Skip to main content

Advertisement

SpringerLink
Log in

Novel Uses for the Anabolic Androgenic Steroids Nandrolone and Oxandrolone in the Management of Male Health

  • Men’s Health (A Dabaja, Section Editor)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

There has recently been renewed interest in novel clinical applications of the anabolic-androgenic steroid (AAS) testosterone and its synthetic derivatives, particularly given with the rising popularity of testosterone supplementation therapy (TST) for the treatment of male hypogonadism. In this manuscript, we provide a brief review of the history of AAS and discuss clinical applications of two of the more well-known AAS: nandrolone and oxandrolone. Both agents exhibit favorable myotrophic/androgenic ratios and have been investigated for effectiveness in numerous disease states. We also provide a brief synopsis of selective androgen receptor modulators (SARMs) and postulate how these orally active, non-aromatizing, tissue-selective agents might be used in contemporary andrology. Currently, the applications of testosterone alternatives in hypogonadism are limited. However, it is tempting to speculate that these agents may one day become accepted as alternatives, or adjuncts, to the treatment of male hypogonadism.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

AAS:

Anabolic-androgenic steroid

TST:

Testosterone supplementation therapy

SARMS:

Selective androgen receptor modulator

References

  1. Dotson JL, Brown RT. The history of the development of anabolic-androgenic steroids. Pediatr Clin North Am. [Internet]. Elsevier; 2007;54:761–9. Available from: doi:10.1016/j.pcl.2007.04.003.

  2. Bhasin S, Storer TW, Berman N, Callegari C, Clevenger B, Phillips J, et al. The effects of supraphysiologic doses of testosterone on muscle size and strength in normal men. N Engl J Med. 1996;335:1–7.

    Article  CAS  PubMed  Google Scholar 

  3. Nieschlag E, Vorona E. Mechanisms in endocrinology: medical consequences of doping with anabolic androgenic steroids: effects on reproductive functions. Eur J Endocrinol. 2015;173:R47–58.

    Article  CAS  PubMed  Google Scholar 

  4. US Drug Enforcement Agency. Designer Anabolic Steroid Control Act of 2014. 2014.

  5. Eaton DK, Kann L, Kinchen S, Shanklin S, Flint KH, Hawkins J, et al. Youth risk behavior surveillance—United States, 2011. MMWR Surveill Summ. United States; 2012;61:1–162.

  6. Pope HG, Kanayama G, Athey A, Ryan E, Hudson JI, Baggish A. The lifetime prevalence of anabolic-androgenic steroid use and dependence in Americans: current best estimates. Am J Addict. 2014;23:371–7.

    Article  PubMed  Google Scholar 

  7. Lumia AR, McGinnis MY. Impact of anabolic androgenic steroids on adolescent males. Physiol Behav. [Internet]. Elsevier B.V.; 2010;100:199–204. Available from: doi:10.1016/j.physbeh.2010.01.007.

  8. Rahnema CD, Lipshultz LI, Crosnoe LE, Kovac JR, Kim ED. Anabolic steroid-induced hypogonadism: diagnosis and treatment. Fertil Steril. [Internet]. Elsevier Inc.; 2014;101:1271–9. Available from: doi:10.1016/j.fertnstert.2014.02.002.

  9. Pope HG, Kanayama G, Ionescu-Pioggia M, Hudson JI. Anabolic steroid users’ attitudes towards physicians. Addiction. 2004;99:1189–94.

    Article  PubMed  Google Scholar 

  10. Bird S, Greaves RF, Burke LM, Goebel C. ANNALS EXPRESS: Doping in sport and exercise: anabolic, ergogenic, health and clinical issues. Ann Clin Biochem An Int J Biochem Lab Med. [Internet]. 2015;0:1–26. Available from: doi:10.1177/0004563215609952.

  11. Parkinson AB, Evans NA. Anabolic androgenic steroids: a survey of 500 users. Med Sci Sports Exerc. United States; 2006;38:644–51.

  12. De Souza GL, Hallak J. Anabolic steroids and male infertility: a comprehensive review. BJU Int. 2011;108:1860–5.

    Article  PubMed  Google Scholar 

  13. Guo W, Schmidt PJ, Fleming MD, Bhasin S. The effects of testosterone on erythropoiesis in a female mouse model of anemia of inflammation. Endocrinology [Internet]. 2016;en.2016–1150. Available from: doi:10.1210/en.2016-1150.

