IMPACT OF ANABOLIC STEROIDS AND IMPAIRMENT MECHANISM OF REPRODUCTIVE FUNCTION

Abstract

Introduction. The male factor accounts for approximately 30-50% of infertility. A common cause of male infertility is the abuse of anabolic substances. Men's interest in strength training has contributed to the excessive use of anabolic steroids, sports supplements and other auxiliary substances, to improve muscle strength, without paying attention to the long-term side effects. The study was conducted to investigate the effect of anabolic substances on male fertility.

Materials and method. Scopus, Pubmed, Medline, Science Direct, Google Scholar databases were searched using the Medical Subjects Headings index and the keywords "anabolic androgenic steroids", "testosterone", "male infertility", "spermatogenesis". From the initial 7170 articles extracted, after reviewing the title, abstract and inclusion and exclusion criteria, we included 43 articles in the final study.

Results. Anabolic drugs have long-term effects on the male reproductive system and disrupt spermatogenesis through four distinct mechanisms, including direct effects on gametes, alteration of the hypothalamic-pituitary-gonadal axis, erectile dysfunction, and decreased libido. Reducing endogenous testosterone production and suppressing spermatogenesis takes place by inhibiting the negative feedback of luteinizing hormone and follicle-stimulating hormone levels. Most side effects are reversible after discontinuation of treatment, but long-term use during reproductive ages and testicular development stages disturbs sperm parameters. Insufficient information has been reported on the time required to restore male fertility after discontinuation of treatment.

Conclusions. The use of anabolic steroids has obvious adverse effects on male reproductive health. Anabolic steroids can be beneficial when used therapeutically, their non-medical use or abuse leads to impairment of hypothalamic-pituitary-gonadal functions, increased DNA fragmentation and sperm apoptosis and reduced sperm quality. More studies with an appropriate methodological and statistical approach are needed to assess the effects and mechanisms of impact related to substance use on male fertility.