Clinical Opal - Androgen abuse recovery in a younger male
Jeremy is a 22-year-old who presents with low energy, fatigue, weaker erections and decreasing libido. He plays football and works out at the gym a few times a week.
Jeremy’s physical examination shows a moderate reduction in testes size of approximately 10ml. Jeremy’s blood tests return with total testosterone extremely low at 1.2nmol/L, and LH 1IU/L, indicating secondary hypogonadism along with a high creatinine (124umol/L) and haematocrit (55%) and upper normal haemoglobin (178g/L).
What do these results suggest?
In this case Jeremy’s symptoms and clinical findings are consistent with withdrawal from androgenic steroids used for muscle and performance enhancement. Other diagnoses have been excluded. This presents as transient hypogonadotropic hypogonadism. His pituitary function will recover over time.
Jeremy’s recovery may take many months depending mainly on the time since cessation. The outlook for recovery of fertility and testosterone production is generally good but prolonged. The support of an interdisciplinary team including the general practitioner, endocrinologist and psychologist can help to support Jeremy.
Learn more in our Androgen use, misuse and abuse online learning modules.
References:
Handelsman DJ. Androgen Physiology, Pharmacology, Use and Misuse. In: Feingold et al., editors. Endotext available from: https://www.ncbi.nlm.nih.gov/books/NBK279000/
Anawalt, 2019. Diagnosis and Management of Anabolic Androgenic Steroid Use. The Journal of Clinical Endocrinology & Metabolism
Christou & Tigas, 2018. Recovery of reproductive function following androgen abuse. Current Opinion in Endocrinology, Diabetes and Obesity
Become a member and get unlimited access to 100s of hours of premium education.
Learn moreSuccessful resuscitation attempts rely on the optimisation of cerebral and coronary perfusion. For this to occur it is important to work like a NASCAR pit crew and deliver high performance CPR.
Laser safety in operating theatres is crucial for staff and patient protection. Implementing training, protective eyewear, safety protocols, and controlled access ensures effective surgical procedures and minimises risks like tissue damage. Prioritising these measures enhances overall procedural safety and effectiveness.
Recognising and responding appropriately to student disclosure of sexual violence at educational institutes is urgently needed to mitigate the significant adverse mental and behavioural outcomes of such conduct.