Download PDF
Int J Sports Med 2003; 24(3): 195-196
DOI: 10.1055/s-2003-39089
Physiology & Biochemistry
© Georg Thieme Verlag Stuttgart · New York

Androgenic Anabolic Steroid Use and Severe Hypothalamic-Pituitary Dysfunction: a Case Study

E.  van Breda1 , H. A.  Keizer1 , H.  Kuipers1 , B. H. R.  Wolffenbuttel2
  • 1 Department of Movement Sciences , Nutrition and Toxicology Research Institute Maastricht (NUTRIM), University, Maastricht, the Netherlands
  • 2 Department of Endocrinology, University Hospital Maastricht, Maastricht, the Netherlands
Further Information

Publication History



Accepted after revision: September 10, 2002

Publication Date:
12 May 2003 (online)

Also available at
    Permissions and Reprints

The data of the present case demonstrate that the abuse of androgenic anabolic steroids (AAS) may lead to serious health effects. Although most clinical attention is usually directed towards peripheral side effects, the most serious central side effect, hypothalamic-pituitary-dysfunction, is often overlooked in severe cases. Although this latter central side-effect usually recovers spontaneously when AAS intake is discontinued, the present case shows that spontaneous recovery does not always take place. We suggest that hypothalamic-pituitary dysfunction should always be considered in the differential diagnosis in athletes seen with typical presentation of anabolic steroid use. In order to regain normal hypothalamic-pituitary function, supraphysiological doses of 200 μg LH-RH should be considered when the physiological challenge test with LH-RH (50 μg) fails to show an acceptable response.

Key words

Hypogonadism - high dose LHRH-treatment - body building - drug abuse

References

  • 1 Arvery D, Pope H G. Anabolic-androgenic steroids as a gateway to opioid dependence.  New Engl J Med. 2000;  342 1532
    CrossrefPubMedSearch in Google Scholar
  • 2 Gill G V. Anabolic steroid induced hypogonadism treated with human chorionic gonadotropin.  Postgrad Med J. 1998;  74 45-46
    PubMedSearch in Google Scholar
  • 3 Hickson R C, Ball K L, Falduto M T. Adverse effects of anabolic steroids.  Med Toxicol Adverse Drug Exp. 1989;  4 254-271
    PubMedSearch in Google Scholar
  • 4 Kindlundh A M, Isacson D G, Berglund L, Nyberg F. Factors associated with adolescent use of doping agents: anabolic-androgenic steroids.  Addiction. 1999;  94 543-553
    CrossrefPubMedSearch in Google Scholar
  • 5 Madea B, Grellner W. Long-term cardiovascular effects of anabolic steroids.  Lancet. 1998;  352 33
    PubMedSearch in Google Scholar
  • 6 Martikainen H, Alen M, Rahkila P, Vihko R. Testicular responsiveness to human chorionic gonadotrophin during transient hypogonadotrophic hypogonadism induced by androgenic/anabolic steroids in power athletes.  J Steroid Biochem. 1986;  25 109-112
    PubMedSearch in Google Scholar
  • 7 Matsumoto A M. Effects of chronic testosterone administration in normal men: safety and efficacy of high dosage testosterone and parallel dose-dependent suppression of luteinizing hormone, follicle stimulation hormone, and sperm production.  J Clin Endocrinol Metbab. 1990;  70 282-287
    PubMedSearch in Google Scholar
  • 8 Mori T, Murakami Y, Nishiki M, Kato Y. Clinical course of long term treatment with intermittent subcutaneous injection of LHRH in combination with GH replacement in a male patient with hypothalamic hypogonadism due to disruption of the pituitary stalk.  Endocr J. 1998;  45(suppl) S155-S158
    PubMedSearch in Google Scholar
  • 9 Wichstrom L, Pedersen W. Use of anabolic-androgenic steroids in adolescence: winning, looking good or being bad?.  J Stud Alcohol. 2001;  62 5-13
    PubMedSearch in Google Scholar

Dr. E. van Breda

Dept. Movement Sciences · Maastricht University,

P. O. Box 616 · 6200 MD Maastricht · Netherland ·

Phone: +31 43 3881318

Fax: +31 43 3670972

Email: eric.vanbreda@bw.unimaas.nl