Priapism after androstenedione intake for athletic performance enhancement

Priapism is a relatively rare condition characterized by persistent painful erection of the corpora cavernosum that occurs unrelated to sexual stimulation or desire. It has been associated with cocaine exposure, sickle cell anemia, anticoagulant therapy, neoplastic syndromes, diabetes, and the use of psychotropic medications. Androstenedione is a testosterone precursor used by athletes to enhance performance; the lay press has recently touted this substance as an over-the-counter sexual stimulant. We describe an otherwise healthy man with 2 episodes of priapism after the use of androstenedione. The patient did not have any factors known to precipitate priapism.