Clinical features of androgen abuse withdrawal in men during the first year of cessation: a community dwelling study
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Context
Androgen abuse is an increasing public health concern, particularly among young men seeking muscular or image enhancement. Although most achieve biochemical recovery within 12 months of cessation, mood disturbances, sexual dysfunction, and fatigue is widely reported for years afterward.
Objective
To examine symptom severity the relationship to biochemical recovery during the first year after androgen abuse cessation.
Methods
We conducted a cross-sectional study of community-dwelling men grouped as non-users, current users, or past users who had ceased within the last 12 months. Participants completed questionnaires on androgen and substance use and four validated instruments assessing mood (BDI-II), anxiety (GAD-7), sexual function (IIEF-15), and quality-of-life (SF-36). Morning fasted serum hormonal analysis and screening to exclude undisclosed androgen use were performed.
Results
247 men were included: 50 non-users, 125 current users, 72 past users. Self-reported psychiatric diagnoses were 2.5-fold higher among current and past users than non-users. Total testosterone was highest in current users (p<0.001) with no difference between past and non-users. Past users reported significantly worse mood, anxiety, sexual function, and quality of life versus non-users. Multivariable analyses showed psychiatric comorbidity was independently associated with depression (p=0.001), anxiety (p<0.001), and poorer quality-of-life (p<0.05). Older age and higher LH were associated with reduced sexual function (p<0.05), while lower testosterone showed only a modest association with depressive symptoms (p=0.03).
Conclusion
Among men in the first year after stopping androgen abuse, psychological symptoms and reduced quality-of-life were most strongly associated with psychiatric comorbidity than biochemical recovery. These findings challenge the assumption that androgen withdrawal symptoms are predominantly driven by hypogonadism, and supports developing psychological and behavioural interventions, rather than pharmacological, to support androgen withdrawal in men.
Androgen abuse is an increasing public health concern, particularly among young men seeking muscular or image enhancement. Although most achieve biochemical recovery within 12 months of cessation, mood disturbances, sexual dysfunction, and fatigue is widely reported for years afterward.
Objective
To examine symptom severity the relationship to biochemical recovery during the first year after androgen abuse cessation.
Methods
We conducted a cross-sectional study of community-dwelling men grouped as non-users, current users, or past users who had ceased within the last 12 months. Participants completed questionnaires on androgen and substance use and four validated instruments assessing mood (BDI-II), anxiety (GAD-7), sexual function (IIEF-15), and quality-of-life (SF-36). Morning fasted serum hormonal analysis and screening to exclude undisclosed androgen use were performed.
Results
247 men were included: 50 non-users, 125 current users, 72 past users. Self-reported psychiatric diagnoses were 2.5-fold higher among current and past users than non-users. Total testosterone was highest in current users (p<0.001) with no difference between past and non-users. Past users reported significantly worse mood, anxiety, sexual function, and quality of life versus non-users. Multivariable analyses showed psychiatric comorbidity was independently associated with depression (p=0.001), anxiety (p<0.001), and poorer quality-of-life (p<0.05). Older age and higher LH were associated with reduced sexual function (p<0.05), while lower testosterone showed only a modest association with depressive symptoms (p=0.03).
Conclusion
Among men in the first year after stopping androgen abuse, psychological symptoms and reduced quality-of-life were most strongly associated with psychiatric comorbidity than biochemical recovery. These findings challenge the assumption that androgen withdrawal symptoms are predominantly driven by hypogonadism, and supports developing psychological and behavioural interventions, rather than pharmacological, to support androgen withdrawal in men.
Date Issued
2026-09-01
Date Acceptance
2026-03-09
Citation
Journal of Clinical Endocrinology and Metabolism (JCEM), 2026, 111 (9), pp.2649-2663
ISSN
0021-972X
Publisher
Oxford University Press
Start Page
2649
End Page
2663
Journal / Book Title
Journal of Clinical Endocrinology and Metabolism (JCEM)
Volume
111
Issue
9
Copyright Statement
© The Author(s) 2026. Published by Oxford University Press on behalf of the Endocrine Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. See the journal About page for additional terms.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/41818709
PII: 8516682
Subjects
anabolic-androgenic steroids
androgen abuse
depression
erectile dysfunction
hypogonadism
testosterone
withdrawal
Publication Status
Published
Coverage Spatial
United States
Article Number
dgag110
Date Publish Online
2026-03-12