Concomitant abuse of anabolic androgenic steroids and human chorionic gonadotrophin impairs spermatogenesis in power athletes. The effects of supraphysiological doses of testosterone on angry behavior in healthy eugonadal men--a clinical research center study. Effect of short-term treatment with an anabolic steroid (methandienone) and dehydroepiandrosterone sulphate on plasma hormones, red cell volume and 2,3-diphosphoglycerate in athletes. "ANABOLIC" EFFECTS OF METHANDIENONE IN MEN UNDERGOING ATHLETIC TRAINING Short-term recombinant human growth hormone administration improves respiratory function in abstinent anabolic-androgenic steroid users. Evidence for a decrease in cardiovascular risk factors following recombinant growth hormone administration in abstinent anabolic-androgenic steroid users. Recombinant human growth hormone in abstinent androgenic-anabolic steroid use: psychological, endocrine and trophic factor effects. Effect of growth hormone treatment on hormonal parameters, body composition and strength in athletes. Testosterone increases human platelet thromboxane A2 receptor density and aggregation responses. Prophylactic misuse and recommended use of non-steroidal anti-inflammatory drugs by athletes Resistance exercise and supraphysiologic androgen therapy in eugonadal men with HIV-related weight loss: a randomized controlled trial. Testosterone replacement therapy restores normal ghrelin in hypogonadal men. Physical activity as a possible aggravating factor for athletes with varicocele: impact on the semen profile. Effect of oral androstenedione on serum testosterone and adaptations to resistance training in young men: a randomized controlled trial. Preventing substance use and disordered eating: initial outcomes of the ATHENA (athletes targeting healthy exercise and nutrition alternatives) program. Hip structural analysis in adolescent and young adult oligoamenorrheic and eumenorrheic athletes and nonathletes. [Osteoarthritis from long-distance running?]. Intense androgen-deprivation therapy with abiraterone acetate plus leuprolide acetate in patients with localized high-risk prostate cancer: results of a randomized phase II neoadjuvant study. Repeated-sprint performance and plasma responses following beetroot juice supplementation do not differ between recreational, competitive and elite sprint athletes Effects of transdermal testosterone application on the ovarian response to FSH in poor responders undergoing assisted reproduction technique--a prospective, randomized, double-blind study. Effect of Fatigue on Knee Kinetics and Kinematics in Stop-Jump Tasks A longitudinal examination of athletes' emotional and cognitive responses to anterior cruciate ligament injury. Cerebrospinal fluid and behavioral changes after methyltestosterone administration: preliminary findings.
Abuse of anabolic and rogenic steroids ( AASs ) may be an aetiological factor in male infertility among recreational power athletes . They try to avoid AAS-induced deterioration in spermatogenesis by combining doses of human chorionic gonadotrophin ( HCG ) and /or antiestrogens with their AAS abuse . Eighteen healthy male power athletes using massive doses of AASs were recruited for the study . Semen sample s were collected during AAS abuse and 1.5 and 6 months after cessation of the abuse . They were also asked about their reproductive activity six years after the study . At the end of the AAS cycle , the sperm count was 33 + /- 49 x 10 ( 6 ) /ml ( mean + /- SD ) , and only one subject had azoospermia . At 1.5 months after cessation of the AAS cycles , the mean sperm concentration was 30 + /- 42 x 10 ( 6 ) /ml , and after six months 77 + /- 70 x 10 ( 6 ) /ml . There were significant differences between the sample drawn six months after cessation of AAS abuse and both sample s drawn during and 1.5 months after the abuse ( p < /= 0.05 , repeated measures of ANOVA ) . There was a significant positive correlation between  HCG dose during the cycle and the relative amount of morphologically abnormal spermatozoa ( r = 0.60 , p < 0.01 ) . The concomitant abuse of HCG and supraphysiological AAS dose cause transient impairment on semen quality in males , although spermatogenesis is maintained with this regimen despite prolonged abuse of massive doses of AAS UNLABELLED Anecdotal reports of " roid rage " and violent crimes by and rogenic steroid users have brought attention to the relationship between anabolic steroid use and angry outbursts . However , testosterone effects on human aggression remain controversial . Previous studies have been criticized because of the low and rogen doses , lack of placebo control or blinding , and inclusion of competitive athletes and those with preexisting psychopathology . To overcome these pitfalls , we used a double-blind , placebo-controlled design , excluded competitive athletes and those with psychiatric disorders , and used 600 mg testosterone enanthate (TE)/week . Forty-three eugonadal men , 19 - 40 yr , were r and omized to 1 of 4 groups : Group I , placebo , no exercise ; Group II , TE , no exercise ; Group III , placebo , exercise ; Group IV , TE plus exercise . Exercise consisted of thrice weekly strength training sessions . The Multi-Dimensional Anger Inventory ( MAI ) , which includes 5 different dimensions of anger ( inward anger , outward anger , anger arousal , hostile outlook , and anger eliciting situations ) , and a Mood Inventory ( MI ) , which includes items related to mood and behavior , were administered to subjects before , during , and after the 10 week intervention . The subject 's significant other ( spouse , live-in partner , or parent ) also answered the same questions about the subject 's mood and behavior ( Observer Mood Inventory , OMI ) . No differences were observed between exercising and nonexercising and between placebo and TE treated subjects for any of the 5 subdomains of MAI . Overall there were no significant changes in MI or OMI during the treatment period in any group . CONCLUSION Supraphysiological doses of testosterone , when administered to normal men in a controlled setting , do not increase angry behavior . These data do not exclude the possibility that still higher doses of multiple steroids might provoke angry behavior in men with preexisting psychopathology The effects of a one-month course of treatment with a potent anabolic steroid , meth and ienone ( 5 and 10 mg daily ) , and a very weak and rogen and hormone precursor , dehydroepi and rosterone sulphate ( DHEAS , 20 and 40 mg daily ) and placebo on plasma testosterone , LH and FSH levels , red cell volume and red cell 2,3-diphosphoglycerate ( 2,3-DPG ) concentration in endurance sportsmen were studied using a double-blind test system . A highly significant decrease in mean plasma testosterone was observed after the 5 and 10 mg meth and ienone regimen ( 66 and 73 % ) . Treatment with 40 mg of DHEAS decreased mean testosterone levels by 41 % ( not statistically significant ) . Pre-test testosterone levels were reattained about 10 days after the end of the treatment period with the higher doses of both compounds , while 2–6 weeks afterwards a significant over-compensation in mean plasma testosterone levels was observed . No significant changes in plasma gonadotropins were seen immediately after treatment with either of these steroids bu After failure to confirm an anabolic action of testosterone and its derivatives in rats , meth and ienone ( ' Dianabol ' , an " anabolic steroid " used by athletes ) has been given to 11 athletic men during a course of weight-training , in a double-blind , crossover experiment . The dose of meth and ienone was 100 mg/day for 6 wk . Body weight and composition , muscular strength and performance , and indices of endocrine function were studied . Compared with the placebo period , on meth and ienone the subjects gained weight ( mean 3 - 3 kg + /- 0 - 6 kg ) and accumulated a disproportionately large amount of potassium ( 420+/-68 mmol ) ; the increase in weight was confined to the lean part of the body , and the muscles increased in size . Strength and performance improved over each training period , but not significantly differently on drug and placebo . On the drug , plasma-cortisol concentration and urinary cortisol excretion increased , and plasma-testosterone decreased . Although the weight and body-composition changes may demonstrate an anabolic action of meth and ienone in man , they may alternatively have been caused by an increase in intracellular fluid , and the question of anabolic action therefore remains open OBJECTIVES To determine whether 6 days recombinant human growth hormone ( rhGH ) administration , in an abstinent anabolic- and rogenic steroid ( AAS ) using group had any respiratory , endurance exercise and biochemical effects compared with an abstinent AAS control group . METHODS Male subjects ( n=48 ) were r and omly divided , using a single blind procedure into two groups : ( 1 )  control group ( C ) n=24 , means+/-SD , age 32+/-11 years ; height 1.8+/-0.06 m ; ( 2 ) rhGH using group ( 0.019 mg kg(-1 ) day(-1 ) ) ( GH ) n=24 , means+/-SD , age 32+/-9 years ; height 1.8+/-0.07 m.  Anthropometry , respiratory muscle function and endurance exercise were investigated . Respiratory measurements examined , were forced expiratory volume in one second , forced vital capacity , maximum inspiratory pressure and maximum expiratory pressure . Endurance exercise was assessed by measuring peak oxygen uptake ( VO(2)peak ) . Biochemical analysis included ; haemoglobin , packed cell volume , glucose , sodium , urea , creatinine , total protein , albumin , testosterone and insulin like growth factor-I ( IGF-I ) . RESULTS Forced expiratory volume in one second/forced vital capacity , maximum inspiratory pressure , maximum expiratory pressure , and IGF-I significantly increased compared with the control group ( all P<0.05 ) . Body mass index , fat free mass index , peak oxygen uptake , maximum inspiratory pressure , maximum expiratory pressure , IGF-I and serum sodium significantly increased , whilst body fat , total protein and albumin , significantly decreased within the GH group ( all P<0.017 ) . CONCLUSION The findings of this study indicated that short-term high dose rhGH increased aerobic performance and respiratory muscle strength in former AAS users OBJECTIVES To determine whether six days recombinant human growth hormone ( rhGH ) in an abstinent anabolic- and rogenic steroid ( AAS ) group had any cardiovascular and biochemical effects compared with a control group . METHODS Male subjects ( n=48 ) were r and omly divided , using a single blind procedure into two groups : ( 1 )  control group ( C ) n=24 , mean+/-SD , age 32+/-11 years ; height 1.8+/-0.06 m ; ( 2 ) rhGH using group ( 0.058IUkg(-1)day(-1 ) ) ( GH ) n=24 , mean+/-SD , age 32+/-9 years ; height 1.8+/-0.07 m . Physiological responses , anthropometry , arterial pulse wave velocity ( APWV ) , blood pressure ( BP ) , heart rate ( HR ) , peak oxygen uptake ( VO(2 ) peak ) and biochemical indices were investigated . RESULTS Body mass index , fat-free mass index and VO(2 ) peak significantly increased while body fat significantly decreased within GH ( all