  14. Shahani S, Braga-Basaria M, Maggio M, Basaria S. Androgens and erythropoiesis: past and present. J Endocrinol Invest. 2009;32:704–16.

    Article  CAS  PubMed  Google Scholar 

  15. Hartgens F, Kuipers H. Effects of androgenic-anabolic steroids in athletes. Sport Med N Z. 2004;34:513–54.

    Article  Google Scholar 

  16. Kicman AT. Pharmacology of anabolic steroids. Br J Pharmacol. [Internet]. 2008;154:502–21. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2439524&tool=pmcentrez&rendertype=abstract.

  17. Yarrow JF, McCoy SC, Borst SE. Tissue selectivity and potential clinical applications of trenbolone (17beta-hydroxyestra-4,9,11-trien-3-one): a potent anabolic steroid with reduced androgenic and estrogenic activity. Steroids [Internet]. Elsevier Inc.; 2010;75:377–89. Available from: doi:10.1016/j.steroids.2010.01.019.

  18. Maravelias C, Dona A, Stefanidou M, Spiliopoulou C. Adverse effects of anabolic steroids in athletes: a constant threat. Toxicol Lett. 2005;158:167–75.

    Article  CAS  PubMed  Google Scholar 

  19. Kanayama G, Hudson JI, Pope HG. Long-term psychiatric and medical consequences of anabolic-androgenic steroid abuse: a looming public health concern? Drug Alcohol Depend. 2008;98:1–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Orr R, Fiatarone Singh M. The anabolic androgenic steroid oxandrolone in the treatment of wasting and catabolic disorders: review of efficacy and safety. Drugs. 2004; 725–50.

  21. Shahidi NT. A review of the chemistry, biological action, and clinical applications of anabolic-androgenic steroids. Clin Ther. 2001;23:1355–90.

    Article  CAS  PubMed  Google Scholar 

  22. Glazer G. Atherogenic effects of anabolic steroids on serum lipid levels. A literature review. Arch Intern Med. [Internet]. 1991;151:1925–33. Available from: http://www.ncbi.nlm.nih.gov/pubmed/1929679.

  23. Hartgens F, Rietjens G, Keizer HA, Kuipers H, Wolffenbuttel BHR. Effects of androgenic-anabolic steroids on apolipoproteins and lipoprotein (a). Br J Sports Med. [Internet]. 2004;38:253–9. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1724824&tool=pmcentrez&rendertype=abstract.

  24. Anderson SJ. Adolescents and anabolic steroids: a subject review. American Academy of Pediatrics. Committee on Sports Medicine and Fitness. Pediatrics [Internet]. 1997;99:904–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9190555.

  25. Liow RY, Tavares S. Bilateral rupture of the quadriceps tendon associated with anabolic steroids. Br. J. Sports Med. ENGLAND; 1995;29:77–9.

  26. Ishak KG. Hepatic lesions caused by anabolic and contraceptive steroids. Semin Liver Dis. United States; 1981;1:116–28.

  27. Soe KL, Soe M, Gluud C. Liver pathology associated with the use of anabolic-androgenic steroids. Liver. Denmark; 1992;12:73–9.

  28. Hartgens F, Kuipers H. Effects of androgenic-anabolic steroids in athletes. [Internet]. Sports Med 2004; 513–54. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15248788.

  29. Evans L, Larsen M, Cox A, Skyrme R. Steroids, drugs and stuttering priapism; the rock-and-roll lifestyle of a 24-year-old man. BMJ Case Rep. England; 2016;2016.

  30. van Amsterdam J, Opperhuizen A, Hartgens F. Adverse health effects of anabolic-androgenic steroids. Regul Toxicol Pharmacol. [Internet]. Elsevier Inc.; 2010;57:117–23. Available from: doi:10.1016/j.yrtph.2010.02.001.

  31. Brennan R, Wells JSG, Van Hout MC. The injecting use of image and performance-enhancing drugs (IPED) in the general population: a systematic review. Health Soc Care Community [Internet]. 2016;n/a – n/a. Available from: doi:10.1111/hsc.12326.

