Anabolic steroid-induced hypogonadism – Towards a unified hypothesis of anabolic steroid action
Introduction
The development of AAS compounds was originally for treatment of hypogonadal dysfunction and commencement of delayed puberty in men and for growth promotion [1]. AAS have, however, not always been used for pure medical purposes. Due to their anabolic effects, AAS became vastly popular among athletes, bodybuilders, and power lifters. Moreover, scientific and official court documents, including doctoral theses and scientific reports, demonstrate the positive effects of these and other hormonal drugs on muscle strength and performance in elite sports, which was common knowledge and had been in practice since the early 1960s [2].
Controversy raged for decades over the effectiveness of AAS in promoting muscle mass and muscle strength. Despite the admitted illicit use of AAS by athletes, the record breaking in Olympic events, and the obvious appearance in musculature enhancement, the medical and research community disputed and denied the AAS effects [3], [4]. After a considerable period of scientific controversy, it is now clear that anabolic–androgenic steroid hormones are effective in increasing both muscle mass and muscle strength [5].
Another of the beliefs held by the medical community deals with the period after anabolic steroid cessation, not their administration. The prevailing medical opinion is that clinically significant ASIH occurs from nonprescription AAS use but not from clinically prescribed AAS [6], [7]. The signs and symptoms of ASIH will necessarily impact upon our understanding for the clinical use of AAS. Additionally, these very same signs and symptoms might be instrumental in what has been described as AAS dependency.
Section snippets
Anabolic steroid-induced hypogonadism (ASIH)
Anabolic–androgenic steroids (AAS) are a class of compounds that include any drug or hormonal substance, chemically and pharmacologically related to testosterone that stimulates the growth or manufacturing of bone and muscle. It has long been held that nonprescription AAS use results in a functional type of hypogonadotropic hypogonadism. Boje was the first physician to suggest, in 1939, that AAS might enhance athletic performance, but he was also the first to forewarn athletes of potential
Psychological and behavioral effects
The association of AAS with adverse psychological and behavioral effects is extensive [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32]. Historically, researchers went so far as to categorically state that AAS are without any evidence upon muscle going so far as to argue that there is saturation of the androgen receptor with eugonadal levels of testosterone. This attitude spurned the concept that the large doses commonly used by illicit AAS users indicate that the drug use is for
Muscle effects
The idea that secretions of the testis might regulate body composition is as old as humanity itself. For decades, testosterone and testosterone analogues, anabolic–androgenic steroids (AAS), have long been used in the athletic community for improving muscle mass and muscle strength. Despite the obvious changes in musculature and appearance to even the most uninitiated, the academic community steadfastly refused to admit to any association. The scientific evidence shows the contrary to be true.
Future treatments
A treatment goal of HPTA restoration will have its basis in the regulation and control of testosterone production. The HPTA has two components, both spermatogenesis and testosterone production. In males, luteinizing hormone (LH) secretion by the pituitary positively stimulates testicular testosterone (T) production; follicle-stimulating hormone (FSH) stimulates testicular spermatozoa production. The pulsatile secretion of gonadotropin-releasing hormone (GnRH) from the hypothalamus stimulates LH
Discussion – a unified hypothesis
There are reports of the use of anabolic steroids by athletes since the 1950s to increase muscle size and strength to improve performance. Anabolic steroids use became more prominent in the athletic world, but use by the lay public has also increased. Long confined to bodybuilding and professional sports, the use of AAS is nowadays a problem that involves a wider population. In 2006, a report demonstrates that AAS use is common among males over 18 years [75]. In the United States, prevalence
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