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Anabolic steroid-induced hypogonadism — SCE Endocrinology MCQ

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ModerateReproductive EndocrinologyAnabolic steroid-induced hypogonadismSCE Endocrinology

A 35-year-old man using anabolic steroids has infertility and testicular atrophy. Testosterone is high-normal, LH and FSH are suppressed, and semen analysis shows azoospermia. What is the underlying pathophysiology?

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Correct answer: A — Suppression of hypothalamic-pituitary-gonadal axis

Exogenous androgens suppress GnRH, LH and FSH, reducing intratesticular testosterone and spermatogenesis. Primary testicular failure would raise gonadotrophins. Fertility recovery can take months after cessation and may require specialist treatment.

Reference: Endocrine Society Testosterone Therapy Guideline