Anabolic androgenic steroid-induced hypogonadism, a reversible condition in male individuals? A systematic review

Anabolic androgenic steroid-induced hypogonadism, a reversible condition in male individuals? : A systematic review / José de Oliveira Vilar Neto, Carlos Alberto da Silva, Carlos Antônio Bruno da Silva, Daniel V. Pinto, Juan de Sá Roriz Caminha, Robson S. de Matos, Júlio C.C. Nunes Filho, Felipe R. Alves, Saulo C. Magalhães, Elizabeth De Francesco Daher. - (Andrologia (2021) e14062 (22 April))

  • PMID: 33887077
  • DOI: 10.1111/and.14062


The anabolic-androgenic steroids (AAS) are clinically used as an androgen replacement, in hypogonadism treatment, to induce puberty, and also in the treatment of chronic degenerative diseases. The AAS use out of clinical context is becoming massively, being used merely for aesthetic reasons. AAS abuse may cause severe disarrangement on the HPG axis and generate a significant decrease in testosterone synthesis and secretion by the testes. This review aims to evaluate whether the hypogonadism induced by AAS abuse is reversible and under what circumstances the reversibility is possible. For this, PRISMA guidelines and several databases are used between July and September 2020. Altogether, this systematic review identified and analysed 179 cases of AAS users. Of these, 168 cases had the hypogonadism clearly diagnosed and proven to be linked exclusively to AAS abuse. However, between these 168 cases, only 38 cases presented fully known outcomes and among these, merely in 4, the hypogonadism was completely reversible (2 based on drug therapy) with HPG axis recovery. In conclusion, this review presents evidences that AAS-induced hypogonadism is a seriously underestimated problem, and in the majority of cases, full recovery is very difficult to succeed.


22 April 2021
Alves, Felipe R.
Daher, Elizabeth Francesco
Filho, Júlio C.C. Nunes
Magalhães, Saulo C.
Matos, Robson S.
Neto, José Oliveira Vilar
Pinto, Daniel V.
Roriz Caminha, Juan Sá
Silva, Carlos Alberto
Silva, Carlos Antônio Bruno
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Universidade de Fortaleza (UNIFOR) - University of Fortaleza
Universidade Federal do Ceará (UFC) - Federal University of Ceará
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2 June 2021
Date of last modification
4 June 2021
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