Post-cycle therapy may help former anabolic steroid users recover testosterone levels
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CHICAGO — Men who stop using anabolic-androgenic steroids may be able to restore their testosterone with the use of post-cycle therapy drugs, according to data presented at ENDO 2023.
In findings from an audit of data from a clinic in Scotland, men who discontinued anabolic-androgenic steroid use had higher mean testosterone if they used post-cycle therapy drugs such as human chorionic gonadotropins, selective estrogen receptor modulators and aromatase inhibitors, compared with men not using post-cycle drugs, with greater odds for testosterone normalization observed in men who used fewer steroids and used steroids for a shorter period of time.
“When men stop steroids, you get a crash in testosterone levels, which produces awful symptoms,” Channa Jayasena, MD, PhD, a reproductive endocrinologist at Imperial College London, said during a press conference. “Men are actually self-treating themselves with drugs to stimulate the testes, which is not recommended. [However], they have a fourfold higher chance ... to prevent hypogonadism.”
Researchers conducted a clinical audit of 613 men who discontinued use of anabolic-androgenic steroids in Scotland from 2015 to 2022 at a single addiction service clinic. Participants underwent a random blood test within 12 months of discontinuing use. The cohort was split into a group that used post-cycle therapy drugs and those who did not use post-cycle therapy drugs. Biochemical response was defined as a combination of reference range levels of total testosterone, serum luteinizing hormone and serum follicle-stimulating hormone as a marker for biochemical recovery from hypogonadism.
Of the cohort, 76% reported post-cycle therapy drug use. Men who used post-cycle therapy drugs had a higher mean total testosterone than men who did not use post-cycle therapy drugs (12.8 nmol/L vs. 11.3 nmol/L; P = .024). Normalized hormone levels were achieved in 48% of men using post-cycle therapy drugs compared with 38% of those who did not (P = .04). Men in the post-cycle therapy group achieved normalized hormone levels at 13.3 weeks after stopping steroids compared with 18.7 weeks for those who did not use post-cycle therapy (P < .01).
Jayasena noted biochemical recovery of hormones was significant only for men who used post-cycle therapy and had used steroids for less than 3 months. Use of only one post-cycle therapy drug and post-cycle therapy duration of longer than 6 months were also associated with a greater likelihood of biochemical recovery.
During a Q&A session, Jayasena said the men taking post-cycle therapy were using a variety of different drugs and some men were not sure what they were taking.
“We’re not there in terms of recommending this, because there’s no causality,” Jayasena said.
Jayasena said a forensic investigation should be conducted to study the mechanistic effects of post-cycle therapy and how it could be made safe for men who previously used anabolic-androgenic steroids.
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Jayasena CN. Abstract OR25. Presented at: ENDO Annual Meeting; June 15-18, 2023; Chicago.
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