Rise in infertility linked to craze for body-building

The body-building craze sweeping north-east England has led to a rise in male infertility linked with anabolic steroid use, according to a new study.

Doctors in Newcastle say that scores of young men - some as young as 15 - are taking the drugs for recreational purposes, and are ignorant of the potentially devastating effect on sperm production.

They are advising colleagues at infertility clinics to watch out for men who may be using steroids, and to ask them directly if they take the drugs. The "at risk" group can be easily recognised on examination by their bulky physique and small testicles, the doctors say.

Their report in tomorrow's issue of the British Medical Journal (BMJ) details five recent cases of couples attending the infertility clinic at the Centre for Reproductive Medicine at the Royal Victoria Infirmary in Newcastle, in which the men had zero or very low sperm counts after taking steroids.

One 29-year-old, whose hobby was weightlifting, said he took oral steroids for two weeks a year before attending the clinic. However, tests suggested continuing steroid use and he admitted to taking a "protein health drink" made up by the gym before he started training. Three months after stopping the "drink" his sperm count had returned to normal.

Another man, 28, who was a regular at the gym and a keen weight-trainer, took steroids given to him by friends but doubled the suggested dose, causing a sharp reduction in his sperm count. He obtained needles for his injections from a needle-exchange programme intended for intravenous drug users to reduce the risks posed by sharing dirty needles. His wife became pregnant six months after he stopped taking the steroids.

In the BMJ, Dr Alison Murdoch and colleagues report: "Over the past year we have noted an increased number of men attending the infertility clinic who have been using anabolic steroids for body-building. This has been associated with an apparent substantial increase in body-building as a recreational pastime in the North East."

The report says that because of the "great secrecy" surrounding steroids and the illicit means by which they are obtained, men hide it from doctors. "The lack of awareness of the implications of steroid abuse is shown by the polypharmacy [range of steroid drugs used], the carelessness of the dosage, and the young age at which the problem starts," it argues.

The incidence of steroid use among recreational body-builders and weightlifters is unknown, although one 1992 study suggested that it may be as high as 40 per cent. The patients in the Newcastle study estimated that between 100-300 men regularly attended their own gymnasiums, and that between one-quarter and three-quarters were taking steroids.

The adverse effects of anabolic steroids include liver cancer and other liver diseases, growth of breasts, reduced libido, prostate cancer, mood changes, and dependency, plus fertility problems. Reversal of the effects on sperm can take up to 12 months after stopping the drugs, and problems can persist for up to three years. Some body-builders take up to 40 times the doses at which adverse effects have been recorded.

All the men in the study said they were unaware of severe side effects of the drugs, and that their gymnasiums gave little or no information.