P<0.017 ) . Insulin like growth factor-I significantly increased within GH ( P<0.017 ) and compared with C ( P<0.05 ) . Serum sodium significantly increased ( P<0.017 ) and serum homocysteine , high sensitivity C-reactive protein , thyroid stimulating hormone and tetra-iodothyronine ( T(4 ) ) , significantly decreased within GH ( all P<0.017 ) . T(4 ) significantly decreased compared with C ( P<0.05 ) . Arterial pulse wave velocity , peak and recovery systolic and diastolic BP , significantly decreased compared with C ( P<0.05 ) . Resting HR and rate pressure product ( RPP ) significantly increased compared with C ( P<0.05 ) . CONCLUSION The findings of this study suggest that short term use of rhGH may have beneficial effects on endothelial function and specific inflammatory markers of cardiovascular disease in abstinent AAS users , but may have an adverse effect on the cardiovascular system , as evidence d by the increase in resting RPP This study examined whether six days recombinant human growth hormone ( rhGH ) affected psychological profile in an abstinent and rogenic-anabolic steroid ( AAS ) abusing group , compared with an abstinent AAS control group . Male subjects ( n = 48 ) were assigned in a r and om fashion into one of two groups : ( 1 ) : ( n=24 ) control group ( C ) ; ( 2 ) : ( n=24 ) rhGH group ( GH ) . A hospital anxiety scale ( HADS ) question naire was completed by all subjects . Physiological responses investigated included anthropometry . Biochemical markers examined included ; serum glucose , sodium , urea , lipid profile , high sensitivity C-reactive protein ( hsCRP ) , homocysteine ( HCY ) , tetra-iodothyronine ( T4 ) , thyroid stimulating ( TSH ) , luteinising ( LH ) and follicle stimulating ( FSH ) hormones , testosterone ( T ) , prolactin ( PRL ) , cortisol and insulin like growth factor-1 ( IGF-I ) . HADS question naire significantly decreased in both anxiety ( A ) and depression ( D ) symptoms within GH ( P<0.017 ) and compared with C ( P<0.05 ) . Body mass index ( BMI ) and fat-free mass index ( FFMI ) significantly increased ( both P<0.017 ) while body fat significantly decreased within GH ( P<0.017 ) . IGF-I significantly increased within GH ( P<0.017 ) and significantly increased compared with C ( P<0.05 ) . Serum sodium significantly increased ( P<0.017 ) and serum HCY , hsCRP , TSH and T4 , significantly decreased within GH ( all P<0.017 ) . PRL significantly increased and T4 significantly decreased compared with C ( both P<0.05 ) . The findings of this study suggest that short term use of rhGH has beneficial effects on mental state  in individuals who were previous abusers of AAS and appeared to have a beneficial effect on cardiovascular risk markers associated with adverse mental health The effect of recombinant GH on strength , body composition and endocrine parameters in power athletes was investigated in a controlled study . Twenty-two healthy , non-obese males ( age 23.4 + /- 0.5 years ; ideal body weight 122 + /- 3.1 % , body fat 10.1 + /- 1.0 % ; mean + /- SEM ) were included . Prob and s were assigned in a double-blind manner to either GH treatment ( 0.09U ( kg BW)-1 day-1 sc ) or placebo for a period of six weeks . To exclude concurrent treatment with and rogenic-anabolic steroids urine specimens were tested at regular intervals for these substances . Serum was assayed for GH , IGF-I , IGF-binding proteins , insulin and thyroxine before the onset of the study and at two-weekly intervals thereafter . Maximal voluntary strength of the biceps and quadriceps muscles was measured on a strength training apparatus . Fat mass and lean body mass were derived from measurements of skinfolds at ten sites with a caliper . For final evaluation only data of those 8 and 10 subjects in the two groups who completed the study were analyzed . GH , IGF-I and IGF-binding protein were in the normal range before therapy and increased significantly in the GH-treated group . Fasting insulin concentrations increased insignificantly and thyroxine levels decreased significantly in the GH-treated prob and s. There was no effect of GH treatment on maximal strength during concentric contraction of the biceps and quadriceps muscles . Body weight and body fat were not changed significantly during treatment . We conclude that the anabolic , lipolytic effect of GH therapy in adults depends on the degree of fat mass and GH deficiency . ( ABSTRACT TRUNCATED AT 250 WORDS BACKGROUND The incidence of thrombotic cardiovascular disease is greater in men than in premenopausal women .  Testosterone has been implicated as a significant risk factor for cardiovascular disease and for acute myocardial infa rct ions and strokes in young male athletes who abuse anabolic steroids . Thromboxane A2 ( TXA2 ) is a vasoconstrictor and platelet proaggregatory agent that has been implicated in the pathogenesis of cardiovascular disease . We therefore tested the hypothesis that testosterone regulates the expression of human platelet TXA2 receptors . METHODS AND RESULTS In a double-blind , placebo-controlled , r and omized , parallel-group study , we determined the effects of testosterone cypionate 200 mg IM given twice , 2 weeks apart , or saline placebo in 16 healthy men .  