{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T21:07:30Z","timestamp":1793308050803,"version":"4.5.0"},"reference-count":96,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>The non-medical use of exogenous testosterone and other anabolic\u2013androgenic steroids (AAS) has increased substantially in recent years, particularly among young men engaged in recreational strength training. Although often perceived as a means of enhancing muscle mass and physical performance, this practice represents a growing public-health concern due to its wide-ranging endocrine, reproductive, and multisystem adverse effects. This narrative review synthesizes current international evidence on the non-medical use of testosterone and AAS in non-professional athletic settings, with a primary focus on endocrine disruption and reproductive health. The review outlines the classification of commonly used anabolic\u2013androgenic compounds, discusses their pharmacological mechanisms of action, and integrates clinical, experimental, and epidemiological data on associated adverse outcomes. Particular attention is given to suppression of the hypothalamic\u2013pituitary\u2013gonadal axis, impaired spermatogenesis, fertility disturbances, and the potential for long-term or persistent endocrine sequelae. In addition, psychological and behavioural factors contributing to AAS use\u2014including muscle dysmorphia, social pressure, and body-image concerns\u2014are discussed as important modulators of risk. The review also addresses current clinical approaches to the management of AAS-related complications, including strategies aimed at hormonal recovery and restoration of reproductive function. By presenting a comprehensive, mechanistic, and clinically oriented overview, this article highlights the need for increased awareness among clinicians and underscores priorities for future research and preventive interventions in endocrine and reproductive health.<\/jats:p>","DOI":"10.3389\/fendo.2026.1781416","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T05:25:15Z","timestamp":1772688315000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Non-medical use of exogenous testosterone and anabolic\u2013androgenic substances in young men: health, psychological, and fertility consequences"],"prefix":"10.3389","volume":"17","author":[{"given":"Krzysztof","family":"Kowalik","sequence":"first","affiliation":[{"name":"Clinical Department of General Surgery, Pomeranian Medical University in Szczecin","place":["Szczecin, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patryk","family":"Harasny","sequence":"additional","affiliation":[{"name":"Department of Urology, Provincial Hospital","place":["Pozna\u0144, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Kaliczy\u0144ska","sequence":"additional","affiliation":[{"name":"University of Szczecin","place":["Szczecin, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konrad","family":"Reweda-Kwiatkowski","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Pomeranian Medical University in Szczecin","place":["Szczecin, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dariusz","family":"Starzy\u0144ski","sequence":"additional","affiliation":[{"name":"Endocrinology Clinic, Sedimed Medical Centre","place":["Szczecin, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha\u0142","family":"Pawlak","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, Pomeranian Medical University in Szczecin","place":["Szczecin, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arkadiusz","family":"Waloryszak","sequence":"additional","affiliation":[{"name":"Clinical Department of General Surgery, Pomeranian Medical University in Szczecin","place":["Szczecin, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Ptak","sequence":"additional","affiliation":[{"name":"Independent Unit of Perineological Physiotherapy, Faculty of Health Sciences, Pomeranian Medical University in Szczecin","place":["Szczecin, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrzej","family":"Modrzejewski","sequence":"additional","affiliation":[{"name":"Clinical Department of General Surgery, Pomeranian Medical University in Szczecin","place":["Szczecin, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dagmara","family":"Lisman","sequence":"additional","affiliation":[{"name":"Department of Genomics and Forensic Genetics, Pomeranian Medical University in Szczecin","place":["Szczecin, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/add.16643","article-title":"What is the prevalence of anabolic-androgenic steroid use among women? 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