  32. Kicman AT, Gower DB. Anabolic steroids in sport: biochemical, clinical and analytical perspectives. Ann Clin Biochem. [Internet]. 2003;40:321–56. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12880534.

  33. Birch A. Hydroaromatic steroid hormones. 10-Nortestosterone. J Chem Soc. 1950;367–8.

  34. Pan MM, Kovac JR. Beyond testosterone cypionate: evidence behind the use of nandrolone in male health and wellness. Transl Androl Urol. China; 2016;5:213–9.

  35. Mulligan K, Schambelan M. Anabolic treatment with GH, IGF-I, or anabolic steroids in patients with HIV-associated wasting. Int J Cardiol. Ireland; 2002;85:151–9.

  36. Chen C-T, Lin S-H, Chen J-S, Hsu Y-J. Muscle wasting in hemodialysis patients: new therapeutic strategies for resolving an old problem. Sci World J. England; 2013;2013:643954.

  37. Sharma S, Arneja A, McLean L, Duerksen D, Leslie W, Sciberras D, et al. Anabolic steroids in COPD: a review and preliminary results of a randomized trial. Chron. Respir. Dis. England; 2008;5:169–76.

  38. Vogel RB, Books CA, Ketchum C, Zauner CW, Murray FT. Increase of free and total testosterone during submaximal exercise in normal males. Med Sci Sports Exerc. United States; 1985;17:119–23.

  39. Griggs RC, Kingston W, Jozefowicz RF, Herr BE, Forbes G, Halliday D. Effect of testosterone on muscle mass and muscle protein synthesis. J Appl Physiol. United States; 1989;66:498–503.

  40. Häkkinen K, Pakarinen A, Kraemer WJ, Newton RU, Alen M. Basal concentrations and acute responses of serum hormones and strength development during heavy resistance training in middle-aged and elderly men and women. J Gerontol A Biol Sci Med Sci. 2000;55:B95–105.

    Article  PubMed  Google Scholar 

  41. Hakkinen K, Kraemer WJ, Pakarinen A, Triplett-McBride T, McBride JM, Hakkinen A, et al. Effects of heavy resistance/power training on maximal strength, muscle morphology, and hormonal response patterns in 60-75-year-old men and women. Can J Appl Physiol. United States; 2002;27:213–31.

  42. Jannatifar R, Shokri S, Farrokhi A, Nejatbakhsh R. Effect of supraphysiological dose of nandrolone decanoate on the testis and testosterone concentration in mature and immature male rats: a time course study. Int J Reprod Biomed. (Yazd, Iran). Iran; 2015;13:779–86.

  43. Boregowda K, Joels L, Stephens JW, Price DE. Persistent primary hypogonadism associated with anabolic steroid abuse. Fertil Steril [Internet]. Elsevier Ltd; 2011;96:e7–8. Available from: doi:10.1016/j.fertnstert.2011.04.029.

  44. Fox M, Minot AS, Liddle GW. Oxandrolone: a potent anabolic steroid of novel chemical configuration. J Clin Endocrinol Metab. Not Available; 1962;22:921–4.

  45. Rosenfeld J, King RM, Smith JE. Oxandrolone in ALS: preliminary analysis. Amyotroph. Lateral Scler. Other Motor Neuron Disord. England; 2000;1 Suppl 4:21–6.

  46. Kuhn CM. Anabolic steroids. Recent Prog. Horm. Res. United States; 2002;57:411–34.

  47. Berger JR, Pall L, Hall CD, Simpson DM, Berry PS, Dudley R. Oxandrolone in AIDS-wasting myopathy. AIDS. United States; 1996;10:1657–62.

  48. Fenichel GM, Griggs RC, Kissel J, Kramer TI, Mendell JR, Moxley RT, et al. A randomized efficacy and safety trial of oxandrolone in the treatment of Duchenne dystrophy. Neurology. United States; 2001;56:1075–9.

  49. Yeh S-S, DeGuzman B, Kramer T. Reversal of COPD-associated weight loss using the anabolic agent oxandrolone. Chest. United States; 2002;122:421–8.

  50. Pena JE, Thornton MHJ, Sauer M V. Reversible azoospermia: anabolic steroids may profoundly affect human immunodeficiency virus-seropositive men undergoing assisted reproduction. Obstet Gynecol. United States; 2003;101:1073–5.

