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La eficacia de una intervención de reducción de daños para el abuso de andrógenos: un ensayo controlado
Tijs Johannes Verdegaal1,2, Willem de Ronde1, Manon Jansen2
1Department of Internal Medicine, Spaarne Gasthuis, Boerhaavelaan 22, 2035 RC, Haarlem, the Netherlands; Department of Endocrinology and Metabolism, Amsterdam UMC, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.
Objective:
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.
Design:
Historically controlled trial.
Methods:
This one-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 outcome included within-participant deviation from planned abuse.
Results:
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 -9,609) mg lower in the intervention group (6,323 ± 5,229 mg) compared to controls (19,410 ± 16,497 mg). Within-person differences showed an average reduction of 8,729 (95% CI -11,297 to -6,287) mg in the intervention group compared to controls. Multivariable regression confirmed the interventions' effect was independent of baseline differences. No significant enabling effect was observed.
Conclusion:
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.
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