Androgen abuse is relatively common amongst young amateur bodybuilders seeking to enhance their performance and physical condition. Prolonged or permanent post-androgen abuse hypogonadism (PPAAH) has been described in some of those who subsequently cease.

Botman et al. describe management of a singular case of an individual in this situation, and use this to illustrate the problems faced by such patients. They highlight difficulties encountered by the normal clinician sourcing investigations for this condition, and discuss the lack of a widely accepted definition of PPAAH, which makes diagnosis more challenging. The case follows the patient through his journey in the healthcare system and charts his diagnosis, investigations and treatment.

However, it is also important for clinicians to note that the patient’s account of the issue may not reflect its true extent. There have also been instances of people misappropriating the medical prescription of exogenous androgens to supplement their own misuse. The authors’ recommendation, therefore, is to use short duration preparations such as gels when there is a genuine need for replacement; they highlight the reasons for this.

Read the full article in Clinical Endocrinology doi:10.1111/cen.14686