Pandemic of testosterone abuse: Considerations for male fertility.
Level 5 - mechanism / opinion, no new human data
Narrative review without systematic methodology
PubMed 40747477 · doi:10.1080/20905998.2025.2509456
What was done
This is a narrative review synthesizing the physiological roles of testosterone, the pathophysiological mechanisms of exogenous testosterone and anabolic-androgenic steroid (AAS) abuse on male reproductive function, diagnostic evaluation methods, and management strategies for AAS-induced infertility.
What was found
The abstract reports no primary experimental data or quantitative summary statistics. It describes how testosterone abuse suppresses the hypothalamic-pituitary-gonadal axis, reducing intratesticular testosterone, causing testicular atrophy, azoospermia, oxidative stress, and sperm DNA damage. It notes that fertility recovery post-cessation can be prolonged or incomplete, and outlines management approaches including substance cessation, pharmacotherapies (such as hCG and SERMs), lifestyle changes, and assisted reproductive technologies.
Why it matters
It provides clinicians with an overview of the reproductive consequences of non-medical testosterone and AAS use, outlining current diagnostic steps and treatment pathways for restoring spermatogenesis.
Limits
The review presents qualitative descriptions rather than systematic quantitative data, meta-analyses, or clearly defined study selection criteria. Specific effect sizes, recovery rates, and time-to-recovery metrics are not provided in the abstract.
Cited by
- supports Exogenous testosterone suppresses fertility in men.