Nelson Vergel
Founder, ExcelMale.com
Introduction
The world of sports and bodybuilding often brings to the forefront the use of anabolic androgenic steroids (AAS), substances that can enhance performance and muscle growth. However, the use of these steroids is not without risks. This article delves into the effects of AAS on men's health, particularly focusing on a condition known as hypogonadism, and the various strategies men use to counteract these effects.What are Anabolic Androgenic Steroids?
Anabolic androgenic steroids are synthetic substances similar to the male sex hormone testosterone. They are often used to build muscle mass and improve athletic performance. However, their use can lead to serious health issues, including a condition called hypogonadism.Hypogonadism: The Dark Side of Steroid Use
Hypogonadism is a condition where the body's natural testosterone production is suppressed. This can be a direct consequence of AAS use. Testosterone, produced in the testes, is regulated by luteinizing hormone (LH) from the pituitary gland. When AAS are introduced into the body, they can disrupt this natural process, leading to reduced or halted testosterone production.Symptoms of AAS-Induced Hypogonadism
Men who experience hypogonadism due to AAS use often report a range of physical and psychological symptoms, including:- Weakness
- Reduced libido (sex drive)
- Erectile dysfunction
- Depression and anxiety
- Suicidality
The Vicious Cycle of AAS Dependence
To avoid the discomfort of these symptoms, some men may resume using AAS, thereby entering a dangerous cycle of dependence. This cycle can be hard to break, leading to long-term health problems.Coping Strategies: "Blast and Cruise" and "Cycling"
Men using AAS have developed various strategies to manage the symptoms of hypogonadism.1. Blast and Cruise
This strategy entails using large doses of AAS, frequently in advance of an event, then continuing to use lower-dose AAS for a longer period of time.2. Cycling
Men using this method consume AAS for 6–12 weeks (on-cycle) and then take a break (off-cycle), during which they engage in post-cycle therapy (PCT).Post-Cycle Therapy (PCT)
PCT is a crucial aspect of the cycling approach. It involves self-administered treatments aimed at reducing AAS side effects or accelerating the recovery of the hypothalamic-pituitary-gonadal (HPG) axis, the system responsible for regulating hormones. PCT often includes:- Human chorionic gonadotrophin (hCG) stimulates testosterone production
- selective estrogen receptor modulators (SERMs) and aromatase inhibitors (AIs) to lower the negative effects of estrogen on the HPG axis
The Uncharted Territory of PCT
Despite its widespread use, the effectiveness of PCT in restoring HPG function after AAS cessation is unproven. There is a lack of randomized controlled trials to support this approach, making it a field ripe for research.Investigating the Effects of PCT
A recent survey involving 470 men who used AAS sought to understand their experiences when ceasing AAS use, the effect of PCT on symptom relief, and their perception of the need for health service support. This study aims to shed light on the actual impact of PCT and the role it plays in men's health after AAS use.Understanding the Impact of Anabolic-Androgenic Steroid Cessation and Post-Cycle Therapy
Introduction
Anabolic-androgenic steroids (AAS) are often used to enhance physical performance and muscle growth. However, stopping AAS can lead to various physical and mental health issues. Recently, a comprehensive study has shed light on these effects and the role of post-cycle therapy (PCT) in alleviating these symptoms.Counterfeit AAS and Lack of Adverse Effects
A significant portion of AAS available on the black market is counterfeit or substandard. This could explain why many users do not experience adverse effects typically associated with AAS use.Symptoms After Stopping AAS
Upon cessation of AAS, users often report symptoms like low mood, reduced libido, tiredness, and physical weakness. These effects are now becoming more widely recognized and documented.Impact on Sexual Function
- Reduced Libido: Over half of the respondents in the study reported a decrease in libido after stopping AAS use.
- Erectile Dysfunction (ED): Some studies have shown improvements in ED symptoms with drugs used in PCT. However, these findings are not conclusive due to methodological limitations like the lack of randomization and placebo controls.
Neuropsychiatric Effects and PCT
- Self-Reported Benefits: The use of self-administered PCT was reported to reduce cravings, withdrawal symptoms, and suicidal thoughts significantly.
- Mixed Findings: Some users reported an increase in mood disturbances after stopping AAS, while others noted improvements with PCT. However, PCT sometimes worsened psychiatric symptoms.
- COVID-19 Impact: The pandemic made accessing PCT more challenging, potentially worsening mental health issues in men stopping AAS use.
Long-Term Commitment to AAS Use
Many respondents expressed reluctance to stop AAS use in the foreseeable future, mainly due to concerns about the effects of cessation on body composition, physical performance, and recovery of testosterone levels or fertility.Challenges in Obtaining PCT
- Accessibility and Legitimacy Concerns: Obtaining legitimate PCT is difficult, with most sourced illicitly online or through peers. This uncertainty about the quality and effectiveness of PCT is a significant barrier to safe cessation practices.
- Preference for Community-Based Support: Users often preferred community harm reduction clinics over specialist clinics or general practitioners for accessing PCT.
Current Treatment and Future Recommendations
- Treatment for AAS-Induced Hypogonadism: PCT drugs, commonly used for male hypogonadism, have not been conclusively proven effective or safe for AAS-induced conditions.
- Need for Controlled Trials: More research, including controlled trials, is needed to establish the efficacy of PCT in treating AAS-induced hypogonadism.
Limitations of the Study
The study's findings are subject to regional biases, voluntary response bias, recall bias, and uncertainty due to the lack of detailed information on PCT regimes and AAS usage history.Conclusion
The study provides critical insights into the effects of AAS cessation and the potential benefits of PCT. It highlights the need for well-designed research to evaluate treatment options and calls for an integrated approach involving healthcare professionals and peer networks to support men seeking to stop AAS use long-term.The use of anabolic androgenic steroids carries significant risks, particularly regarding men's hormonal health. While strategies like the blast and cruise approach and cycling with post-cycle therapy are commonly used to mitigate these risks, there is a clear need for more scientific research to understand their effectiveness and safety. It is crucial to inform and support those who are suffering from the effects of steroid use as the sporting world continues to wrestle with this issue.
Source: The use of post-cycle therapy is associated with reduced withdrawal symptoms from anabolic-androgenic steroid use: a survey of 470 men - Substance Abuse Treatment, Prevention, and Policy
