• OBJECTIVE
    • To develop an understanding of hypogonadal men with a history of anabolic-androgenic steroid (AAS) use and to outline recommendations for management.
  • DESIGN
    • Review of published literature and expert opinions. Intended as a meta-analysis, but no quality studies met the inclusion criteria.
  • SETTING
    • Not applicable.
  • PATIENT(S)
    • Men seeking treatment for symptomatic hypogonadism who have used nonprescribed AAS.
  • INTERVENTION(S)
    • History and physical examination followed by medical intervention if necessary.
  • MAIN OUTCOME MEASURES(S)
    • Serum testosterone and gonadotropin levels, symptoms, and fertility restoration.
  • RESULT(S)
    • Symptomatic hypogonadism is a potential consequence of AAS use and may depend on dose, duration, and type of AAS used. Complete endocrine and metabolic assessment should be conducted. Management strategies for anabolic steroid-associated hypogonadism (ASIH) include judicious use of testosterone replacement therapy, hCG, and selective estrogen receptor modulators.
  • CONCLUSION(S)
    • Although complications of AAS use are variable and patient specific, they can be successfully managed. Treatment of ASIH depends on the type and duration of AAS use. Specific details regarding a patient's AAS cycle are important in medical management.