title: Anabolic steroid-induced hypogonadism: diagnosis and treatment.
abstract: OBJECTIVE
  To develop an understanding of hypogonadal men with a history of anabolic-androgenic steroid (AAS) use and to outline recommendations for management.
  
  
  METHODS
  Review of published literature and expert opinions. Intended as a meta-analysis, but no quality studies met the inclusion criteria.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Men seeking treatment for symptomatic hypogonadism who have used nonprescribed AAS.
  
  
  METHODS
  History and physical examination followed by medical intervention if necessary.
  
  
  METHODS
  Serum testosterone and gonadotropin levels, symptoms, and fertility restoration.
  
  
  RESULTS
  Symptomatic hypogonadism is a potential consequence of AAS use and may depend on dose, duration, and type of AAS used. Complete endocrine and metabolic assessment should be conducted. Management strategies for anabolic steroid-associated hypogonadism (ASIH) include judicious use of testosterone replacement therapy, hCG, and selective estrogen receptor modulators.
  
  
  CONCLUSIONS
  Although complications of AAS use are variable and patient specific, they can be successfully managed. Treatment of ASIH depends on the type and duration of AAS use. Specific details regarding a patient's AAS cycle are important in medical management.
authors.affiliation: University of Tennessee Graduate School of Medicine, Knoxville, Tennessee.
authors.forename: Cyrus D
authors.initials: CD
authors.lastname: Rahnema
authors.affiliation: Scott Department of Urology, Baylor College of Medicine, Houston, Texas.
authors.forename: Larry I
authors.initials: LI
authors.lastname: Lipshultz
authors.affiliation: University of Tennessee Graduate School of Medicine, Knoxville, Tennessee.
authors.forename: Lindsey E
authors.initials: LE
authors.lastname: Crosnoe
authors.affiliation: Scott Department of Urology, Baylor College of Medicine, Houston, Texas.
authors.forename: Jason R
authors.initials: JR
authors.lastname: Kovac
authors.affiliation: University of Tennessee Graduate School of Medicine, Knoxville, Tennessee. Electronic address: ekim@utmck.edu.
authors.forename: Edward D
authors.initials: ED
authors.lastname: Kim
mesh_terms: D045930:Anabolic Agents / Q000009:adverse effects*; D006801:Humans; D007006:Hypogonadism / Q000139:chemically induced* / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D020127:Recovery of Function; D016896:Treatment Outcome
chemical_list: D045930:Anabolic Agents
keywords: Anabolic-androgenic steroids; androgens; clomiphene citrate; erectile dysfunction; gynecomastia; human chorionic gonadotropin; hypogonadotropic hypogonadism; tamoxifen; testicular atrophy