2023 Endocrine Case Management: Meet the Professor-2023 Endocrine Case Management: Meet the Professor

2023 Endocrine Case Management: Meet the Professor - web PDF

Pdf Summary

Androgen abuse, or the misuse of androgens such as testosterone, is a concern in individuals who use these substances for muscle building and athletic performance enhancement. Clinicians should be suspicious of androgen abuse in highly muscular men who present with unexplained male-factor infertility, seek prescriptions for testosterone or related treatments, and have a history of using over-the-counter diet/nutritional supplements and preoccupation with bodybuilding. The drug history is key in diagnosing androgen abuse, as many individuals may initially deny or withhold information about their use.<br /><br />Clinically, androgen abusers often have a normal puberty and good general health, but a history of delayed or incomplete puberty may indicate undiagnosed congenital hypogonadotropic hypogonadism. Physical examination may reveal small, atrophic testes, active truncal acne, gynecomastia, and tendon ruptures. Laboratory tests, including toxicologic urine drug screens, serum LH, FSH, testosterone, and SHBG measurements, and semen analysis, can help diagnose and manage androgen abuse.<br /><br />Androgen abuse can have various harmful effects, including neuropsychiatric, cardiovascular, and neuroendocrine disorders, as well as hepatotoxicity. Recovery from androgen abuse is slow but progressive, and supportive medical management is crucial in sustaining no androgen intake and allowing for gradual recovery. Treatment options for fertility issues associated with androgen abuse may include intracytoplasmic sperm injection/in vitro fertilization and continued follow-up.<br /><br />In the case of individuals who have ceased androgen intake, monitoring serum LH and FSH levels can provide a prognosis for recovery of testicular function. It is important to educate patients on the slow recovery process and the risks of resuming androgen abuse. Overall, prevention, accurate diagnosis, and supportive management are essential in addressing androgen misuse and abuse.

Keywords

Androgen abuse

testosterone

muscle building

athletic performance enhancement

male-factor infertility

over-the-counter supplements

congenital hypogonadotropic hypogonadism

neuropsychiatric disorders

hepatotoxicity

fertility issues


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