Platelet TXA2 receptor density ( Bmax ) and dissociation constant ( Kd ) were measured by use of the TXA2 mimetic 125I-BOP . Platelet aggregation responses to I-BOP and to thrombin and plasma testosterone concentrations were measured before treatment ( pretreatment phase ) , at 2 and 4 weeks ( active phase ) , and again at 8 weeks ( recovery phase ) . Treatment with testosterone was associated with an increase in the Bmax value from 0.95 + /- 0.13 to 2.10 + /- 0.4 pmol/mg protein ( n = 9 ) , with a peak effect at 4 weeks ( P = .001 ) , returning to baseline by 8 weeks . There was no significant change in Bmax values in the saline-treated group . The Kd values were unchanged . Testosterone treatment was associated with a significant increase in the maximum platelet aggregation response to I-BOP ( P < .001 ) at 4 weeks and returned to baseline at 8 weeks . The EC50 values were not significantly changed . Platelet TXA2 receptor density was positively correlated ( r = .56 , P < .001 , n = 32 measurements ) with pretreatment ( endogenous ) plasma testosterone levels ( range , 215 to 883 ng/dL ) but not Kd . CONCLUSIONS Testosterone regulates the expression of platelet TXA2 receptors in humans . This may contribute to the thrombogenicity of and rogenic steroids Superstitions and rituals are commonplace in sports and range from simple activities such as each player touching a special inanimate object before entering the field of play to more extreme behaviours such as not washing a uniform or wearing the same underwear during a winning streak . These practice s are relatively harmless and may reduce precompetition anxiety , but a concerning ritual that has recently developed in sports is the prophylactic use of non-steroidal anti-inflammatory drugs ( NSAIDs ) . Athletes have relatively unrestricted access to NSAIDs , as they are readily available over-the-counter preparations and not considered as performance-enhancing drugs by the World Anti-Doping Agency.1 It has been known for some years that athletes are frequent users of NSAIDS,2 with approximately a quarter of athletes competing at the Sydney 2000 Olympic Games reporting NSAID use in the 3 days before r and om drug testing.3 Such prevalent NSAID use may reflect the physical rigors of elite athletic endeavours , but more recent data suggest athletes misuse their open access to NSAIDs . Tscholl and colleagues4 recently reported in this journal that 23 % of top-level male football players  used NSAIDs  in two out of three matches during the 2002 and 2006 CONTEXT Repletion of lean body mass ( LBM ) that patients lose in human immunodeficiency virus ( HIV ) infection has proved difficult . In healthy , HIV-seronegative men , synergy between progressive resistance exercise ( PRE ) and very high-dose testosterone therapy has been reported for gains in LBM and muscle strength . OBJECTIVE To determine whether a moderately supraphysiologic and rogen regimen , including an anabolic steroid , would improve LBM and strength gains of PRE in HIV-infected men with prior weight loss and whether protease inhibitor antiretroviral therapy prevents lean tissue anabolism . DESIGN Double-blind , r and omized , placebo-controlled trial ; post hoc analysis for effect of HIV-protease inhibitor therapy conducted from January to October 1997 . SETTING Referral center in San Francisco , Calif. PATIENTS Volunteer sample of 24 eugonadal men with HIV-associated weight loss ( mean , 9 % body weight loss ) , recruited from an AIDS clinic and by referral and by advertisement . INTERVENTION For 8 weeks , all subjects received supervised PRE with physiologic intramuscular testosterone replacement ( 100 mg/wk ) to suppress endogenous testosterone production . R and omization was between an anabolic steroid , ox and rolone , 20 mg/d , and placebo . MAIN OUTCOME MEASURES Lean body mass , nitrogen balance ( 10-day metabolic ward measurements ) , body weight , muscle strength , and and rogen status . RESULTS Twenty-two subjects completed the study ( 1 1 per group ) . Both groups showed significant nitrogen retention and increases in LBM , weight , and strength . The mean ( SD ) gains were significantly greater in the ox and rolone group than in the placebo group ( 5.6 [ 2.1 ] vs 3.8 [ 1.8 ] g of nitrogen per day [ P=.05 ] ; 6.9 [ 1.7 ] vs 3.8 [ 2.9 ] kg of LBM [ P=.005 ] ; greater strength gains for various upper and lower body muscle groups by maximum weight lifted [ P = .02-.05 ] and dynamometry [ P = .01 -.05 ] ) . The mean ( SD ) high-density lipoprotein cholesterol level declined 0.25 ( 0.14 ) mmol/L ( 9.8 [ 5.4 ] mg/dL ) significantly in the ox and rolone group ( P < .001 compared with placebo ) . Results were similar whether or not patients were taking protease inhibitors . One subject in the ox and rolone group discontinued the study because of elevated liver function test results . CONCLUSIONS A moderately supraphysiologic and rogen regimen that included an anabolic steroid , ox and rolone , substantially increased the lean tissue accrual and strength gains from PRE , compared with physiologic testosterone replacement alone , in eugonadal men with HIV-associated weight loss . Protease inhibitors did not prevent lean tissue anabolism We recently described a connection between and rogens and ghrelin in women affected by the polycystic ovary syndrome . To further investigate the interaction between sex steroids and ghrelin , we investigated  circulating ghrelin levels  in a group of hypogonadal men before and after therapeutic intervention aim ing at normalization low testosterone ( T ) concentrations . Seven hypogonadal men were compared with nine overweight/moderately obese men matched for body mass index and body fat distribution parameters , as well as with 10 normal weight controls .  