The use of steroids today has taken on an epidemic character: in professional sports, one cannot survive without them, as everyone uses them; in amateur sports, the opportunity to quickly gain mass while also burning fat looks very tempting.
However, hormonal changes in the body rarely go unnoticed.
Anabolic steroids have an extensive list of side effects that are a consequence of their use in excessively large doses, over a long period, and in combination with other pharmaceuticals.
Main thoughts:
When steroids are taken by men, the volume of sperm and the motility of spermatozoa decrease
Recovery of sperm production after stopping steroid use can take several years
The principles of scientific ethics prohibit conducting experiments to study the effects of steroids on the human body. Therefore, many conclusions about the consequences of their use in sports are drawn by scientists based on the analysis of various medical cases where the testosterone level in men exceeds the norm.
In this material, we will discuss the impact of steroids on sexual function in men: effects on potency or libido, volume and quality of sperm, the ability to conceive a child from the male side, and why “it is not worth it” to be on a steroid cycle, as well as testicular and prostate cancer.
The foundation of this article is the results of a scientific study by Professor Eberhard Nieschlag from the Center for Reproductive Medicine and Andrology at the University of Münster in Germany 1.
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The Impact of Steroids on Sexual Function in Men
Volume and Quality of Sperm
When steroids (testosterone) are administered by athletes, they affect the mechanism of natural testosterone production: hypothalamus-pituitary-testes. This leads to a decrease in the natural production of testosterone in the body, its levels in the testes, and, as a result, a reduction in sperm volume.
How do scientists know this if experiments on athletes are prohibited, and they themselves deny everything and keep it secret? From clinical studies. One example is hormonal therapy as a method of contraception in men.
Contrary to popular belief, in medicine, testosterone is used to reduce the likelihood of conception from the male side, not to increase it: its injections in therapeutic doses reduce sperm motility and their quantity in semen 2.
Anabolic steroids are derivatives of testosterone. They differ slightly at the molecular level. In medicine, some of them are also used for male contraception. In particular, 19-nortestosterone and MENT 3,4.
When men take steroids, the volume of sperm and sperm motility decrease
– Does the mechanism of sperm production in men get irreversibly damaged with steroid use or not?
After stopping steroid use, the sperm production mechanism recovers to its original level, and there is no basis to believe that the damage may be irreversible 1.
The duration of recovery can range from 6 to 24 months. It depends more on individual characteristics of the body rather than on how the steroids were taken (doses and cycles) 5.
However, these conclusions are based on medical cases where the doses of testosterone and steroids are close to natural levels. In bodybuilding, the unpredictability of the effect remains, as the doses are significantly higher, steroids are taken cyclically, and in combination with other substances.
In some athletes, the recovery of sperm production and its motility can take a very long time. This may be a consequence of very high doses of steroids 6,7. For example, after stopping the intake of nandrolone, its metabolites can be present in urine for up to a year in some men 8.
The recovery of sperm production after stopping steroid use can take several years
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– How do steroids affect potency in adolescents?
During adolescence, the sexual organs are still developing, and hormonal imbalance can be potentially dangerous for sexual health.
How dangerous it is remains unclear to scientists. There are no scientific studies on this matter.
However, once again, medicine comes to the rescue: medical studies on tall adolescents, for whom steroids are sometimes used in doses close to those used in bodybuilding to stop growth, indicate that the function of the testes in sperm production is not irreversibly damaged during adolescence and recovers after stopping steroid use 1,9,10.
It is unlikely that steroid use by adolescents leads to irreversible damage to the function of the testes in sperm production and impotence
– Why does the size of the testes decrease with steroid use?
Along with the suppression of sperm production, the size of the testes also decreases. This is explained by the fact that 95% of their volume is occupied by sperm-producing structures, which atrophy 1.
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Testicular cancer in men
There is no definitive scientific evidence that steroid use can lead to testicular cancer in men.
In the scientific literature, there is one case of testicular cancer in a former weightlifter from Germany who took turinabol in large doses (20 tablets a day) from the age of 18 to 23. He developed gynecomastia, and at the age of 32, he underwent surgery due to testicular cancer (leiomyosarcoma) 11.
This type of cancer is quite rare, but one study showed its development in hamsters as a result of administering testosterone propionate and diethylstilbestrol 12. The authors concluded that there is a positive correlation between steroid use and testicular cancer.
There is no definitive scientific evidence that the use of steroids leads to the development of testicular cancer in men. However, experiments on animals suggest that the likelihood of cancer may increase.
The Impact of Steroids on Potency and Libido or “Why You Shouldn’t Use Steroids”
In addition to reducing sperm volume and decreasing testicle size, some athletes report a loss of libido and erectile function when “not performing after a course of steroids and during the course.”
This effect is most often observed in men who take aromatizing steroids, which raise the level of the female sex hormone estrogen in the blood.
Estrogen is also necessary for the proper functioning of the male body and is present in it in its natural form. However, when its level rises above normal, the imbalance between testosterone and estrogen leads to erectile (potency) problems.
