[Prevalence of anabolic androgenic steroid use, its effect on the male pituitary-gonadal axis, and the possibility of reproductive rehabilitation].

The purpose of this review is to assess the prevalence of AA steroid use, to identify the steroids that are used, and to present the negative effects of AA steroids on the human body while describing the mechanisms of their actions on the male reproductive system. The review highlights the diagnostic features of steroid-induced hypogonadism, and assesses the effectiveness of various drugs in the reproductive rehabilitation of patients who cease taking AA steroids. Emphasis is placed on the feasibility and effectiveness of various drug treatments in the context of post cycle therapy (PCT), which seeks to stabilize and restore normal hormonal function. All this data is necessary for the development of modern treatment algorithms for steroid-induced hypogonadism in men.

[The medical aspect of using anabolic androgenic steroids in males attending gyms of Saint-Petersburg].

BACKGROUND: Anabolic androgenic steroids (AASs) are often used by individuals engaged in physical recreational activity. AASs inhibit the hypothalamus-pituitary-gonad axis and can cause erectile dysfunction and reduced fertility. There is no data on the use of AASs in this category of people in the Russian Federation; therefore, a study exploring the rate and patterns of using steroids for non-medical purposes is topical. Aim - of this study was to investigate the rate and patterns of using AASs in males attending gyms in Saint Petersburg. MATERIAL AND METHODS: We used individual anonymous postal survey of males attending gyms. We analyzed demographic and anthropometric data, information on the use of AASs, awareness of their side effects, used agents, patterns and duration of their use, and rehabilitation therapy. RESULTS: Out of 1,815 sent questionnaires, we received back 762 ones. The criteria were met by 550 questionnaires. The mean age was 29.3±7.4 years. The use of AASs was reported by 30.4% of respondents. The main AAS (74.3%) consumers were males aged 22 to 35 years. The most popular drug was Testosterone Propionate (51.5%); the drug was often combined with Oxandrolone (19.7%). In 70.6% of cases, drugs were administered by injection or injection combined with tablet intake. The injectable testosterone dose ranged from 500 to 2,000 mg/week and above. The most common dose was 1,000 mg/week (23.9%). AAS administration for more than 1 year was reported in 16.1% of males. Anastrozole (55%), hCG (51.3%), Clomiphene (41.3%), and Tamoxifen (30.5%) were used during the recovery period. The main source of information on AASs, doses, and dosage patterns was the Internet (48.7%). A negative attitude towards AASs was found in 17.3% of respondents. The desire to receive qualified information about AASs and their impact on health was reported by 54.8% of the surveyed respondents. CONCLUSION: Almost every fourth gym visitor has experience in using AASs. These are males of an optimal reproductive age. The common pattern of using AASs is an aggressive steroid course followed by a recovery period. The list of used drugs and their doses indicate a significant pharmacological intervention and a high risk to health.

[The frequency of formation of a motivated refusal to take androgenic anabolic steroids by men with recreational activity].

BACKGROUND: The widespread use of AAS for non-medical purposes is more than often becoming the cause of secondary hypogonadism. The study of the formation of the negative attitude towards the use of AAS among the gym visitors is quite relevant. AIMS: To identify the frequency of the formation of a motivated refusal to continue taking androgenic anabolic steroids among men who voluntarily declared their use. MATERIALS AND METHODS: The study included 44 men, all users of AAS. There has been estimated the effectiveness of the clinical examination: how ready they were to disclose information about the use of AAS (drugs, doses, regimens, duration) or how much they were aware of the mechanisms of action of AAS and their effects on the body. The participants were also asked to evaluate their psychological and emotional state (on the scale Index of life satisfaction, Hamiltons depression, aggressiveness). The experience of our informational lectures on the topic Risks of using AAS prior to the selection of volunteers for research, anonymous surveys and interviews with potential participants in the clinical trial, the clinical work itself with the selected volunteers, the characteristic features of a medical history and tests that we identified were compared with clinical recommendations for hypogonadism diagnostic (domestic and foreign). RESULTS: More than 105 gym visitors responded positively to a motivated offer (free medical consultation and laboratory tests) to participate in a clinical study. Based on the results of the individual interview, 54 men (51.4%) who indicated the use of AAS signed an informed consent. 44 volunteers (41.9%) completed all stages of the study. Among them, 32 participants (72.7%) were aware of the mechanisms of action and side effects of AAS. 21 volunteers (47.7%) filled in the scales. The index of life satisfaction was determined as high, equal to 34 [29; 38] points; the index of aggressiveness was higher than the generally accepted standard and composed 27 [25; 29] points, the level of depression corresponded to a mild depressive disorder, equal to 9 [3; 12] points. Over the use of AAS 22.7% (n = 10) of the examined noted an increase in aggressiveness, which they themselves associated with the use of steroids. The clinical symptoms of hypogonadism (decreased libido, erectile dysfunction) after the cancellation of AAS were indicated by 25% (n = 11) of the volunteers and that was one of the reasons they continued to use anabolics. 31.8% (n = 14) of the participants were ready to completely stop using the steroids. CONCLUSIONS: Individual informational interviews aimed at providing knowledge about the negative effects of steroids on the body motivated the desire to stop using them amongst 31.8% of AAS users. The obtained data points out to a developed AAS addiction which requires the involvement of psychiatrists to get rid of it.