The link between anabolic steroid use and male fertility

The term “anabolic” refers to the body’s process of using energy to promote physical growth and regulate metabolism. “Androgens” are important for the development of male sex characteristics (think muscle growth, hair growth, deep voice, etc.).


Anabolic-Androgen Steroids (AAS) are synthetic derivatives of the male hormone testosterone that are often medically prescribed to treat hormone imbalance conditions such as hypogonadism (low T), impotency, delayed puberty, breast cancer in women and other conditions.


However, for decades people have been misusing and abusing anabolic steroids to gain a boost in the gym and improve athletic performance. And lately androgen misuse has become a serious global public health concern due to a transition from use for strictly sport to a much wider spectrum of the population. The effects of anabolic steroid abuse on reproductive fertility has been well documented in the past and suggests that the recent increments seen in androgen misuse over the world may have contributed in part to the global decline in male fertility.


The Olympics banned steroid use in 1974 and all anabolic steroids were subsequently classified as DEA Schedule III drugs. But those bans did not stop the underground market for steroids as a growing population of both professional and non-professional athletes, such as weightlifters, bodybuilders, baseball players, soccer players and wrestlers started using these image- and performance- enhancing drugs in their regular lives. An estimated 3-4 million Americans, most of which are likely to be non-professional male athletes between 20 and 30, are using anabolic to increase muscle mass and performance for sport, or for cosmetic purposes such as enhancing their physical appearance.


These drugs are often obtained from the internet and other dubious sources meaning that they haven’t undergone proper testing and may potentially have been contaminated (cut) with unknown chemicals. Moreover, users are highly likely to consume them at high doses and combined with concomitant illegal drug use, which increases the probability of the user engaging in health risk or problem behaviours, such as drinking and driving, carrying a gun, STDs and suicide.


In addition anabolic steroids have a tremendous negative impact on fertility. Steroids raise men’s testosterone levels so much that it suppresses the body’s natural production of FSH and LH, and in turn natural testosterone which hinders or halts the creation of sperm. Steroids also can lead to testicular atrophy (ie your  balls get smaller), erectile dysfunction, gynecomastia (man boobs) and acne. In women, steroids often disrupt ovarian function as well as propagate hirsutism, acne and deepening of the voice.


In addition to the risks described above, male steroid users tend to have lower self-esteem, higher rates of depression, more suicide attempts, poor knowledge and attitudes about health and might have great concerns regarding weight gain, eating disorders and substance abuse. If you’re a steroid user, or considering starting a steroid regiment, we urge you to think twice. There’s more to life than big delts and chiseled calves. But if you do decide to do it, please do it under the care of a medical professional to minimize the risks to you and your health.

Why junk food might wreck your sperm count 

The data is in: eating garbage can affect how long it takes for you to conceive.


First, for the ladies:


Australian researchers recently published a study suggesting that women who “rarely or never” eat fast food had an 8% risk of infertility, while women who eat McDonald’s four or more times a week are twice as likely to experience periods of infertility. The frequent fast food fanatics also took on average one month longer to conceive than women with apparently “healthier” diets, and although no specific link has been made between dietary components and their relationship with fertility, lead researcher Jessica Grieger stated that “fast food may be one factor mediating infertility through altered ovarian function”.


And lads watch out, it’s not just women!


According to a recent Harvard study, dietary patterns are just as responsible for affecting testicular function in men as ovarian function in women. The diet, semen quality, reproductive hormones and lifestyle factors of nearly 3000 Danish men were separated into groups by dietary pattern. The Western diet – consisting of pizza, processed foods, refined grains, red meat, snacks, candy and energy drinks; the Prudent diet – which consisted of fish, chicken, fruit, vegetables and water; the Smørrebrød diet – which involved whole grains, cold fish, mayonnaise and cold processed meats; and the Vegetarian diet, which included soy milk and eggs.


Men with the healthiest, happiest and most numerous sperm followed the Prudent diet and the worst sperm were produced by those following the traditional Western diet, and the reason for this is as follows. Inhibins (A or B) are protein hormones which are secreted by ovarian granulosa cells in females, and by testicular Sertoli cells in males. Inhibin selectively suppresses follicle-stimulating hormone (FSH) in both males and females, more specifically in males inhibin helps to locally regulate spermatogenesis and in females inhibin inhibits FSH production from ovarian granulosa cells at different stages.


