Can anabolic steroid use suppress Luteinizing Hormone (LH) and bioavailable testosterone?

From the Guidelines

Yes, anabolic steroid use can significantly suppress both luteinizing hormone (LH) and bioavailable testosterone levels in the body. The use of synthetic anabolic steroids disrupts the normal functioning of the hypothalamic-pituitary-gonadal axis, leading to a reduction in the production of gonadotropin-releasing hormone (GnRH) and subsequently, a decrease in LH secretion from the pituitary gland 1. As LH is crucial for stimulating testosterone production in the testes, this suppression results in reduced natural testosterone production. This feedback mechanism can cause testicular atrophy and potentially long-lasting hormonal imbalances.

The severity and duration of suppression depend on several factors including the type of steroid used, dosage, duration of use, and individual physiological differences. Recovery of natural hormone production after steroid cessation can take months or even years, and some users may require post-cycle therapy with medications like clomiphene citrate or human chorionic gonadotropin (hCG) to help restore normal hormonal function. It is essential to consider these factors when evaluating the impact of anabolic steroid use on LH and bioavailable testosterone levels.

Some key points to consider include:

• The type of anabolic steroid used can affect the degree of suppression, with some steroids causing more significant suppression than others.
• The dosage and duration of use also play a critical role, with higher doses and longer durations of use leading to more pronounced suppression.
• Individual physiological differences, such as genetic predispositions and overall health, can influence the severity and duration of suppression.
• Post-cycle therapy may be necessary to help restore normal hormonal function after steroid cessation.

In the context of male infertility, it is crucial to address the underlying causes of hypogonadism, including the use of anabolic steroids, to optimize treatment outcomes 1. Clinicians should inform patients about the potential risks and benefits of anabolic steroid use and provide guidance on safe and effective alternatives for managing hypogonadism and infertility.

Overall, the evidence suggests that anabolic steroid use can have significant and potentially long-lasting effects on LH and bioavailable testosterone levels, emphasizing the need for careful consideration and management of these factors in clinical practice.

From the FDA Drug Label

During exogenous administration of androgens, endogenous testosterone release is inhibited through feedback inhibition of pituitary luteinizing hormone (LH). At large doses of exogenous androgens, spermatogenesis may also be suppressed through feedback inhibition of pituitary follicle stimulating hormone (FSH)

Yes, anabolic steroid use can suppress Luteinizing Hormone (LH) and bioavailable testosterone. This is because exogenous administration of androgens inhibits endogenous testosterone release through feedback inhibition of pituitary LH, leading to decreased production of bioavailable testosterone 2.

From the Research

Anabolic Steroid Use and Hormone Suppression

• Anabolic steroid use has been shown to suppress Luteinizing Hormone (LH) and bioavailable testosterone in several studies 3, 4.
• A study published in 1976 found that administration of an anabolic steroid (metandienon) caused a pronounced lowering of plasma levels of testosterone, LH, and FSH in 16 well-trained athletes 3.
• A systematic review and meta-analysis published in 2017 found that anabolic androgenic steroid (AAS) use resulted in significant reductions in LH, FSH, and endogenous testosterone levels in male athletes and recreational users 4.
• The review also found that serum gonadotropin levels gradually returned to baseline values within 13-24 weeks after AAS discontinuation, whereas serum testosterone levels remained lower compared to baseline 4.

Mechanism of Hormone Suppression

• The negative feedback mechanism involved in the hypothalamic-pituitary-gonadal axis is thought to be responsible for the suppression of LH secretion in response to exogenous testosterone therapy 5, 6.
• A study published in 2022 found that LH suppression profiles may be relevant for dose titration during testosterone therapy and perhaps to minimize testicular atrophy 6.
• The study also found that the intramuscular route of testosterone administration, baseline LH levels, and estradiol levels were significant predictors of LH suppression 6.

Clinical Implications

• The suppression of LH and bioavailable testosterone in response to anabolic steroid use or exogenous testosterone therapy may have significant clinical implications, including effects on fertility and testicular function 5, 4, 6.
• Clinicians should be aware of these potential effects and monitor patients accordingly, taking into account individual patient characteristics and adjusting treatment as necessary 7, 6.