regret were signifcantly less likely to have understood the
potential long term, negative eFFects on Fertility From AAS
use (
R
=
16.6% understood,
n
=
2/12 versus NR
=
52.2%
understood,
n
=
35/67;
P
=
0.029).
Interestingly,
the
amount oF men who actually experienced Fertility diFfcul-
ties was similar between the subgroups (
R
=
16.7%,
n
=
2/12; NR
=
13.4%,
n
=
9/67) (±ig. 2b). This suggests
that the perception oF Future long-term Fertility problems
is more important in regretting AAS use than actual diFf-
culties with conception.
Discussion
AAS use in hypogonadal men seeking TST is common
(Coward
et al.
, 2013). Because AAS use has been sug-
gested to be addictive, and other addictive substances
such as marijuana are associated with regret Following
use, we sought to elucidate whether hypogonadal patients
0
10
20
30
40
50
60
70
80
90
100
Percentage of men
Spousal awareness & Relationship effect
0
10
20
30
40
50
60
Cholesterol Change
Aggression
Acne
Fluid Retention
Percentage of men
Side effects with AAS use
0
10
20
30
40
50
60
Erections
Mood
Percent of men
(a)
(b)
(c)
Fig. 1
AAS use and regret. (a) Men who reported regret of AAS use
experienced similar side effects for cholesterol (
P
=
0.29), aggression
(
P
=
1), acne (
P
=
0.34) and Fuid retention (
P
=
0.35) to those who
did not regret AAS use. (b) No differences in regret were found in sit-
uations where men had spouses who were aware of their use of AAS
with no relationship effects (Column 1;
P
=
0.44). No statistical differ-
ences were found between men who regretted prior AAS use and
those who did not in the following situations: (Column 2) Spouse was
aware of AAS use and this had effects on the relationship (Aware &
Effect,
P
=
1); (Column 3) Spouse was not aware of AAS use and this
had no effects on the relationship (Not Aware & No Effect,
P
=
1)
and; (Column 4) Spouse was not aware and this effected the relation-
ship (
P
=
1). (c) Regret had no effect on erections and mood in men
who reported AAS use. Decreased frequency and quality of erections
(
P
=
0.54) as well as poor mood (
P
=
0.74) affected men who regret-
ted AAS use to a similar degree as those who did not (Black
bars
=
men with regret; white bars
=
men with NO regret).
*
0
10
20
30
40
50
60
Percent of men
0
5
10
15
20
Percent of men
(a)
(b)
Fig. 2
Regret, AAS and the long-term effects on serum testosterone
levels and fertility. (a) Men who regretted their AAS use (black bars)
did not understand the potential long-term effects on their serum tes-
tosterone levels; however, this relationship did not reach statistical sig-
ni±cance (
P
=
0.06). Patients who regretted their prior AAS use were
less aware of the potential long-term effects on future fertility
(
*
P
=
0.029) compared to those that did not regret AAS use (white
bars). (b) Men with regret were equally as likely to experience actual
problems with fertility as those without regret. These results suggest
that patient perceptions had more impact on regret than actual
events (Black bars
=
men with regret; white bars
=
men with NO
regret).
©
2014 Blackwell Verlag GmbH
875
Andrologia
2015,
47
, 872–878
J. R. Kovac
et al.
Anabolic steroid use and regret