Daily Archives: February 8, 2020

Male Infertility Among Steroid Users

Midsection of a man taking injection

Midsection of a man taking injection

From swimsuit ads featuring young muscular men to superhero movies featuring a Hollywood buff, the pressure to attain a certain level of fitness in today’s world is intense. And for men, there are plenty of products to help attain this goal: protein powder, shakes, and supplements are among the most common.

However, another method of achieving muscle mass, strength, and stamina have posed a major threat to men’s health: anabolic steroids.

Most people know the major consequences of steroid use: excess body hair, intense aggression, and severe acne just to name a few. But, what many men and athletes do not know is how these drugs can alter their reproductive systems in a way that could cause infertility.

The use of anabolic steroids, aka “doping”, is nothing new, and has been around since 1935, when testosterone was first synthesized in a lab. The development of anabolic steroids was originally intended as a treatment for delayed puberty in men. However, it gradually became an underground market for men and women alike seeking peek athlete status. During WWII, German scientists used anabolic steroids to increase soldiers’ strength and aggressiveness. It was not until after WWII when studies began on how these drugs work and the fertility consequences associated with them.

In men, according to Exercise and Human Reproduction, about 95% of testosterone is secreted by the testes, the other 5% comes from adrenal glands, which are located right above the kidneys. Daily production rates vary from person to person, but consistently across men is that they produce the most testosterone in the early morning compared with the lowest concentrations in the evening. The hormone naturally produced in the body circulates in the blood and is regulated by the body.

So how can a hormone that is found naturally in men cause so much damage?

According to Web MD, taking testosterone is essentially male birth control. In 2009, The Journal of Clinical Endocrinology & Metabolism conducted a study of over 1000 fertile men and gave them monthly injections of testosterone-based contraceptives. This proved to be 99% effective in preventing partner pregnancy.

Anabolic steroids work essentially the same way. Anabolic steroids are synthetic, lab-made, variations of the human sex hormone testosterone. These drugs are referred to as anabolic-androgenic steroids and are the drugs some male athletes may take to gain muscle and strength. “Anabolic” refers to muscle building and “androgenic” refers to male characteristics.

Testosterone in high amounts, such as when a person is taking anabolic steroids, can have harmful effects on male sex organs. The abuse of this drug causes hormonal changes that affect the HPG axis. The HPG axis stands for the hypothalamic-pituitary-gonadal axis. Simply, it is a category that includes the major glands and organs in the body that play a key role in homeostasis and regulation of the production of sperm.

Many different hormones are dependent on this HPG axis. For example, the hormone FSH (follicle-stimulating hormone) is secreted and regulated by the HPG axis. FSH regulates spermatogenesis (aka the building of sperm in the testes). With the introduction of anabolic steroids, the HPG axis is altered, which alters the secretion of FSH, which changes semen characteristics. These changes in semen include decreased counts and quality, which both lead to infertility. This is only one example of the many different processes that anabolic steroids can alter, which ultimately lead to infertility. These hormone changes can also lead to an array of other problems within the user, shown in the picture below.

Consequences of steroid use including hair loss, acne, etc.

Consequences of steroid use including hair loss, acne, etc.

An object lesson is the life-changing story of MLB star Jose Conseco, who pled guilty in 2005 to the use of anabolic steroids to enhance his baseball performance. Not only would his baseball career be compromised but his family life as well. In 2008, Conseco was arrested for smuggling a fertility drug over from Mexico. Jose Conseco was only one of many men who struggled with the dilemma of fertility issues after intense steroid use.

The good news? Fertility issues associated with anabolic steroid use are treatable and appear to stop once drug use ends.

In many cases, when a man stops steroid use, sperm generally return to normal levels within a year. In men who are not so lucky, doctor-prescribed drugs can assist in resolving these issues.

However, according to the Journal of Andrology, about 56% of anabolic steroid users have not revealed their use to a physician. This number is extremely alarming, as not only does use affect fertility, but could also become life-threatening for other critical systems, including cardiovascular and nervous.

It is well-advised that if you have used non-prescribed steroids you should plan to visit your physician to ensure problems do not arise before it is too late. Consult your doctor, find a trainer, and work harder to achieve your desired figure before succumbing to harsh drugs that might compromise you and your loved one’s future happiness.

By: P Black


Boyles, S. (2009) Testosterone Tested as Male Contraceptive. Retrieved from https://www.webmd.com/sex/birth-control/news/20090506/testosterone-tested-as-male-contraceptive#1

Fronczak, C. M., Kim, E. D., & Barqawi, A. B. (2012) The Insults of Illicit Drug Use on Review Male Fertility. Journal of Andrology,  33 (4), 515–528.

García-Manso, J. M., & Esteve, T. V. (2016) Consequences of the Use of Anabolic-Androgenic Steroids for Male Athletes’ Fertility. Exercise and Human Reproduction, 153–161.

Red, C. (2018) Jose Canseco was busted for the same drug that led to Manny Ramirez’s ban. Retrieved from https://www.nydailynews.com/sports/baseball/jose-canseco-busted-drug-led-manny-ramirez-ban-article-1.409312

Steroid Use and Male Fertility. (n.d.) Retrieved from https://www.ovationfertility.com/male-infertility/steroid-use-male-fertility-2/

Yiqun, G., Xiaowei L., Weixiong W., Minli L., Shuxiu S., Lifa C., Liwei B., Chengliang X., Xinghai W., Xiaozhang L., Lin P., & Kangshou Y. (2009) Multicenter Contraceptive Efficacy Trial of Injectable Testosterone Undecanoate in Chinese Men. The Journal of Clinical Endocrinology & Metabolism, 94 (6), 1910–1915.


Image Credits 

Image 1: Midsection Of A Man Taking Injection, Dreamstime, https://www.dreamstime.com/stock-photo-midsection-man-taking-injection-gym-image60541559

Image 2: Androgenic Adverse Effects in Men, NPS Medicinewise, https://www.nps.org.au/australian-prescriber/articles/adverse-effects-of-sports-supplements-in-men#f1