Rate and extent of recovery from reproductive and cardiac dysfunction due to androgen abuse in men

Abstract

Context: Androgen abuse impairs male reproductive and cardiac function, but the rate, extent,and determinants of recovery are not understood.Objective: To investigate recovery of male reproductive and cardiac function after ceasingandrogen intake in current and past androgen abusers compared with healthy non-users.Methods: Cross-sectional, observational study recruited via social media 41 current and 31 pastusers (=3 months since last use, median 300 days since last use) with 21 healthy, eugonadalnon-users. Each provided a history, examination, and serum and semen sample and underwenttesticular ultrasound, body composition analysis, and cardiac function evaluation.Results: Current abusers had suppressed reproductive function and impaired cardiac systolicfunction and lipoprotein parameters compared with non-or past users. Past users did not differfrom non-users, suggesting full recovery of suppressed reproductive and cardiac functionsafter ceasing androgen abuse, other than residual reduced testicular volume. Mean time torecovery 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) whereasspermatogenesis (serum follicle-stimulating hormone [FSH], inhibin B, inhibin) took longer. Theduration of androgen abuse was the only other variable associated with slower recovery ofsperm output (but not hormones).Conclusion: Suppressed testicular and cardiac function due to androgen abuse is effectively fullyreversible (apart from testis volume and serum sex hormone binding globulin) with recoverytaking between 6 to 18 months after ceasing androgen intake with possible cumulative effectson spermatogenesis. Suppressed serum AMH, LH, and FSH represent convenient, useful, andunderutilized markers of recovery from androgen abuse.