Misuse of Testosterone
Testosterone, for the right patient is an important medication but not for those seeking fertility. Unfortunately, in Pakistan, it is being prescribed as an adjunct to other medical therapies for the fertility purposes. It should be noticed that it is a male contraceptive and diminishes spermatogenesis (sperm formation). Physicians prescribing it should be educated about it and using quack medications should be discouraged as it has been found to contain large amounts of steroids.
Other users are bodybuilders or even non-athletes who use testosterone for aesthetic purposes only. In addition, it may be found in dietary supplements, which are supposed to be anabolic-androgenic steroid-free. International surveys recently revealed an overall steroid contamination rate of 15% to 25%, depending on the country, and the increasing prevalence of anabolic-androgenic steroid abuse is of major concern.
Testosterone abuse results in an acquired variant of hypogonadotropic hypogonadism characterized by extremely low or undetectable serum levels of sex hormones, atrophic testes and severe oligozoospermia or azoospermia. Patients of reproductive age prescribed testosterone replacement therapy should be counseled about its detrimental effect on spermatogenesis.
Treatment is possible but is takes up to a year and is expensive. The initial step in the recovery of spermatogenesis is discontinuation of exogenous testosterone or other anabolic-androgenic steroids. After this, depending upon hormonal levels, treatment plan can be tailored according to each individual’s need.
To conclude, testosterone replacement is a domain of men’s health that is worth understanding. But, at the same time, sound knowledge about it is mandatory in order to save your patients about its deleterious effects.