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🏋♀️ Androgen abuse suppresses GnRH, LH, and FSH secretion, leading to reduced endogenous testosterone secretion, impaired spermatogenesis, and testicular atrophy. In addition, excess testosterone is converted by aromatase to estradiol, which can lead to gynecomastia.
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- Testosterone stimulates increased protein synthesis by skeletal myocytes. Some competitive athletes and body builders abuse testosterone and other exogenous androgens to increase muscle mass and improve athletic performance. However, excessive androgenic activity can cause significant adverse effects, including acne (increased dermal sebum production) and neuropsychiatric changes (eg, irritability, aggression, and anxiety).
- Androgen abuse can also result in profound endocrine and reproductive effects. Spermatogenesis in the seminiferous tubules is driven by FSH and requires a high local concentration of testosterone, which is produced by nearby Leydig cells and retained by androgen-binding protein. Exogenous androgens suppress GnRH, LH, and FSH secretion, leading to reduced endogenous testosterone secretion, impaired spermatogenesis, and testicular atrophy.
- In addition, excess testosterone is converted by aromatase to yield high levels of estradiol, which can lead to gynecomastia. In adolescent users, high circulating estrogen levels can also cause premature epiphyseal closure and short stature.