Reversible azoospermia induced by the anabolic steroid 19-nortestosterone

Schürmeyer, T. H.; Knuth, Ulrich A.; Belkien, L.; Nieschlag, Eberhard

doi:10.1530/acta.0.107s060

Cited by 28 publications

(52 citation statements)

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“…The favourable combination of intramuscular DMPA injections combined with androgen injections showed its potential contraceptive efficacy by suppressing sperm concentrations to 51610 6 /ml in the majority of men 38 . Especially the additive effect of the longacting synthetic androgen 19-nortestosterone seemed promising, as this anabolic steroid had already shown contraceptive potency 39 . Encouraged by a study demonstrating that threeweekly injections of 200 mg 19-nortestosterone together with injections of 250 mg of DMPA achieved azoospermia in eight out of 12 volunteers, while three more had only single sperm in the ejaculate and one showed severe oligozoospermia 40 , the WHO initiated a multi-centre trial in Indonesia to directly compare the administration of DMPA combined with either testosterone enanthate or 19-nortestosterone 41 .…”

Section: E P O T -M E D R O X Y P R O G E S T E R O N E a C E T A T Ementioning

confidence: 99%

Male contraception: A realistic option?

Nieschlag

2006

The European Journal of Contraception & Reproductive Health

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This review illustrates the principle of hormonal male contraception and gives an overview of current trials aiming at the development of a marketable hormonal contraceptive for men. The principle of male hormonal contraception is based on strong suppression of gonadotropins in order to arrest spermatogenesis at the spermatogonial stem cell level, thus leading to azoospermia or severe oligozoospermia. Until now, it has not been possible to interrupt spermatogenesis effectively without simultaneously inhibiting the production of androgens by Leydig cells, resulting in a deficiency of extra-testicular androgens. Therefore, testosterone needs to be replaced. By administering exogenous testosterone alone azoospermia can be reached in East Asians, whereas azoospermia is only achieved in two-thirds of Caucasian volunteers so that in these men an additional agent is required. Currently injectable testosterone combined with gestagens or administered as implants are being tested for possible licensing. Although scrotal and non-scrotal testosterone patches, orally administered testosterone undecanoate and testosterone gels are generally well tolerated and provide stable testosterone levels in the normal range, their use showed generally disappointing efficacy due to insufficient gonadotropin suppression. Further large multi-centre studies are required to establish the contraceptive efficacy of the most promising steroid combinations.

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Section: E P O T -M E D R O X Y P R O G E S T E R O N E a C E T A T Ementioning

confidence: 99%

Male contraception: A realistic option?

Nieschlag

2006

The European Journal of Contraception & Reproductive Health

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“…Infertility is a common effect of anabolic steroid use and this has been utilised by the WHO in the research for a male contraceptive (Schurmeyer et al 1984, WHO Task Force on Methods for the Regulation of Male Fertility 1990). A reduction in testicular volume can be observed.…”

Section: Genitourinarymentioning

confidence: 99%

Drugs in sport - the role of the physician

Dawson¹

2001

Journal of Endocrinology

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Sportsmen have used anabolic steroids since the 1950s and yet it was not until the 1980s that we, as physicians, admitted that they could improve performance. We now find ourselves in the invidious position of being unable to predict convincingly either safety or major health risks with performance-enhancing drug use.The use of performance-enhancing drugs is no longer limited to the elite athlete. In 1993 the Canadian Center for Drug-free Sport estimated that 83 000 children between the ages of 11 and 18 had used anabolic steroids in the previous 12 months. Recent evidence suggests anabolic steroids are now the third most commonly offered drugs to children in the UK, behind cannabis and amphetamines.The role of the physician of today is to regain our position of impartiality and objectivity within both the sporting and general community. Only then will we be able to pursue a harm minimisation strategy designed to convince the public that it is better to be the best you can be naturally.For the majority, the improvement through the use of performance-enhancing drugs can equally be achieved through dietary and training advice. For the elite athlete, what price a gold medal that is tarnished by deceit? Its value then can only lie with the sponsors and politicians, for they can no longer claim to be sportsmen, only entertainers. Journal of Endocrinology (2001) 170, 55-61 Drugs in sport -the role of the physicianLife is short, art is long, opportunity fleeting, experiment dangerous, judgement difficult. Not only must the physician show himself prepared to do what is necessary; he must also secure the co-operation of the patient, the attendants, and of external circumstances.Hippocrates, Aphorisms I.1 (IV.485L)Little has changed for the physician over the centuries. Our role remains to do what is necessary for the benefit of our patients. At times this can lead to an ethical dilemma as we struggle with behaviour we believe to be morally wrong and yet we must put the health and well-being of our patient first. This dilemma is typified by the use of performanceenhancing drugs in sport and of anabolic steroids in particular. As we struggle to control a problem that has become endemic in sport, are current drug policies providing no more than Pyrrhic victories as we alienate those we have sworn to protect, our patients?The use of drugs in sport is not new but few drugs have fuelled the public's imagination as anabolic steroids have. With an onset of use in sport by the Russians in the 1950s (Wade 1972) it was not until the 1980s that the medical profession finally accepted their efficacy as performance-enhancing drugs. This has caused many athletes to doubt our impartiality and knowledge of performance-enhancing drugs. Ultimately, this has led to an increasing reliance, by many, on locker-room anecdotes rather than turning to their physician for a trusted medical opinion. Prohibition -a flawed strategy in a climate of rewardThe sporting authorities have adopted a policy of prohibition for performance-enhancing dru...