The same can happen after a course of steroid use when natural testosterone production has not yet recovered. I remind you that it is suppressed during steroid administration.
When men take aromatizing steroids, the level of the female hormone estrogen in the blood increases, which can affect potency, particularly disrupting erection.
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– What to do if you can’t perform during or after a course of steroids?
Potency and erection recover after stopping steroid use.
Additionally, many therapeutic methods have been developed today to accelerate recovery, which athletes slangily refer to as PCT – post-cycle therapy.
Most often, athletes take gonadotropin growth hormone 13, as well as tamoxifen and clomid to suppress and prevent gynecomastia and other undesirable side effects of increased estrogen levels in the blood.
However, taking growth hormone along with anabolic steroids to maintain potency and the ability to conceive leads to an increase in the proportion of sperm with morphological changes 14. That is, it helps maintain sperm quantity but not its quality.
There are no scientific studies on how to avoid potency issues when taking anabolic steroids. Due to their absence, scientists recommend stopping steroid use as the only effective method.
The practice of correcting the effects of one hormone (testosterone) with other hormones and drugs (growth hormone, tamoxifen, clomid) is not endorsed by scientists 1.
To restore potency (erection) during and after a course of steroids, scientists name the only correct method – cessation of steroid use. The practice of using other hormones and drugs (PCT) for this purpose is not approved.
Prostate Cancer
The growth and development of the prostate during adolescence occurs under the influence of male sex hormones, androgens 15, which include testosterone.
There are cases when the prostate is underdeveloped and small due to hormonal disorders. Testosterone injections help to correct the problem.
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– What will happen to the prostate in healthy individuals under conditions of elevated testosterone levels?
It is widely believed that large doses of testosterone and other steroids typical for athletes provoke prostate growth, lead to its hypertrophy, and stimulate the development of prostate cancer.
However, in the scientific literature, there is only one recorded case where a bodybuilder who used a combination of injectable steroids in high doses for 18 years (sometimes along with growth hormone) developed adenocarcinoma or prostate cancer at the age of 40 16.
Based on this, one would like to conclude that “the use of steroids in bodybuilding leads to the development of prostate cancer,” but apart from this case, there are no others 17.
Does this mean that there is no correlation between steroids and prostate cancer?
Definitely not.
Recall what was said at the beginning: athletes and bodybuilders, in particular, do not lend themselves to scientific research, and even if prostate cancer occurs, the doctor cannot always determine the exact cause (an honest admission from patients about anabolic use is required), and even if they do determine it, this information is not always publicly available, even on the most scientific resources.
There is a recorded case in the scientific literature of prostate cancer development in a bodybuilder who took large doses of steroids for 18 years.
– How do the type of sport and duration of training affect the risk of prostate cancer?
Some facts indicate that the risk of developing prostate cancer (as well as issues with erection and inability to conceive) is influenced by the type of sport and the duration of participation in it, which further complicates the understanding of the relationship between steroids and prostate cancer.
In one study, researchers found a clear correlation between prostate cancer and the number of hours spent training per week among cyclists based on an analysis of information from over 5000 cyclists 18: the likelihood of cancer is higher in those who spend more than 3.5 hours a week cycling; however, the duration of training does not affect potency (erectile dysfunction, ability to conceive children).
The duration of training in cyclists is a factor that increases the likelihood of developing prostate cancer
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– Does the size of the prostate increase with steroid use?
There is also no scientific data indicating that regular steroid use leads to an increase in prostate size. Experiments on monkeys have shown that testosterone injections combined with norethisterone prevent prostate growth, which is characteristic only of testosterone 19.
This may be one explanation for the actual absence of prostate cancer cases among bodybuilders on steroids, as steroids in bodybuilding are taken in combination, and some of them have the same progestogenic effect as in the monkey experiment, i.e., they prevent prostate growth stimulated by testosterone.
The use of steroids with a progestogenic effect prevents prostate growth stimulated by testosterone
And finally: observations by doctors of patients undergoing testosterone hormone therapy show that the incidence of prostate cancer among them is not higher than that observed in patients with the same issues who do not take testosterone 20.
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Conclusion
The principles of scientific ethics do not allow researchers to conduct experiments investigating the effects of steroid use on athletes. Therefore, no one can provide a definitive answer to the question of how steroids affect male potency, the ability to conceive a child, the risk of prostate and testicular cancer today, and it is unlikely that this will be possible in the future.
Most of the conclusions drawn above about the harm of steroids to men’s sexual health are made based on medical case data, where testosterone levels in the blood differ only slightly from natural levels and are incomparable to those used in sports.
Based on the available data, it can be concluded that the use of steroids in sports negatively affects men’s potency, reducing sperm volume and motility, which may be a reason why one “should not” be on a steroid cycle, but it is unlikely to increase the risk of prostate and testicular cancer in men.
Strict scientific research on the issue is necessary.
