Hormone normalization after steroid use

Many wonder how long does it take for the human body to recover after an anabolic androgenic steroid (AAS) cycle?

This is a complex question as it may vary from individual to individual, with several variants including: AAS used, combinations, duration of cycle, dose used, etc.

Here we will briefly review the scientific evidence available.

A paper from September 2000, reported a 20 year old bodybuilder with a 10-month use of Bionabol (mean total dose of 1,120 mg per month), and Retabolil (mean total dose of 150 mg per month) with extremely low testosterone levels that self-regulated to normal levels after 10 months of AAS withdrawal. [1]

As a rule, it takes weeks to months to recover from whatever cycle used, yet cases have been described with users that took up to years. [2]

There’s one case reported in which the patient stopped using AAS one year before and still had the effects (manifested as azoospermia, meaning, low spermatozoid count in the semen) and was successfully treated with HCG (human chorionic gonadotropin), which further supports the use of post-cycle treatment. [3]

Though spontaneous return is usually expected and conservative approach can be used too.
In the next figure we’ll see the concentrations of sperm in the semen and the number of weeks after AAS cessation in four different users, which took from 5 to 20 weeks to become normal. [4]

There are proposed treatment to this hypogonadal (low testosterone) state, as published by kanayama and summarize in the next algorithm.

Figure 2. Proposed treatments for multiple AAS adverse effects. [4]

Another study with 41 bodybuilders showed that it took up to 4 months to return sperm counts and testosterone levels to normal (in the affected individuals). [5]

So in conclusion, it can take the body a range from 3-26 months to normalize the levels of testosterone after AAS use, but the “frequent” range would be around 2-4 months probably.

Bibliography

1-. J Sports Med Phys Fitness. 2000 Sep;40(3):271-4. Reversible hypogonadism and azoospermia as a result of anabolic-androgenic steroid use in a bodybuilder with personality disorder. A case report. Boyadjiev NP, Georgieva KN, Massaldjieva RI, Gueorguiev SI.
(http://www.ncbi.nlm.nih.gov/pubmed/11125771 )
2-. Drug Alcohol Depend. 2010 Jun 1;109(1-3):6-13. doi: 10.1016/j.drugalcdep.2010.01.011. Epub 2010 Feb 25. Treatment of anabolic-androgenic steroid dependence: Emerging evidence and its implications. Kanayama G, Brower KJ, Wood RI, Hudson JI, Pope HG Jr.
(http://www.ncbi.nlm.nih.gov/pubmed/20188494)

3-. Fertil Steril. 2003 Jun;79 Suppl 3:1659-61. Successful treatment of anabolic steroid-induced azoospermia with human chorionic gonadotropin and human menopausal gonadotropin. Menon DK.
(http://www.ncbi.nlm.nih.gov/pubmed/?term=12801577 )
4-. Hum Reprod. 1997 Aug;12(8):1706-8. Conservative management of azoospermia following steroid abuse. Gazvani MR, Buckett W, Luckas MJ, Aird IA, Hipkin LJ, Lewis-Jones DI.
(http://www.ncbi.nlm.nih.gov/pubmed/?term=9308797 )
5-. Fertil Steril. 1989 Dec;52(6):1041-7. Anabolic steroids and semen parameters in bodybuilders. Knuth UA, Maniera H, Nieschlag E.
(http://www.ncbi.nlm.nih.gov/pubmed/2512180 )