Testicular morphology in hypogonadotropic hypogonadism after the abuse of anabolic steroids

Hypogonadism in men results from the failure of the testes to produce physiological levels of testosterone and a normal number of spermatozoa due to a disruption of the hypothalamic-pituitary-testicular axis. An example of secondary hypogonadism as a result of anabolic steroid abuse is presented with the case report of a man who committed suicide after a history of aggressive behavior and physical abuse of his wife. The autopsy revealed shrunken testicles, with more than 30% of parenchymatous sclerosis, absent spermatogenesis, and very few Leydig cells detected only by immunohistochemistry. A low-specific immunochemical analysis revealed a very high level of total testosterone (serum 109.8 nmol/L; urine 81.2 nmol/L). A more accurate analysis confirmed an overdose of synthetic anabolic steroids. Doctors in different medical areas should be alerted to chronic abusers of synthetic anabolic steroids among the growing number of recreational athletes.