With today’s world always in a rush to get to tomorrow, it may seem an insurmountable task to work 60 hours per week, maintain a relationship and social life, exercise regularly, sleep at least 7-9 hours every night AND have to make sure were inhaling a low-saturate, low-salt balanced diet with at least 10 portions (according to CBS News) of fruit and vegetables a day. And it damn near is, but for couples who are at that stage and ready to have a family, not making these drastic lifestyle changes may be detrimental to your family-building goals.

Meet the Male Reproductive Health Initiative (MRHI), a global consortium fighting to get sperm the attention they need.

Male reproductive health is in crisis. Recent evidence of declining sperm counts and increasing male reproductive-system abnormalities reveals that this is a global problem that is rapidly worsening. In many parts of the world, fertility rates have hit rock bottom and the rise in male factor infertility is almost certainly part of the cause.

Do we know what’s driving this problem? Not really. There are a lot of theories, and most likely there are multiple factors contributing to the problem, but we don’t yet have a smoking gun.  This lack of understanding can be partly attributed to limited healthcare policies, diminishing research funding, and extremely underdeveloped societal awareness and education.

Enter the Male Reproductive Health Initiative (MRHI); a newly established consortium of globally renown key opinion leaders across research, medicine, funding, and policy agencies who are pushing male reproductive health to the top of the political and public health agenda.

MRHI seeks to raise the awareness of society, policy and funding agencies, and others around four main issues:

  1. The significance of male reproductive health
  2. The connection with overall male health and illness
  3. The role the male has in the health and wellness of his offspring and the next generation, and
  4. The significant burden that is currently carried by his female partner when seeking diagnosis and treatment for infertility.

In addition, the MRHI aims to increase the participation of men in seeking healthcare, as well as advocate to invigorate policy and funding agencies to support increased research into male reproductive biology.

The MRHI is spearheaded by Dr. Chris De Jonge and Dr. Chris Barratt, two world-renowned andrologists who serve on the World Health Organization (WHO) task force for male fertility. In the course of helping the WHO revise its clinical guidelines for the diagnosis of male infertility, the pair identified several fundamental aspects of men’s reproductive health that still lack sufficient knowledge and data upon which clinical decisions can be made. They have published their findings and recommendations for improving the scientific landscape recently in the journals Human Reproduction and Andrology.

Why should we care? As men, having a poor reproductive health profile not only results in greater healthcare costs but also places the burden of infertility treatment solely on women. Therefore the consequences our lifestyle choices extend beyond just us: men’s health is just as much an issue affecting women’s health as well as the health of our future children.

One such choice in particular is the father’s age-at-conception. Researchers have linked spermatozoa from advanced-paternal-age fathers to increased risk of adverse perinatal effects, including early child mortality, cancer, autism and schizophrenia. This may sound daunting, but the harsh realities remain; the sperm epigenome is uniquely complex and susceptible to environmentally associated modification. High paternal-age, smoking, obesity and pollution (just to name a few), are factors that can artificially age a man’s spermatozoa which will consequently impact the gestating foetus, neonate and child. If action is not taken regarding more routine male reproductive health assessments and lifestyle guidance, then men will continue to die young, suffer with chronic disease and will unwittingly continue to pass down genomic mutations to future generations. By coming together, raising awareness and reducing the toxic masculinity and stigma surrounding infertility we will be able to bridge the gender gap in current healthcare policies and enjoy a much more gender-inclusive reproductive health ecosystem, where male reproductive biology is equally as well researched and funded as female reproductive biology is today.

Dr. De Jonge and Dr. Barratt elegantly state the urgency in this matter in their recent opinion piece in the journal Andrology:

If action is not taken, and swiftly, then men will continue to die younger, suffer longer with chronic disease and will, unwittingly, continue to pass their potentially altered genomic and epigenomic signatures to future generations. Men’s health is global community health!” 
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