Department of Andrology, Concord Repatriation General Hospital and ANZAC Research Institute, University of Sydney, Concord Hospital, NSW, Australia.
Department of Cardiology, Concord Repatriation General Hospital and ANZAC Research Institute, University of Sydney, Concord Hospital, NSW, Australia.
J Clin Endocrinol Metab. 2020 Jun 1;105(6). doi: 10.1210/clinem/dgz324.
Androgen abuse impairs male reproductive and cardiac function, but the rate, extent, and determinants of recovery are not understood.
To investigate recovery of male reproductive and cardiac function after ceasing androgen intake in current and past androgen abusers compared with healthy non-users.
Cross-sectional, observational study recruited via social media 41 current and 31 past users (≥3 months since last use, median 300 days since last use) with 21 healthy, eugonadal non-users. Each provided a history, examination, and serum and semen sample and underwent testicular ultrasound, body composition analysis, and cardiac function evaluation.
Current abusers had suppressed reproductive function and impaired cardiac systolic function and lipoprotein parameters compared with non- or past users. Past users did not differ from non-users, suggesting full recovery of suppressed reproductive and cardiac functions after ceasing androgen abuse, other than residual reduced testicular volume. Mean time to recovery was faster for reproductive hormones (anti-Mullerian hormone [AMH], 7.3 months; luteinizing hormone [LH], 10.7 months) than for sperm variables (output, 14.1 months) whereas spermatogenesis (serum follicle-stimulating hormone [FSH], inhibin B, inhibin) took longer. The duration of androgen abuse was the only other variable associated with slower recovery of sperm output (but not hormones).
Suppressed testicular and cardiac function due to androgen abuse is effectively fully reversible (apart from testis volume and serum sex hormone binding globulin) with recovery taking between 6 to 18 months after ceasing androgen intake with possible cumulative effects on spermatogenesis. Suppressed serum AMH, LH, and FSH represent convenient, useful, and underutilized markers of recovery from androgen abuse.
雄激素滥用会损害男性生殖和心脏功能，但目前尚不清楚停止雄激素摄入后男性生殖和心脏功能恢复的速度、程度和决定因素。
与健康非使用者相比，调查当前和过去雄激素滥用者停止雄激素摄入后男性生殖和心脏功能的恢复情况。
通过社交媒体招募了 41 名当前和 31 名过去（最后一次使用后≥3 个月，最后一次使用后中位数 300 天）的雄激素滥用者，以及 21 名健康、正常睾丸酮的非使用者。每位参与者都提供了一份病史、体检和血清及精液样本，并进行了睾丸超声、身体成分分析和心脏功能评估。
与非或过去使用者相比，当前滥用者的生殖功能受到抑制，心脏收缩功能和脂蛋白参数受损。过去使用者与非使用者没有差异，这表明停止雄激素滥用后，除了睾丸体积缩小外，生殖和心脏功能的抑制得到了完全恢复。恢复生殖激素（抗缪勒管激素[AMH]，7.3 个月；促黄体生成激素[LH]，10.7 个月）的时间比精子变量（产量，14.1 个月）更快，而精子发生（血清卵泡刺激素[FSH]、抑制素 B、抑制素）则需要更长时间。雄激素滥用的持续时间是与精子产量恢复较慢相关的唯一其他变量（但与激素无关）。
由于雄激素滥用导致的睾丸和心脏功能抑制是完全可以逆转的（除了睾丸体积和血清性激素结合球蛋白），停止雄激素摄入后 6 至 18 个月内恢复，对精子发生可能有累积影响。抑制的血清 AMH、LH 和 FSH 代表了从雄激素滥用中恢复的方便、有用且未充分利用的标志物。