Total and free T and plasma ghrelin levels were significantly lower in the hypogonadal men than in the control groups . Hypogonadal men also had a significantly higher insulin resistance state . Ghrelin levels were positively correlated with both total and free T concentrations . A significant correlation was also found between ghrelin and the anthropometric parameters and the insulin resistance indexes . However , in a multiple regression analysis in which a correction for all covariants was performed , only the relationship with total and free T persisted . After the 6-month replacement T therapy , ghrelin levels of hypogonadal patients increased and did not differ significantly in comparison with both control groups . The positive correlation between ghrelin and and rogens still persisted after T replacement therapy , after adjusting for confounding variables . These data further indicate that sex hormones modulate circulating ghrelin concentrations in humans . This may be consistent with the concept that ghrelin may exert a relevant role in the endocrine network connecting the control of the reproductive system with the regulation of energy balance The aim of the present study was to evaluate the influence of physical exercise on seminal parameters of male athletes with varicocele . Sixty healthy male volunteers ( athletes and non-athletes , n = 30 + 30 ) and 60 volunteers affected by varicocele ( athletes and non-athletes , n = 30 + 30 ) were r and omly selected for a clinical study . All subjects provided at least two semen sample s for routine microscopic analysis . Determinations for basal luteinizing hormone ( LH ) , follicle stimulating hormone ( FSH ) , prolactin , oestradiol , total and free testosterone under resting conditions were also performed . In both groups with varicocele the percentage of total and progressive forward sperm motility and the percentage of normal spermatozoa were significantly reduced . The percentage of both progressive forward motility and normal spermatozoa were significantly lower in athletes with varicocele compared with non-athletes with varicocele ( P < 0.05 ) . Only athletes with varicocele had mean left testis volume significantly lower than the contralateral testis ( P < 0.05 ) . No modifications of hormonal parameters at rest were observed in any groups . Physical activity might represent an aggravating factor for spermatogenesis in athletes with varicocele . In countries where sport eligibility is granted by an authoritative body , these results suggest the need to establish general medical criteria to guarantee the continuation of an athlete 's training whilst at the same time taking care of his reproductive health CONTEXT And rostenedione , a precursor to testosterone , is marketed to increase blood testosterone concentrations as a natural alternative to anabolic steroid use . However , whether and rostenedione actually increases blood testosterone levels or produces anabolic and rogenic effects is not known . OBJECTIVES To determine if short- and long-term oral and rostenedione supplementation in men increases serum testosterone levels and skeletal muscle fiber size and strength and to examine its effect on blood lipids and markers of liver function . DESIGN AND SETTING Eight-week r and omized controlled trial conducted between February and June 1998 . PARTICIPANTS Thirty healthy , normotestosterogenic men ( aged 19 - 29 years ) not taking any nutritional supplements or and rogenic-anabolic steroids or engaged in resistance training . INTERVENTIONS Twenty subjects performed 8 weeks of whole-body resistance training . During weeks 1 , 2 , 4 , 5 , 7 , and 8 , the men were r and omized to either and rostenedione , 300 mg/d ( n = 10 ) , or placebo ( n = 10 ) . The effect of a single 100-mg and rostenedione dose on serum testosterone and estrogen concentrations was determined in 10 men . MAIN OUTCOME MEASURES Changes in serum testosterone and estrogen concentrations , muscle strength , muscle fiber cross-sectional area , body composition , blood lipids , and liver transaminase activities based on assessment s before and after short- and long-term and rostenedione administration . RESULTS Serum free and total testosterone concentrations were not affected by short- or long-term and rostenedione administration . Serum estradiol concentration ( mean [ SEM ] ) was higher ( P<.05 ) in the and rostenedione group after 2 ( 310 [ 20 ] pmol/L ) , 5 ( 300 [ 30 ] pmol/L ) , and 8 ( 280 [ 20 ] pmol/L ) weeks compared with presupplementation values ( 220 [ 20 ] pmol/L ) . The serum estrone concentration was significantly higher ( P<.05 ) after 2 ( 153 [ 12 ] pmol/L ) and 5 ( 142 [ 15 ] pmol/L ) weeks of and rostenedione supplementation compared with baseline ( 106 [ 11 ] pmol/L ) . Knee extension strength increased significantly ( P<.05 ) and similarly in the placebo ( 770 [ 55 ] N vs 1095 [ 52 ] N ) and and rostenedione ( 717 [ 46 ] N vs 1024 [ 57 ] N ) groups . The increase of the mean cross-sectional area of type 2 muscle fibers was also similar in and rostenedione ( 4703 [ 471 ] vs 5307 [ 604 ] mm2 ; P<.05 ) and placebo ( 5271 [ 485 ] vs 5728 [ 451 ] mm2 ; P<.05 ) groups . The significant ( P<.05 ) increases in lean body mass and decreases in fat mass were also not different in the and rostenedione and placebo groups . In the and rostenedione group , the serum high-density lipoprotein cholesterol concentration was reduced after 2 weeks ( 1.09 [ 0.08 ] mmol/L [ 42 ( 3 ) mg/dL ] vs 0.96 [ 0.08 ] mmol/L [ 37 ( 3 ) mg/dL ] ; P<.05 ) and remained low after 5 and 8 weeks of training and supplementation . CONCLUSIONS And rostenedione supplementation does not increase serum testosterone concentrations or enhance skeletal muscle adaptations to resistance training in normotestosterogenic young men and may result in