The article delves into the impacts of anabolic steroids and testosterone replacement therapy (TRT) on testicular health, emphasizing changes in testicular size and hormone regulation. Anabolic steroids and exogenous testosterone administered for performance enhancement or TRT disrupt the body's natural hormonal balance. Testosterone therapy usually involves creams, gels, patches, or injectable testosterone cypionate/enanthate, while steroid users may employ multiple synthetic anabolic compounds, including testosterone variants, nandrolone, stanozolol, oxandrolone, methandrostenolone, and trenbolone. Despite their muscle-building potential, these substances carry legal restrictions, health risks, and side effects, prominently testicular atrophy.
TRT use triggers a feedback mechanism wherein higher testosterone levels signal the brain to reduce natural testosterone production. This regulatory process involves the hypothalamus reducing gonadotropic hormones (LH and FSH), responsible for testosterone