  51. Menon DK. Successful treatment of anabolic steroid-induced azoospermia with human chorionic gonadotropin and human menopausal gonadotropin. Fertil Steril. United States; 2003;79 Suppl 3:1659–61.

  52. Yi P, Rehmel JF, Cassidy K, Hadden C, Campanale K, Patel N, et al. Disposition and metabolism of LY2452473, a selective androgen receptor modulator, in humans. Drug Metab Dispos. 2012;40:2354–64.

    Article  CAS  PubMed  Google Scholar 

  53. Cozzoli A, Capogrosso RF, Sblendorio VT, Dinardo MM, Jagerschmidt C, Namour F, et al. GLPG0492, a novel selective androgen receptor modulator, improves muscle performance in the exercised-mdx mouse model of muscular dystrophy. Pharmacol Res. [Internet]. Elsevier Ltd; 2013;72:9–24. Available from: doi:10.1016/j.phrs.2013.03.003.

  54. Zhang X, Sui Z. Deciphering the selective androgen receptor modulators paradigm. Expert Opin Drug Discov. [Internet]. 2013;8:191–218. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23231475.

  55. Choi SM, Lee BM. Comparative safety evaluation of selective androgen receptor modulators and anabolic androgenic steroids. Expert Opin Drug Saf. [Internet]. 2015;14:1773–85. Available from: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=prem&NEWS=N&AN=26401842.

  56. Hanada K, Furuya K, Yamamoto N, Nejishima H, Ichikawa K, Nakamura T, et al. Bone anabolic effects of S-40503, a novel nonsteroidal selective androgen receptor modulator (SARM), in rat models of osteoporosis. Biol Pharm Bull. Japan; 2003;26:1563–9.

  57. Gao W, Kearbey JD, Nair VA, Chung K, Parlow AF, Miller DD, et al. Comparison of the pharmacological effects of a novel selective androgen receptor modulator, the 5alpha-reductase inhibitor finasteride, and the antiandrogen hydroxyflutamide in intact rats: new approach for benign prostate hyperplasia. Endocrinology. United States; 2004;145:5420–8.

  58. Miner JN, Chang W, Chapman MS, Finn PD, Hong MH, Lopez FJ, et al. An orally active selective androgen receptor modulator is efficacious on bone, muscle, and sex function with reduced impact on prostate. Endocrinology. United States; 2007;148:363–73.

  59. Ostrowski J, Kuhns JE, Lupisella JA, Manfredi MC, Beehler BC, Krystek SRJ, et al. Pharmacological and x-ray structural characterization of a novel selective androgen receptor modulator: potent hyperanabolic stimulation of skeletal muscle with hypostimulation of prostate in rats. Endocrinology. United States; 2007;148:4–12.

  60. Dalton JT, Taylor RP, Mohler ML, Steiner MS. Selective androgen receptor modulators for the prevention and treatment of muscle wasting associated with cancer. Curr Opin Support Palliat Care [Internet]. 2013;7:345–51. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24189892.

  61. Leder BZ, Rohrer JL, Rubin SD, Gallo J, Longcope C. Effects of aromatase inhibition in elderly men with low or borderline-low serum testosterone levels. J Clin Endocrinol Metab. United States; 2004;89:1174–80.

  62. Burnett-Bowie S-AM, McKay EA, Lee H, Leder BZ. Effects of aromatase inhibition on bone mineral density and bone turnover in older men with low testosterone levels. J Clin Endocrinol Metab. United States; 2009;94:4785–92.

Download references

Author information

Authors and Affiliations

  1. McMaster Institute of Urology, Hamilton, ON, Canada

    Christopher Wu

  2. Men’s Health Center, 8240 Naab Road, Suite #220, Indianapolis, IN, 46260, USA

    Jason R. Kovac

Authors
  1. Christopher Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jason R. Kovac
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jason R. Kovac.

Ethics declarations

Conflict of Interest

Christopher Wu declares no potential conflicts of interest.

Jason R. Kovac reports personal fees from Abbvie.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Men’s Health

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wu, C., Kovac, J.R. Novel Uses for the Anabolic Androgenic Steroids Nandrolone and Oxandrolone in the Management of Male Health. Curr Urol Rep 17, 72 (2016). https://doi.org/10.1007/s11934-016-0629-8

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11934-016-0629-8

Keywords

Search

Navigation