adverse health consequences OBJECTIVES To implement and to assess the efficacy of a school-based , sport team-centered program to prevent young female high school athletes ' disordered eating and body-shaping drug use . DESIGN AND SETTING Prospect i ve controlled trial in 18 high schools , with balanced r and om assignment by school to the intervention and usual-care control conditions . PARTICIPANTS We enrolled 928 students from 40 participating sport teams . Mean age was 15.4 years , 92.2 % were white , and follow-up retention was 72 % . INTERVENTION The ATHENA ( Athletes Targeting Healthy Exercise and Nutrition Alternative ) curriculum 's 8 weekly 45-minute sessions were incorporated into a team 's usual practice activities . Content was gender-specific , peer-led , and explicitly scripted . Topics included healthy sport nutrition , effective exercise training , drug use and other unhealthy behaviors ' effects on sport performance , media images of females , and depression prevention . MAIN OUTCOME MEASURES We assessed participants by confidential question naire prior to and following their sport season . We determined program effects using an analysis of covariance-based approach within the Generalized Estimating Equation framework . RESULTS Experimental athletes reported significantly less ongoing and new use of diet pills and less new use of athletic-enhancing substances ( amphetamines , anabolic steroids , and sport supplements ) ( P<.05 for each ) . Other health-harming actions also were reduced ( less riding with an alcohol-consuming driver [ P = .05 ] , more seat belt use [ P<.05 ] , and less new sexual activity [ P<.05 ] ) . The ATHENA athletes had coincident positive changes in strength-training self-efficacy ( P<.005 ) and healthy eating behaviors ( P<.001 ) . Reductions occurred in intentions toward future use of diet pills ( P<.05 ) , vomiting to lose weight ( P<.05 ) , and use of tobacco ( P<.05 ) and muscle-building supplements ( P<.005 ) . The program 's curriculum components were altered appropriately ( controlling mood [ P<.005 ] , refusal skills [ P = .05 ] , belief in the media [ P<.005 ] , and perceptions of closest friends ' body-shaping drug use [ P<.001 ] ) . CONCLUSIONS Sport teams are effective natural vehicles for gender-specific , peer-led curricula to promote healthy lifestyles and to deter disordered eating , athletic-enhancing substance use , and other health-harming behaviors CONTEXT Stress fractures are common in endurance athletes . Whereas studies have described distal tibia bone structure in athletes , there are few data regarding hip geometric parameters . Hip structural analysis ( HSA ) using dual-energy x-ray absorptiometry is a vali date d technique to assess hip bone structure . OBJECTIVES The purpose of this study was to compare hip geometry in young oligoamenorrheic athletes ( AAs ) , eumenorrheic athletes ( EAs ) , and nonathletes using HSA . We hypothesized that AAs would have impaired bone structure compared with that of EAs . DESIGN This was a cross-sectional study . SETTING The setting was a clinical research center . SUBJECTS We enrolled 55 AAs , 24 EAs , and 23 nonathletes of normal weight who were 14 to 22 years old . Athletes ran ≥20 miles/wk or were engaged in weight-bearing sports for ≥4 hours/wk . MAIN OUTCOME MEASURES Dual-energy x-ray absorptiometry was used for HSA and hip areal bone mineral density ( aBMD ) . RESULTS Hip aBMD Z-scores were lower in AAs and in nonathletes than in EAs ( P = .002 ) . A larger proportion of AAs than EAs and nonathletes had hip Z-scores < -1 ( 30.9 , 4.2 , 17.4 % , P = .01 ) . At the narrow neck , trochanteric region , and femoral shaft , subperiosteal width , cross-sectional moment of inertia , and section modulus were higher in EAs than in nonathletes ; values in AAs did not differ from those of nonathletes . Cross-sectional area was lower in AAs and in nonathletes than in EAs . Groups did not differ for cortical thickness or buckling ratio . Group differences were lost after adjustment for lean mass but not aBMD . CONCLUSIONS In an eugonadal state , athletic activity confers benefits for hip structure independent of aBMD . This advantage is lost in AAs , who do not differ from nonathletes for most parameters and fare worse than EAs for cross-sectional area Long distance running has become a fashionable recreational activity . This study investigated the effects of external impact loading on bone and cartilage introduced by performing a marathon race . Seven beginners were compared to six experienced recreational long distance runners and two professional athletes . All participants underwent magnetic resonance imaging of the hip and knee before and after a marathon run . Coronal T1 weighted and STIR sequences were used . The pre MRI served as a baseline investigation and monitored the training effect . All athletes demonstrated normal findings in the pre run scan . All but one athlete in the beginner group demonstrated joint effusions after the race . The experienced and professional runners failed to demonstrate pathology in the post run scans . Recreational and professional long distance runners tolerate high impact forces well . Beginners demonstrate significant changes on the post run scans . Whether those findings are a result of inadequate training ( miles and duration ) warrant further studies . We conclude that adequate endurance training results in adaptation mechanisms that allow the athlete to compensate for the stresses introduced by long distance running and do not predispose to the onset of osteoarthritis . Significant malalignment