بررسی تأثیر سوء‌مصرف استروئید آنابولیک آندروژنی بر باروری مردان: مطالعه مروری

نوع مقاله : مروری

نویسندگان

1 دکتری بهداشت باروری، دانشکده پزشکی، دانشگاه علوم پزشکی خراسان شمالی، بجنورد، ایران.

2 مربی گروه مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی خراسان شمالی، بجنورد، ایران.

3 دانشجوی دکتری بهداشت باروری، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: علاقه جوانان به ورزش­های قدرتی سبب استفاده زیاد استروئیدهای آنابولیک (AAS) بدون توجه به عوارض طولانی­‌مدت آن شده است. از این رو، مطالعه مروری حاضر با هدف بررسی تأثیر داروهای AAS بر باروری مردان انجام شد.
روش­کار: در راستای هدف مطالعه مروری حاضر، جستجو در پایگاه­های اطلاعاتی Google Scholar، Irandoc، ISC،‌ Science Direct،‌‌Proquest ، ‌Pubmed، Scopus و Magiran با کلید واژه‌های داروهای انرژی­زا، باروری مردان، اسپرماتوژنز، استروئید آنابولیک آندروژنی و AAS بدون محدودیت سال انجام شد. از مجموع 8453 مقاله استخراج شده، پس از بررسی عنوان، چکیده و معیارهای ورود و خروج، در نهایت 33 مقاله مورد بررسی قرار گرفت.
یافته­ها: داروهای AAS عوارض طولانی مدتی بر سیستم­ باروری مردان دارند؛ به‌طوری‌که اسپرماتوژنز را از طریق 4 مکانیسم اولیه شامل اثرات مستقیم بر سلول­های جنسی، تغییر محور هیپوتالاموس، هیپوفیز و بیضه، اختلال عملکرد نعوظ یا انزال و کاهش میل جنسی مختل می­کند. همچنین با مهار بازخورد منفی در سطوح LH و FSH نیز سبب کاهش تولید تستوسترون و سرکوب اسپرماتوژنز می­گردد. اکثر عوارض پس از قطع مصرف، برگشت­پذیرند، اما مصرف طولانی­مدت در سنین باروری و مراحل تکامل بیضه سبب اختلال در آنالیز مایع منی و پارامترهای عملکردی اسپرم می­شود و امکان پاسخ به درمان جایگرین هم وجود ندارد. هنوز اطلاعات کافی برای زمان مورد نیاز جهت برگشت قدرت باروری مردان بعد از قطع مصرف گزارش نشده است.
نتیجه­گیری: مصرف بی‌رویه داروهای AAS اثرات نامطلوب درازمدتی بر سلامت باروری مردان دارد، از این رو وجود اقلام متنوع و ناشناخته دارو در بازار، حجمه تبلیغات در باشگاه‌ها و فضای مجازی و مصرف زیاد دارو بدون توجه به عوارض آن، نیازمند اقدامات مدیریتی جهت حل این معضل بهداشت جهانی و حفظ سلامت باروری مردان دارد‌، لذا آموزش به جامعه، ورزشکاران، مربیان و ارائه­دهندگان مراقبت­های بهداشتی توصیه می­شود.

کلیدواژه‌ها

عنوان مقاله [English]

The effect of anabolic androgenic steroid abuse on male fertility: Review Study

نویسندگان [English]

  • Zohreh Abbasi 1
  • Farzaneh Khodabandeh 2
  • Fatemeh Yahyavi Kouchaksarayie 3
  • Sakineh Nazari 3
1 PhD of Reproductive Health, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran.
2 Instructor, Department of Midwifery, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran.
3 PhD student of Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Young people's interest in strength exercises has led to the high use of anabolic steroids (AAS) regardless of its long-term side effects. Therefore, this review study was conducted with aim to investigate the effect of AAS drugs on male fertility.
Methods: In line with the aim of the present review study, search was performed in the databases of Scopus, Pubmed, Proquest, Science Direct, ISC, Irandoc, Magiran and Google Scholar with the keywords of energy drugs, male fertility, spermatogenesis, androgenic anabolic steroid drugs and AAS without time restrictions. Among a total of 8453 articles extracted, after reviewing the title, abstract and inclusion and exclusion criteria, finally 33 articles were reviewed.
Results: AAS drugs have long-term effects on the male reproductive system and disrupt spermatogenesis through four primary mechanisms including direct effects on gametes, hypothalamic axis change, pituitary and testis, erectile dysfunction or ejaculation, and decreased libido. It also reduces testosterone production and suppresses spermatogenesis by inhibiting negative feedback at LH and FSH levels. Most side effects are reversible after discontinuation, but long-term use during the reproductive ages and testicular developmental stages disrupts semen analysis and sperm function parameters, and there is no possibility of responding to alternative therapy. Not enough information has been reported about the time required to return male fertility after drug discontinuation.
Conclusion: Excessive use of AAS drugs has long-term adverse effects on male reproductive health, so, existence of various and unknown items of drugs in the market, advertising in clubs and cyberspace and high consumption of drugs regardless of its side effects, require management measures to solve this global health problem and maintain male reproductive health. Therefore, education is recommended to the community, athletes, coaches and health care providers.

کلیدواژه‌ها [English]

  • Anabolic-Androgenic Steroids drugs
  • Fertility
  • Male

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مجله زنان، مامایی و نازایی ایران
دوره 24، شماره 3
خرداد 1400
صفحه 71-84

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