS dependent men. In this proof-of-concept, single-site, open longitudinal pilot study, continuous desire permanently discontinue use, were given therapy. The included 25 mg clomiphene citrate (CC) every second day for 16 weeks, transdermal daily during first four if indicated, human chorionic gonadotropin (hCG) injections maximum eight weeks. Physical exams blood collection online questionnaires completed two respectively. Ten participants, median age 32 years (interquartile range 30–45), mean ± standard deviation 11 4 years, CC intervention. Seven participants received hCG as part their protocol. Mild adverse events headaches, dizziness, mood swings, no serious occurred. During intervention, there was decrease hematocrit, hemoglobin ALT (alanine aminotransferase), well an increase serum FSH (follicle stimulating hormone), LH (luteinizing hormone) SHBG (sex hormone binding globulin). Five ten reached total level within normal (9–30 nmol/l). HPG response varied greatly not aligned severity related withdrawal symptoms. findings from proof-of-concept may guide future randomized controlled trials aiming investigate therapeutic approaches ASIH.

Language: Английский

Cardiovascular Disease in Anabolic Androgenic Steroid Users DOI Creative Commons
Josefine Windfeld‐Mathiasen, Ida M. Heerfordt, Kim Dalhoff

et al.

Circulation, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 13, 2025

BACKGROUND: Use of anabolic androgenic steroids (AASs) is associated with increased mortality, and case reports have suggested that some these deaths are due to cardiovascular disease. However, the epidemiology disease in AAS users still relatively unexplored. This study aimed measure incidence male compare rates those a cohort from general population matched by age sex. METHODS: Men sanctioned an antidoping program for use Danish fitness centers between 2006 2018 were included sex 50 times as many controls population. The was followed until June 30, 2023. Using nationwide registries, we obtained information on admissions, prescriptions, educational length, occupational status both controls. investigated acute myocardial infarction, percutaneous coronary intervention, or artery bypass graft, venous thromboembolism, ischemic stroke, arrhythmia, cardiomyopathy, heart failure, cardiac arrest during follow-up period. RESULTS: During average 11 years follow-up, (n=1189) demonstrated significantly higher several events compared (n=59 450). Correspondingly, AASs risk infarction (adjusted hazard ratio [aHR] 3.00 [95% CI, 1.67–5.39]), intervention graft (aHR 2.95 1.68–5.18]), thromboembolism 2.42 1.54–3.80]), arrhythmias 2.26 1.53–3.32]), cardiomyopathy 8.90 4.99–15.88]), failure 3.63 2.01–6.55]). Due limited number stroke cases among users, outcomes not reportable. CONCLUSIONS: substantially large long

Language: Английский

Citations

3
Injury and Poisoning Profile in Anabolic Steroid Users DOI Creative Commons
Josefine Windfeld‐Mathiasen,

Morten Tulstrup,

Ida M. Heerfordt

et al.

Annals of Emergency Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: March 1, 2025

This study investigated the 1-year risk of injuries and poisonings among anabolic androgenic steroid users compared with controls from general population. In a cohort conducted in Denmark, 1,189 were identified through national antidoping program matched 59,450 controls. Participants followed for 1 year. Data on hospital contacts, educational length, occupational status retrieved nationwide registries. The primary outcomes incidence poisonings. secondary differentiated between fracture nonfracture injuries, medicinal versus nonmedicinal causes poisonings, described specific injury-related contacts. Anabolic had significantly higher incidences difference any injury was 7.8% (95% confidence interval [CI] 5.5 to 10.2) adjusted hazard ratio (aHR) 1.46 CI 1.29 1.66). Specifically, fractures more than doubled (aHR 2.23, 95% 1.72 2.89), head being particularly prevalent. poisoning 1.2% 0.5 1.9) aHR 2.98 1.82 4.90). Medicinal most common users, an 3.53 1.94 6.41). use is associated increased both thereby quantifying substantial external harm users.

Language: Английский

Citations

2
The Roles of Androgens in Humans: Biology, Metabolic Regulation and Health DOI Open Access
M. Alemany

International Journal of Molecular Sciences, Journal Year: 2022, Volume and Issue: 23(19), P. 11952 - 11952

Published: Oct. 8, 2022

Androgens are an important and diverse group of steroid hormone molecular species. They play varied functional roles, such as the control metabolic energy fate partition, maintenance skeletal body protein integrity development brain capabilities behavioral setup (including those factors defining maleness). In addition, androgens precursors estrogens, with which they share extensive reproductive mechanisms (in both sexes). this review, types androgens, their functions signaling tabulated described, including some less-known functions. The close interrelationship between corticosteroids is also analyzed, centered in adrenal cortex, together main feedback systems hypothalamic-hypophysis-gonads axis, its modulation by environment, sex, age health. Testosterone (T) singled out because high synthesis rate turnover, but age-related hypogonadism a key signal for biologically planned early obsolescence men, delayed onset faster losses women after menopause. collaboration T estradiol (E2) active presented Their parallel insufficiency has been directly related to ravages senescence syndrome constellation disorders. clinical use correct hypoandrogenism helps maintain functionality core metabolism, limiting excess fat deposition, sarcopenia cognoscitive frailty (part these effects due E2 generated from T). effectiveness using lipophilic esters replacement treatments analyzed depth, problems derived application discussed.

Language: Английский

Citations

61
Cardiovascular safety of testosterone replacement therapy in men: an updated systematic review and meta-analysis DOI
Giovanni Corona, Giulia Rastrelli, Clotilde Sparano

et al.

Expert Opinion on Drug Safety, Journal Year: 2024, Volume and Issue: 23(5), P. 565 - 579

Published: March 30, 2024

Introduction The cardiovascular (CV) safety of testosterone (T) replacement therapy (TRT) is still conflicting. Recent data suggested a TRT-related increased risk atrial fibrillation (AF). To systematic review and meta-analyze CV related to TRT as derived from placebo controlled randomized trials (RCTs).