of the lower extremity may cause increased focal loading of joint and cartilage PURPOSE Cure rates for localized high-risk prostate cancers ( PCa ) and some intermediate-risk PCa are frequently suboptimal with local therapy . Outcomes are improved by concomitant and rogen-deprivation therapy ( ADT ) with radiation therapy , but not by concomitant ADT with surgery . Luteinizing hormone-releasing hormone agonist ( LHRHa ; leuprolide acetate ) does not reduce serum and rogens as effectively as abiraterone acetate ( AA ) , a prodrug of abiraterone , a CYP17 inhibitor that lowers serum testosterone ( < 1 ng/dL ) and improves survival in metastatic PCa . The possibility that greater and rogen suppression in patients with localized high-risk PCa will result in improved clinical outcomes makes paramount the re assessment of neoadjuvant ADT with more robust and rogen suppression . PATIENTS AND METHODS A neoadjuvant r and omized phase II trial of LHRHa with AA was conducted in patients with localized high-risk PCa ( N = 58 ) . For the first 12 weeks , patients were r and omly assigned to LHRHa versus LHRHa plus AA . After a research prostate biopsy , all patients received 12 additional weeks of LHRHa plus AA followed by prostatectomy .  RESULTS The levels of intraprostatic and rogens from 12-week prostate biopsies , including the primary end point ( dihydrotestosterone/testosterone ) , were significantly lower ( dehydroepi and rosterone , Δ(4)- and rostene-3,17-dione , dihydrotestosterone , all P < .001 ; testosterone , P < .05 ) with LHRHa plus AA compared with LHRHa alone . Prostatectomy pathologic staging demonstrated a low incidence of complete responses and minimal residual disease , with residual T3- or lymph node-positive disease in the majority . CONCLUSION LHRHa plus AA treatment suppresses tissue and rogens more effectively than LHRHa alone . Intensive intratumoral and rogen suppression with LHRHa plus AA before prostatectomy for localized high-risk PCa may reduce tumor burden Abstract Purpose : There is an ongoing debate whether highly trained athletes are less responsive to the ergogenic properties of nitrate . We assessed the effects of nitrate supplementation on plasma nitrate and nitrite concentrations and repeated-sprint performance in recreational , competitive and elite sprint athletes . Methods : In a r and omized double-blinded cross-over design , recreational cyclists ( n = 20 ) , national talent speed-skaters ( n = 22 ) and Olympic-level track cyclists ( n = 10 ) underwent two 6-day supplementation periods ; 140 mL/d nitrate-rich ( BR ; ∼800 mg/d ) and nitrate-depleted ( PLA ; ∼0.5 mg/d ) beetroot juice . Blood sample s were collected and three 30-s Wingate tests were performed . Results : Plasma nitrate and nitrite concentrations were higher following BR vs PLA ( P < .001 ) , with no differences between sport levels ( all P > .10 ) . Peak power over the three Wingates was not different between BR and PLA ( 1338 ± 30 vs 1333 ± 30 W ; P = .62 ) , and there was no interaction between treatment ( BR-PLA ) and Wingate number ( 1 - 2 - 3 ; P = .48 ) . Likewise , mean power did not differ between BR and PLA ( P = .86 ) . In contrast , time to peak power improved by ∼2.8 % following BR vs PLA ( P = .007 ) . This improvement in BR vs PLA was not different between Wingate 1 , 2 and 3 . Moreover , the effects of BR vs PLA did not differ between sport levels for any Wingate parameter ( all P > .30 ) . Conclusion : The plasma and repeated-sprint performance responses to beetroot juice supplementation do not differ between recreational , competitive and elite sprint athletes . Beetroot juice supplementation  reduces time to reach peak power , which may improve the capacity to accelerate during high-intensity and sprint tasks in recreational as well as elite athletes BACKGROUND In primates , and rogens can play a synergistic role with FSH in promoting the early follicular recruitment , which is critical in assisted reproduction technique programmes . OBJECTIVE To assess whether poor responders can benefit from and rogen application . METHODS Inclusion criteria were a previous poor ovarian response to controlled ovarian stimulation and a decreased hormonal ovarian reserve . Selected women were r and omized to receive either transdermal application of testosterone ( n = 24 ) or placebo ( n = 25 ) gel for 15 days before FSH treatment for a second IVF cycle . Similar GnRH analogue and equivalent FSH daily doses were used in both cycles . The primary outcome was the total number of oocytes retrieved . RESULTS Testosterone gel application result ed in a significant increase in plasma testosterone levels but did not significantly improve the antral follicle count . Furthermore , after gel application , the main parameters of the ovarian response ( numbers of pre-ovulatory follicles , total and mature oocytes and embryos ) did not significantly differ between testosterone and placebo-treated patients . CONCLUSION No significant beneficial effects of and rogen administration on the ovarian response to FSH could be demonstrated . However , subsequent clinical trials are needed to determine whether an optimal dose and /or a longer duration of testosterone administration may be helpful Background Altered motor control strategies in l and ing and jumping maneuvers are a potential mechanism of noncontact anterior cruciate ligament injury . There are biomechanical differences between male and female athletes in the l and ing phase of stop-jump tasks . Fatigue is a risk factor in musculoskeletal injuries . Hypothesis Lower extremity muscle fatigue alters the knee kinetics and kinematics during the l and ing phase of 3 stop-jump tasks and increases an athlete 's risk of anterior cruciate ligament injury . Study Design Controlled laboratory study . Methods Three-dimensional videography and force plate data were collected for 20 recreational athletes ( 10 male and 10 female athletes ) performing 3 stop-jump tasks before and after completing a fatigue exercise .  