The efficacy of a harm reduction intervention for androgen abuse: a historically controlled trial

Androgen abuse for performance- and image-enhancement is increasing despite preventive efforts, yet no controlled trials have evaluated harm reduction strategies. This trial assessed whether a harm reduction intervention could reduce androgen abuse in males.

Historically controlled trial.

This 1-year prospective intervention study included 99 male amateur athletes planning to start an androgen cycle. Outcomes were compared to a historical cohort study (n = 100) from our research group receiving no intervention. The intervention comprised individualized counseling and medical assessments. Primary outcomes included cumulative androgen dose, cycle duration, and weekly dosage. Secondary outcomes included within-participant deviation from planned abuse.

Baseline characteristics were largely comparable, although intervention participants reported slightly more weekly training time and lower intended cumulative cycle dose. Twelve percent refrained from initiating a cycle due to the intervention. The mean cumulative androgen dose was 13 087 (95% CI -16 564 to -9609) mg lower in the intervention group (6323 ± 5229 mg) compared to controls (19 410 ± 16 497 mg). Within-person differences showed an average reduction of 8729 (95% CI -11 297 to -6287) mg in the intervention group compared to controls. Multivariable regression confirmed that the interventions' effect was independent of baseline differences. No significant enabling effect was observed.

This is the first controlled study to demonstrate that a harm reduction intervention can reduce androgen exposure among men planning to abuse androgens. These findings support harm reduction as a promising strategy to mitigate health risks associated with androgen abuse. Future studies should confirm generalizability and monitor for potential enabling effects.

Registration number P2117, study number NL77191.028.21.