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“…They have been extensively studied in both animals and humans for the last five decades (Birch 1950;Engel et al 1958;Dimick et al 1961;Schu¨rmeyer et al 1984;Belkien et al 1985;Dumasia et al 1989;Minto et al 1997;Bhasin et al 2003). They are also obligatory intermediates in estrogen biosynthesis, in both animals and man (Short 1961;Skinner and Akhtar 1969;Berkowitz et al 1984;Courtot et al 1984;Bergink et al 1985;Dumasia et al 1989;Garrett et al 1991).…”

Section: Resultsmentioning

confidence: 99%

“…Since then, the pharmaceutical industry has produced norsteroids for human, and animal, substitutive (hypogonadism), complementary (osteoporosis and haemological diseases) or contraceptive treatment (Frankle and Leffers 1992;Mauvais-Jarvis 1984;Schu¨rmeyer et al 1984;Segaloff 1963;Wilson 1988).…”

Section: Origin Of Endogenous Nandrolone and Norsteroidsmentioning

confidence: 99%

Update on nandrolone and norsteroids: how endogenous or xenobiotic are these substances?

Bricout

Wright

2004

European Journal of Applied Physiology

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Norsteroids are xenobiotics with androgenic and anabolic properties known since as far back as the 1930s. In doping controls, the use of the banned xenobiotic norsteroids is detected in the competitor's urines by the measurement of norandrosterone (19-NA) and noretiocholanolone (19-NE), which are the main metabolites for nandrolone (NT) and most norsteroids with anabolic properties. In 1996, the IOC subcommission "Doping and Biochemistry of Sport" informed the Heads of the "IOC Accredited Laboratories" that the recommended cut-off limit for reporting an offence was to be 1-2 ng ml(-1) urine for either 19-NA or 19-NE. We will discuss how technical progress in gas chromatography coupled to high-resolution mass spectrometry permitted a dramatic increase in sensitivity with a detection limit of 1 pg ml(-1) urine, or less, and an assay limit of 20-50 pg ml(-1) urine, for either 19-NA or 19-NE. As a paradox, norsteroids have been known for decades as not only xenobiotics but also obligatory endogenous intermediates in the biosynthesis of estrogens from androgens in all species, man included. It is this biochemical observation which fed the active scientific and medical controversy initiated in 1998 over the possibly endogenous production of nandrolone and metabolites well over the new IOC's recommended cut-off limit of 2 ng ml(-1) urine. Notwithstanding the particular technical difficulties attached, we will provide data and discuss the minute endogenous levels detected and measured in man either at rest, after performance or training and compare them to the relatively high levels reported in male athlete's doping controls today. We will also discuss data on the pharmacological effects of some contraceptive therapies containing norsteroids in women. In view of the well-documented noxious effects repeatedly observed after anabolic steroid misuse, the confirmation and implementation of technically proven procedures for reporting norsteroid abuse in sports seems an important enough goal to protect athlete's health against such abuses and justifies up dating the review of the patent scientific and medical experience and knowledge gained over the last 50 years on nandrolone and its minor production in man and woman.

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Reversible azoospermia induced by the anabolic steroid 19-nortestosterone

Cited by 28 publications

References 0 publications

Male contraception: A realistic option?

Male contraception: A realistic option?

Drugs in sport - the role of the physician

Update on nandrolone and norsteroids: how endogenous or xenobiotic are these substances?

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