Secondary male hypogonadism

ICD-10 E29.1 · ICD-11 5A81.1.1

Secondary Male Hypogonadism in Anabolic Steroid-Induced Hypogonadism (Non-Prescription AAS Use)

This protocol covers secondary male hypogonadism that arises from the use of non-prescription anabolic-androgenic steroids (AAS) — a clinically distinct, potentially reversible form of hypogonadotropic hypogonadism driven by exogenous androgen exposure.

Clinical Scenario

Non-prescription AAS use suppresses the hypothalamic-pituitary-gonadal (HPG) axis through feedback inhibition of pulsatile GnRH release, producing a secondary fall in LH and FSH and consequently in endogenous testosterone — the hallmark of anabolic steroid-induced hypogonadism.

Treatment Approach (Partial Overview)

Following a complete endocrine and metabolic assessment, the structured approach involves targeted gonadotropin-stimulating therapy — including hCG as one component — aimed at reactivating the suppressed axis. The full regimen, agent selection, and sequencing are in the complete protocol.

Clinical Goals

Restoration of the reproductive endocrine axis, with recovery of gonadotropin levels (LH and FSH) and serum testosterone into the normal range.

Instant Access to Structured Evidence-Based Regimens

References

  1. Use of AAS results in hypogonadotropic hypogonadism by feedback suppression of the hypothalamic-pituitary-gonadal (HPG) axis via inhibition of pulsatile GnRH release and a subsequent decrease in LH and FSH.
  2. After a complete endocrine and metabolic assessment, the condition may be treated with hCG, and selective oestrogen receptor modulators (SERM), until the reproductive endocrine axis has been restored.
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