Effects of Anabolic Androgenic Steroids on the Reproductive System of Athletes and Recreational Users: A Systematic Review and Meta-Analysis
Abstract
Background Anabolic androgenic steroids (AAS) are testosterone derivatives used by athletes and recreational users to improve athletic performance and/or enhance appearance. Anabolic androgenic steroids use may have serious and potentially irreversible adverse effects on different organs and systems, including the reproductive system. Objective This systematic review and meta-analysis aimed to critically assess the impact of AAS use on the reproductive system of athletes and recreational users. Methods An electronic literature search was conducted using the databases MEDLINE, CENTRAL, and Google Scholar. Studies were included when the following criteria were fulfilled: participants were athletes or recreational users of any age, sex, level or type of sport; AAS use of any type, dose, form or duration; AAS effects on the reproductive system were assessed as stated by medical history, clinical examination, hormone and/or semen analysis. Random-effects meta-analysis was performed to assess the weighted mean difference (WMD) of serum gonadotropin (luteinizing hormone, follicle-stimulating hormone) and testosterone levels compared with baseline, during the period of AAS use, as well as following AAS discontinuation. Results Thirty-three studies (three randomized clinical trials, 11 cohort, 18 cross-sectional, and one non-randomized parallel clinical trial) were included in the systematic review (3879 participants; 1766 AAS users and 2113 non-AAS users). The majority of the partici…
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Long-term use of anabolic steroids is associated with increased risks of hepatic dysfunction, carcinoma, cardiovascular disease, prolonged testicular suppression, and subfertility.
“While short-term use may lead to increased muscle mass, long-term use has been associated with increased risks of hepatic dysfunction, carcinoma, and cardiovascular disease, as well as prolonged testicular suppression and subfertility (33-35).”
From Non-testosterone management of male hypogonadism: an examination of the existing literature (2020) · cites this paper as [33]
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Corona, G., Goulis, D. G., Huhtaniemi, I., Zitzmann, M., Toppari, J., Forti, G., Vanderschueren, D., & Wu, F. C. (2020) · Andrology · doi:10.1111/andr.12770 · Cited by 431 · see citing works
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Non-testosterone management of male hypogonadism: an examination of the existing literature
Krzastek, S. C., & Smith, R. P. (2020) · Translational Andrology and Urology · doi:10.21037/tau.2019.11.16 · Cited by 34 · see citing works
“While short-term use may lead to increased muscle mass, longterm use has been associated with increased risks of hepatic dysfunction, carcinoma, and cardiovascular disease, as well as prolonged testicular suppression and subfertility (33-35).”
BackgroundZaghloul, E., Handousa, H., Singab, A. N. B., Elmazar, M. M., Ayoub, I. M., & Swilam, N. (2023) · Plants · doi:10.3390/plants12010206 · Cited by 11 · see citing works
- Authors
- Christou, M. A., Christou, P. A., Markozannes, G., Tsatsoulis, A., Mastorakos, G., & Tigas, S.
- Affiliations
- University of Ioannina (GR)
- National and Kapodistrian University of Athens (GR)
- Corresponding author
- Tigas, Stelios
- Venue
- Sports Medicine
- Published
- 2017-03-04
- Volume
- 47
- Issue
- 9
- Pages
- 1869-1883
- ISSN
- 0112-1642 (ISSN-L)
- 1179-2035
- OpenAlex
- W2591824702
- Cited by
- 199
- References
- 4
- Citations by year
- 2026: 18 · 2025: 25 · 2024: 24 · 2023: 31 · 2022: 29 · 2021: 22 · 2020: 23 · 2019: 15 · 2018: 11 · 2017: 1
- FWCI
- 1.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Social Sciences › Sociology and Political Science › Doping in Sports
- Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Pharmacological Effects and Assays
- Keywords
- anabolic steroids, reproductive system, athletes, recreational users, luteinizing hormone, follicle-stimulating hormone, testosterone, gonadotropins, male infertility, semen quality, male hypogonadism, female athletes, performance-enhancing drugs, adverse effects, hormone suppression
- MeSH terms
- Androgens, Female, Genitalia, Gonadotropins, Humans, Hypogonadism, Male, Steroids, Testosterone, Testosterone Congeners, Anabolic Agents, Athletes
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