Table 1.

Reports of AAS-withdrawal Hypogonadism With Signs Persisting > 1 Year After Last AAS Exposure

Study	Location	No. of cases	Age, yrs	Duration of AAS use, yrs	Follow-up, mo	Status
Jarow & Lipshultz, 1990 (27)	United States	2	36, 39	2, NS	12–36	The two men displayed a blunted pituitary response to GnRH stimulation at 12 mo and 36 mo after AAS discontinuation, respectively.
Turek et al., 1995 (28)	United States	1	34	2.5	60	T remained below normal 3 yrs after stopping AAS; the patient failed to respond to HCG at 3 yrs but did respond to a second trial of HCG at 5 yrs
Lloyd et al., 1996 (29)	United Kingdom	5	28–35	NS	Up to 16	Four men apparently recovered within ≤ 1 yr, but one still displayed decreased sperm count at 16 months
Gazvani et al., 1997 (30)	United Kingdom	4	27–33	NS	8–20	Three men largely recovered within one year, but one showed persistently low T at 18 months despite normal FSH & LH
Menon, 2003 (31)	Malaysia	1	37	NS	15	At 12 mo, FSH, LH, and T all below normal; the patient subsequently responded to HCG + HMG with normalization of all hormones after 1 mo
Urhausen et al., 2003 (32)	Germany	2	Mean 38.0	Mean 4.5	≥ 12	Two (13%) of 15 former AAS users displayed T below normal at least 12 months after discontinuing AAS.
Garevik et al., 2011 (33)	Sweden	NS	18–57	0.5–17	Up to 12	Study of 39 subjects; individual data not provided, but “some individuals had a sustained suppression of LH and FSH for a period of one year.”
Boregowda et al., 2011 (34)	United Kingdom	1	40	10	36	At 18 months, FSH & LH normalized, but T remained below normal even at 36 months despite supranormal FSH and LH

Abbreviations: NS = Not specified; T = testosterone; LH = luteinizing hormone; FSH = follicle-stimulating hormone; HCG = human chorionic gonadotropin; HMG = human menopausal gonadotropin.