Azevedo Rafael de Almeida, Gualano Bruno, Teixeira Thiago Afonso, Nascimento Bruno C G, Hallak Jorge
Applied Physiology and Nutrition Research Group, Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.
Division of Urology, Department of Surgery, University Hospital, School of Medicine and Drug Research Laboratory, Federal University of Amapa, Macapá, Brazil.
Front Toxicol. 2024 Apr 22;6:1379272. doi: 10.3389/ftox.2024.1379272. eCollection 2024.
The evolving prevalence of anabolic androgenic steroids (AAS) abuse among nonathletes is alarming because of the known harm to an individual's health. Among the adverse effects of AAS abuse, male infertility and sexual dysfunction have been often reported in the literature, but little is known regarding its actual prevalence, possible underpinning mechanisms, and potential treatments either during or post-AAS usage. Thus, the current narrative review summarizes the state-of-art regarding the effects of AAS on male fertility and sexual function. Evidence was gathered from the latest reviews and recent original studies, specifically from prospective cohorts and clinical trials, ultimately resulting in five main topics of discussion. First, AAS usage is briefly characterized by its historical background, main physiological mechanisms, and the most frequently used AAS substances. Second, data on the prevalence of AAS-induced male infertility and sexual dysfunction are described. Third, some new insights on possible underpinning mechanisms of AAS-induced male infertility and sexual dysfunction are thoroughly discussed, with particular attention to histological data derived from animal models and the latest insights from prospective cohorts in humans. Fourth, the potential treatments during and after the AAS usage are presented, highlighting the odds of resolving male infertility and sexual dysfunction. Fifth, future directions on this topic are discussed, focusing on the methodological robustness of scientific studies.
由于已知合成代谢雄激素类固醇（AAS）滥用会对个人健康造成危害，非运动员中AAS滥用情况的不断演变令人担忧。在AAS滥用的不良影响中，男性不育和性功能障碍在文献中常有报道，但对于其实际患病率、可能的潜在机制以及在使用AAS期间或之后的潜在治疗方法知之甚少。因此，当前的叙述性综述总结了关于AAS对男性生育能力和性功能影响的最新研究状况。证据来自最新的综述和近期的原始研究，特别是前瞻性队列研究和临床试验，最终形成了五个主要讨论主题。第一，简要介绍AAS的使用情况，包括其历史背景、主要生理机制以及最常用的AAS物质。第二，描述AAS导致男性不育和性功能障碍的患病率数据。第三，深入讨论AAS导致男性不育和性功能障碍可能的潜在机制的一些新见解，特别关注来自动物模型的组织学数据和人类前瞻性队列研究的最新见解。第四，介绍在使用AAS期间及之后的潜在治疗方法，强调解决男性不育和性功能障碍的可能性。第五，讨论该主题的未来发展方向，重点关注科学研究的方法稳健性。