Knee joint angles and result ant forces and moments were calculated . Results Both male and female subjects had significantly increased peak proximal tibial anterior shear forces ( P = . 01 ) , increased valgus moments ( P = . 03 ) , and decreased knee flexion angles ( P = . 03 ) during l and ings of all 3 stop-jump tasks when fatigued . Fatigue did not significantly affect the peak knee extension moment for male or female athletes . Conclusion Fatigued recreational athletes demonstrate altered motor control strategies , which may increase anterior tibial shear force , strain on the anterior cruciate ligament , and risk of injury for both female and male subjects . Clinic Relevance Fatigued athletes may have an increased risk of noncontact anterior cruciate ligament injury OBJECTIVE To determine the emotional and cognitive impact of injury and surgery on physical recovery in injured athletes . DESIGN A prospect i ve longitudinal study comparing the psychosocial and physical recovery of competitive and recreational athletes . SETTING Tertiary-care sports medicine center . PARTICIPANTS Twenty-seven athletes ( 15 men and 12 women ) who required anterior cruciate ligament ( ACL ) reconstruction surgery .  INTERVENTIONS A repeated- measures design used to compare the psychosocial and physical changes for 6 months after ACL surgery . MAIN OUTCOME MEASURES Emotional ( mood ) and cognitive ( coping ) functions and physical recovery ( range of motion , physician-rated level of recovery , and physician permission to return to sport ) . RESULTS There was a significant time-effect difference in mood , with a greater mood disturbance and recovery rate for competitive athletes than recreational athletes . Differences in mood and pain coping were significant at 2 weeks and 2 months after surgery . CONCLUSION Athletes experience significant mood changes throughout rehabilitation , which may hinder rehabilitation early in the process . Longer-term rehabilitation was not impacted by mood or pain coping . Future studies might focus on examining the process over a longer time period ( 1 - 2 years after surgery ) . Physicians should be aware of these findings and appropriately counsel and motivate athletes toward more favorable positive psychological and physical outcomes BACKGROUND Anabolic and rogen steroid abuse is associated with multiple psychiatric symptoms and is a significant public health problem . The biological mechanisms underlying behavioral symptom development are poorly understood . SUBJECTS AND METHODS We examined levels of monoamine metabolites , neurohormones , and neuropeptides in the cerebrospinal fluid ( CSF ) of 17 healthy men , at baseline and following 6 days of  methyltestosterone ( MT ) administration  ( 3 days of 40 mg/d , then 3 days of 240 mg/d ) . Subjects received MT or placebo in a fixed sequence , with neither subjects nor raters aware of the order . Potential relationships were examined between CSF measures , CSF MT levels , and behavioral changes measured on a visual analog scale . RESULTS Following MT administration , levels of 3-methoxy-4-hydroxyphenylglycol ( MHPG ) were significantly lower ( mean + /- SD , 103.8 + /- 47 vs 122.0 + /- 50.7 pmol/mL ; P<.01 ) , and 5-hydroxyindoleacetic acid ( 5-HIAA ) levels were significantly higher ( mean + /- SD , 104.7 + /- 31.3 vs 86.9 + /- 23.6 pmol/mL ; P<.01 ) . No significant MT-related changes were observed in CSF levels of corticotropin , norepinephrine , cortisol , arginine vasopressin , prolactin , corticotropin-releasing hormone , beta-endorphin , and somatotropin release-inhibiting factor . Changes in CSF 5-HIAA significantly correlated with increases in " activation " symptoms ( energy , sexual arousal , and diminished sleep ) ( r = 0.55 ; P = .02 ) . No significant correlation was observed between changes in CSF and plasma MT , CSF MHPG , and behavioral symptoms . CONCLUSIONS Short-term anabolic and rogenic steroid use affects brain neurochemistry , increasing CSF 5-HIAA and decreasing MHPG . Changes in 5-HIAA levels caused by anabolic and rogenic steroids are related to the behavioral changes we observed . In this small sample , we did not observe a significant relationship between behavioral measures and either dose of MT or CSF and plasma levels of MT
In addition , AAS abuse result ed in structural and functional sperm changes , a reduction in testicular volume , gynecomastia , as well as clitoromegaly , menstrual irregularities , and subfertility .
Conclusion The majority of  AAS users demonstrated hypogonadism with persistently low gonadotropin and testosterone levels , lasting for several weeks to months after AAS withdrawal .
Anabolic and rogenic steroid use results in profound and prolonged effects on the reproductive system of athletes and recreational users and potentially on fertility
Background Anabolic and rogenic steroids ( AAS ) are testosterone derivatives used by athletes and recreational users to improve athletic performance and /or enhance appearance .
Anabolic and rogenic 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 aim ed to critically assess the impact of AAS use on the reproductive system of athletes and recreational users .