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  • Androgenes et Sport
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Effets secondaires des androgènes

Side effects of high-dose androgen administration


Les androgènes utilisés à des doses 10 à 100 fois supérieures aux doses thérapeutiques provoquent des effets qui peuvent être classés en 4 catégories: 1) Effets androgéniques: Chez l’homme, les androgènes provoquent atrophie testiculaire et azoospermie avec stérilité, réversibles en 2 à 3 mois à l’arrêt du traitement. Il serait utile de surveiller à long terme la prostate des sujets soumis à de fortes doses d’androgènes, une étude récente ayant montré une élévation des taux de PSA. Chez la femme, l’enfant et l’adolescent, les effets virilisants sont constants et irréversibles ce qui conduit à proscrire l’utilisation des stéroïdes androgènes/ anabolisants à forte dose chez ces sujets. 2) Effets toxiques: surtout liés à l’utilisation de stéroïdes 17α-alkylés, ils atteignent essentiellement la fonction hépatique. 3) Effets sur le système cardiovasculaire: modifications des lipides et des lipoprotéines sanguines allant dans le sens d’une augmentation du risque athéromateux. 4) Effets comportementaux: les androgènes sont censés développer l’agressivité et l’endurance. Des manifestations de type psychotiques ont été rapportées ainsi que l’apparition d’une dépendance physique et psychologique. Toutefois chez l’homme, ces effets ne sont pas sérieusement documentés; il semble exister un effet placebo important. En conclusion, chez l’homme adulte au moins, les effets androgéniques propres sont largement réversibles à l’arrêt des traitements et ne semblent pas comporter de risques graves. Par contre les effets potentiels à long terme: effets toxiques hépatiques, conséquences des modifications des lipoprotéines et effets éventuels sur le développement d’une pathologie prostatique androgénodépendante ne sont actuellement pas évalués.


Androgens, when used in medical replacement dosages, are well tolerated with no major side effects. In contrast, the illegal use by athletes of doses of androgens 10 to 100 fold higher than therapeutical doses can be responsible for a number of health hazards, all the more so since they are not medically controled. In addition, new usages of androgens at high doses are now emerging such as male contraception and hormone replacement therapy for andropause. Androgen side effects can be classified in 4 categories: il all cases they depend on the dose and the molecule used. 1) Androgenic side-effects are constant. In men, they include testicular atrophy and azoospermia leading to sterility. They are readily reversible in 2 to 3 months after cessation of treatment. However, potential long term effects on prostate should be evaluated. In women and adolescents, high doses of androgens will also produce androgenic side effects (increase of body mass, acne, deepening of the voice, hirsutism, balding) and in adolescents, premature epiphyseal fusion. These effects are often irreversible and should preclude high dose androgen administration in these subjects. 2) Toxic side-effects, especially due to the use of 17α-alkylated derivatives, bear mainly on liver function; they involves pathological liver function tests and jaundice but can also include more serious hepatic complications such aspeliosis hepatitis or hepatoma. 3) Effects on the cardiovascular system: blood lipids and lipoproteins change toward values promoting atherosclerosis are constant and an increased thrombogenic risk has also been reported. 4) Behavioural side-effects: Androgens are supposed to develop aggressivity and mental strength; psychotic manifestations have been reported, but in the human these effects are poorly documented and there seemingly exists a strongplacebo effect. In conclusion, in adult man at least, high doses of androgens seem to result in essentially reversible effects and androgen abuse do not involve major risks. However further studies are necessary to evaluate potential longterm effects such as liver toxic effects, significance of the cardiovascular changes and moreover, the potential development of an androgen-dependent prostate pathology.


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Mowszowicz, I. Effets secondaires des androgènes. Androl. 5, 340–346 (1995).

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