Supraphysiological androgen administration suppresses testicular functions causing reduced sperm output and testosterone secretion; however, the rate and extent of testicular function recovery after cessation is not reported. We undertook a cross-sectional, observational study of current and past androgen abusers together with healthy non-user controls to determine the rate and extent of recovery of sperm output and reproductive hormones after cessation of androgen intake.
We recruited (via social media) age-matched (mean 34 years), regularly exercising volunteers comprising 41 current and 31 past users (≥3 months (median 300 days) since last use) with 21 healthy non-user controls. Each underwent physical examination and provided serum (steroids by LC-MS; LH, FSH, SHBG, hematology and biochemistry) and semen sample (WHO). Current users, compared with past and non-users, had significant suppression of mean (orchidometry) testicular volume (TV, 14.3, 18.6, 23.2 ml), sperm output (excluding 6 vasectomized men, median 4, 215, 203 million/ejaculate) and mean serum LH (0.5, 5.5,5.2 IU/L), FSH (0.5, 4.7, 4.9 IU/L), SHBG (17.2,33.9,42.0 nmol/L) and had significant increases in serum T (133.6, 21.5, 29.8 nmol/L), DHT (1.5, 0.5, 0.7 ng/ml), E2 (146, 41, 48 pg/ml), E1 (65, 32, 38 pg/ml), 3α-androstanediol (2.2, 0.4, 0.6 ng/ml), hemoglobin (164, 154,151 g/l). All but TV and SHBG were not significantly different between past and non-users consistent with full recovery. Rate of recovery for androgen-suppressed variables (estimated as the time to reach the mean for non-users), was 9 months for serum LH, 14.2 months for sperm output and 18.7 months for serum FSH.
We conclude that suppressed testicular function due to androgen abuse is mostly reversible with recovery taking 9 to 18 months after ceasing androgen intake. Suppressed serum LH and FSH represent convenient, useful and underutilized markers of androgen abuse and recovery.