Journal Article

SUN-LB038 Rate and Extent of Testicular Function Recovery after Ceasing Non-Prescribed Androgen Abuse

Handelsman, David, Shankara Narayana, Nandini, Kritharides, Leonard, Yu, Christopher, Desai, Reena, Turner, Leo, Conway, Ann, Fennell, Carolyn, Jayadev, Veena, Savkovic, Sasha

2019

Overview

Supraphysiological androgen administration suppresses testicular functions causing reduced sperm output and testosterone secretion. The rate and extent of testicular function recovery after cessation is not known beyond anecdotal reports. As an illicit activity, androgen abuse is difficult to study prospectively so we undertook a cross-sectional, observational study of current and past androgen abusers together with healthy, eugonadal non-users to determine the rate and extent of recovery of sperm output and reproductive hormones after cessation of androgen intake. We recruited (via social media) age-matched (mean 34 years), regularly exercising volunteers comprising 41 current and 31 past users (≥3 months since last use) with 21 healthy, eugonadal non-users. Each underwent physical examination and provided serum (reproductive hormones, steroids by LC-MS; LH, FSH, SHBG, hematology and biochemistry by routine methods) and semen sample (WHO). Current users, compared with past and non-users, had significant suppression of mean orchidometric testicular volume (TV, 14.3, 18.6, 23.2 ml), sperm output (excluding 6 vasectomized men, median 104, 173, 189 million/ejaculate) and mean serum LH (0.5, 5.5,5.2 IU/L), FSH (0.5, 4.7, 4.9 IU/L), SHBG (17.2,33.9,42.0 IU/L) and HDL cholesterol (0.64, 1.10,1.21 mM) with significant increases in serum T (38.5, 6.2,8.6 ng/ml), DHT (1.5, 0.5, 0.7 ng/ml), E2 (146,41,48 pg/ml), E1 (65,32,38 pg/ml), 3α-androstanediol (2.2, 0.4, 0.6 ng/ml), hemoglobin (164, 154,151 g/l) and triglycerides (1.32,1.02,0.91 mM). All but TV and SHBG were not significantly different between past (median 300 days since last use) and non-users consistent with full recovery. Rate of recovery for androgen-suppressed variables, estimated as the time to reach the mean for non-users, was 9 months for serum LH, 14.2 months for sperm output and 18.7 months for serum FSH. We conclude that suppressed testicular function due to androgen abuse is mostly reversible (apart from persistent TV reduction) with recovery taking between 9 to 18 months or longer after ceasing androgen intake. Suppressed serum LH and FSH represent convenient, useful and underutilized markers of androgen abuse and recovery. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. Abstracts presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.

• Publisher: Endocrine Society
• Subject: Reproductive Endocrinology