Endocrine Abstracts

Background: The global prevalence of anabolic-androgenic steroid (AAS) use among women has been estimated at 1.6% and is rising. AAS use is associated with adverse effects on multiple body systems including the cardiovascular and psychiatric system. Female specific adverse effects include menstrual irregularity, hirsutism, voice deepening, androgenic alopecia and clitoromegaly. In men AAS use results in suppression of the hypothalamic-pituitary-gonadal axis which can take months to years to recover. However, the impact of AAS on the female reproductive system is under researched. Here we report preliminary data from our ongoing study aiming to address this research gap.

Methods: Ethics-approved cross-sectional study of 30 women: no AAS use (Control; n = 13); current AAS use (Current; n = 6); past AAS use (Past; n = 11). Blood samples taken included reproductive hormone levels, haematological, hepatic, and lipid profiles. Urine samples for toxicology testing has been saved. Details about AAS use and menstrual cycles were collected using a standardised questionnaire. Women completed validated questionnaires to assess wellbeing, mental health, and sexual function.

Results: Current AAS users were significantly more likely to experience menstrual irregularity (2/13, 15.4%, Control; 5/6, 83.3%, Current; 2/9, 22.2%, Past; P < 0.01). Current users had lower serum FSH compared with past users (median FSH: 2.2IU/l [IQR 0.2-5.6], Current; 7.4IU/l [6.0-9.9], Past; P = 0.03) and lower SHBG compared with controls (median SHBG: 77mmol/l [47–90], Controls; 17mmol/l [8.1–29], Current; P < 0.01). Current users also had significantly higher serum testosterone levels (median total testosterone: 1.0nmol/l [0.78–1.3], Control; 18.0nmol/l [3.9–65.0], Current; 0.9nmol/l [0.67–1.3], Past; P < 0.01).

Conclusions: This study demonstrates that menstrual irregularity, and FSH suppression is observed during AAS use in women and, for the majority, this normalises with cessation of use. Our preliminary data highlights the possible short, and long-term adverse reproductive effects of AAS use in women.