Language: Английский

Citations

6
Haematological actions of androgens DOI
Annabelle M. Warren, Mathis Grossmann

Best Practice & Research Clinical Endocrinology & Metabolism, Journal Year: 2022, Volume and Issue: 36(5), P. 101653 - 101653

Published: April 1, 2022

Language: Английский

Citations

28
Approach to the Patient: The Evaluation and Management of Men ≥50 Years With Low Serum Testosterone Concentration DOI Creative Commons
Mathis Grossmann, Channa Jayasena, Bradley D. Anawalt

et al.

The Journal of Clinical Endocrinology & Metabolism, Journal Year: 2023, Volume and Issue: 108(9), P. e871 - e884

Published: March 30, 2023

Although testosterone replacement in men with classic hypogonadism due to an identified pathology of the hypothalamic-pituitary-testicular axis is uncontroversial, role treatment for age-related declines circulating unclear. This lack large, long-term therapy trials assessing definitive clinical endpoints. However, ≥50 years age, particularly those who have a body mass index >25 kg/m2 and multiple comorbidities, commonly present features androgen deficiency low serum concentrations. Clinicians are faced question whether initiate therapy, difficult dilemma that entails benefit-risk analysis limited evidence from trials. Using case scenario, we practical approach assessment management such men.

Language: Английский

Citations

12
Testosterone therapy and cardiovascular diseases DOI Open Access
Antonio Cittadini, Andrea M. Isidori, Andrea Salzano

et al.

Cardiovascular Research, Journal Year: 2021, Volume and Issue: 118(9), P. 2039 - 2057

Published: July 20, 2021

Since it was first synthesized in 1935, testosterone (T) has been viewed as the mythical Fountain of Youth, promising rejuvenation, restoring sexual appetites, growing stronger muscles, and quicker thinking. T is endowed with direct effects on myocardial vascular structure function, well risk factors for cardiovascular (CV) disease. Indeed, low serum levels are a factor diabetes, metabolic syndrome, inflammation, dyslipidaemia. Moreover, many studies have shown that deficiency per se an independent CV all-cause mortality. On this background due to direct-to-patient marketing by drug companies, we witnessed widespread use replacement therapy without clear indications particularly late-life onset hypogonadism. The current review will dwell upon evidence controversies surrounding role pathophysiology diseases, link between circulating risk, replacing possible adjuvant treatment specific disorders. Specifically, recent findings suggest heart failure type 2 diabetes mellitus represent two potential targets once state hypogonadism diagnosed. However, only if ongoing solve safety issue orchid may eventually 'bloom'.

Language: Английский

Citations

27
Psychiatric morbidity among men using anabolic steroids DOI Open Access
Josefine Windfeld‐Mathiasen, Thea Christoffersen,

Niels August Willer Strand

et al.

Depression and Anxiety, Journal Year: 2022, Volume and Issue: 39(12), P. 805 - 812

Published: Oct. 25, 2022

Objective The purpose of this study was to investigate the psychiatric morbidity among men with abuse anabolic steroids. Methods design is a retrospectively matched cohort study. Five hundred and fourty-five males, who tested positive for steroids in Danish fitness centers during period January 3, 2006 March 1, 2018, were 5450 randomly chosen male controls. Data cross-referenced seven national registers pertaining information about education, employment status, comorbidity. Main outcomes measures prescription psychopharmacological treatment. Results incidence treatment anxiolytics (HR: 2.34, 95% CI: 1.62−3.38) antipsychotics 2.69, 1.99−3.63) displayed remarkable increase years following doping sanction, compared control group. prevalence antidepressant use already markedly elevated several before but also higher sanction 1.65, 1.28−2.13). associations remained highly significant after controlling socioeconomic factors. Conclusion Anabolic strongly associated morbidity.

Language: Английский

Citations

19
Ageing male (part I): Pathophysiology and diagnosis of functional hypogonadism DOI
Ilpo Huhtaniemi, Frederick C. W. Wu

Best Practice & Research Clinical Endocrinology & Metabolism, Journal Year: 2022, Volume and Issue: 36(4), P. 101622 - 101622

Published: Feb. 11, 2022

Language: Английский

Citations

18
Community pharmacy’s role in dispensing androgens and supporting harm reduction amid current policy dilemmas DOI Creative Commons
Timothy Piatkowski,

Lkhagvadulam Ayurzana,

Michelle A. King

et al.

Substance Abuse Treatment Prevention and Policy, Journal Year: 2025, Volume and Issue: 20(1)

Published: Jan. 18, 2025

Legitimate androgen use, such as testosterone replacement therapy, requires a legal prescription. Off-label use for reasons like wellness and aesthetics continues to grow. Recent regulatory changes in Australia aim curb non-prescribed potentially intensifying stigma, however seeking prescriptions through channels persists. This study aimed explore community pharmacists' knowledge, attitudes, practices regarding individuals who androgens. We conducted semi-structured interviews with 15 pharmacists, knowledge experiences related the dispensing of The data analysis followed an iterative process, developing codebook thematic aligning findings relevant literature. Pharmacists face challenges when meeting needs using They often made judgments based on appearance, leading stigmatisation potential refusal prescription supply. However, this is tempered by complex environment that pharmacists work respect professional requirements. Limited about androgens varying exposure people were evident, prompting unanimous desire tailored training, especially communication skills interaction strategies. Facilitating within regulated healthcare settings, under medical supervision, crucial mitigating health risks. Varied pharmacist underscores urgent need targeted emphasising education initiatives address structural stigma inform policies globally.

Language: Английский

Citations

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