There are numerous hormones in the human body belonging to chemical group steroids. However, in colloquial language term steroid is more commonly used to describe androgenic and anabolic steroids. There are many synthetic analogs of testosterone used to increase muscle mass, strength, and boost physical performance.
Anabolic steroids are not that bad when used mindfully, or strictly for medical use. However, recent times have witnessed an explosion in their use in professional and non-professional sport. Even school-goers are now using them. Such unsupervised use or rather an abuse is causing many side effects (1).
Anabolic steroid abuse may lead to testicular atrophy, reduced fertility, and decline in male libido.
Testosterone, Male Potency, and Anabolic Steroids
For many people, it may sound strange that substances similar to testosterone could negatively affect male sexual performance when the logic says that these substances should be boosting sexual health.
For understanding how steroids cause erectile dysfunction, one has to understand a bit about testosterone, and its metabolism.
The so-called negative feedback controls the level of every hormone in the human body. When any hormone is in excess, the brain gets the signal from the body cells to control and reduce the production of that given hormone.
Testosterone production occurs at the command and control of the brain. The pituitary hormone named LH (Luteinizing hormone) serves as a chemical messenger for testicles (primary site of testosterone production in men) if the body has low testosterone levels, brain commands to produce more by sending more of LH, and vice-versa (2, 3).
When a person is frequently using anabolic steroids, brain receptors understand that something is wrong, and there is an excess of anabolic hormones. As a result, the brain shuts down LH production temporarily. On prolonged abuse of steroids, the brain starts losing the ability to produce LH via the pituitary gland. It means, to a degree, the brain loses its ability to control the production of testosterone by testicles.
When the brain stops sending enough signals to testicles in the form of LH, testicles start losing their volume – as they no longer need to produce testosterone. This is the law of nature; what is not in use is discarded. Steroids abuse leads to irreversible shrinking of testicles (4).
Most professional sportspeople use steroids in cycles, giving the body enough rest so that internal testosterone production can normalize, and testicles shrinkage is prevented. However, steroids are addictive, and many fail to follow the recommendations.
Steroids Related Testicular Dystrophy and Erectile Dysfunction
Erectile dysfunction related to steroid use is worrisome since most of the users are young, physically, and sexually active males. Reversal of such erectile dysfunction is challenging since most individuals living with it have shrunk testicles.
One of the surveys in 321 chronic users of steroids demonstrated that at least half of such men would have erectile dysfunction or reduced libido. However, many do not report reduced libido or related symptoms like decreased energy and muscle mass, as they continue to use steroids all the time. Erectile dysfunction becomes visible when going off the cycle or when discontinuing steroid use. Studies show that there is a direct relationship between erectile dysfunction and the duration of steroid abuse (5).
On the contrary to common belief, most people living with erectile dysfunction have normal testosterone levels, and reasons to gain hard erection are other like vascular conditions, metabolic diseases. However, among the endocrinal causes, testicular dystrophy is the primary cause. And it is common in steroid abuse (6).
Managing Erectile Dysfunction Related to Steroid Use
It is needless to say that one should not abuse steroids. Most men living with steroid-related erectile dysfunction are those who have used steroids for years or even decades. In such cases, reviving the natural production of testosterone may not be possible.
Fortunately, for such men, Viagra provides hope. Most such men can expect to revive their sexual life with the help of Viagra. The good thing about sildenafil is that it does not depend much on the levels of testosterone for providing a hard erection. Viagra acts directly on the penile blood vessels, increases blood flow by increasing the levels of NO (7).
Most of those living with erectile dysfunction caused by steroid use would require hormone replacement therapy. It means that if such individuals have stopped using steroids, or have retired from sports, they would benefit from low level and long-acting testosterone injections. Fortunately, they can get such testosterone even through medical prescription, as such use of testosterone is legal.
However, it is necessary to understand that testosterone therapy would not be enough in most cases to treat erectile dysfunction or revive sexual confidence. Therefore, combining it with Viagra is the right way to manage such conditions.
To summarize, steroids are the most potent performance-enhancing drugs; their use is common. However, they come with some side effects, including loss of testosterone-producing cells in testicles. Fortunately, steroid abuse-related erectile dysfunction is treated with great success by combining hormone replacement therapy, with the use of Viagra.
Viagra rarely produces any side effects in those living with erectile dysfunction related to steroid use. Viagra is also suitable for patients of any age. In young individuals, who are still using steroids, it may even help train better.