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Androgen Misuse and Abuse.

David J Handelsman1,2

  • 1ANZAC Research Institute, University of Sydney, Sydney, Australia.

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|January 23, 2021
PubMed
Summary
This summary is machine-generated.

Testosterone and synthetic androgens are misused and abused for unproven anti-aging or performance benefits. Their only valid use is for pathological hypogonadism, despite widespread off-label prescribing and illicit use.

Keywords:
SARMsaginganabolic steroidandrogendrug abusesynthetic androgenstestosterone

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Area of Science:

  • Endocrinology
  • Pharmacology
  • Public Health

Background:

  • Androgens, including testosterone, have been used therapeutically since the 1930s.
  • Despite decades of use, the only established medical indication for testosterone is replacement therapy for pathological hypogonadism.
  • Widespread off-label prescribing and illicit abuse for non-medical purposes have emerged.

Purpose of the Study:

  • To review the misuse and abuse of testosterone and synthetic androgens.
  • To differentiate between valid therapeutic use and unproven or illicit applications.
  • To highlight the historical context and current trends in androgen misuse.

Main Methods:

  • Literature review focusing on the history and patterns of androgen use and abuse.
  • Analysis of definitions for testosterone misuse (off-label prescribing) and androgen abuse (illicit use).
  • Examination of claims regarding non-medical benefits versus established indications.

Main Results:

  • Testosterone's sole unequivocal indication remains replacement therapy for hypogonadism.
  • Significant misuse exists, with prescriptions for anti-aging, sexual dysfunction, and obesity lacking proven efficacy and safety.
  • Androgen abuse, initially in elite athletes, has become endemic in communities for bodybuilding and image enhancement.

Conclusions:

  • The review underscores the critical distinction between legitimate medical use and the widespread misuse and abuse of androgens.
  • It highlights the unproven and potentially unsafe nature of testosterone for rejuvenation, sexual dysfunction, and obesity.
  • The findings emphasize the public health implications of androgen misuse and abuse, particularly in non-medical contexts.