Androgen misuse is now mainstream — how do you manage it?

Once confined to the realm of professional athletes, androgen misuse has become mainstream.

Mr M is a 32-year-old man who was seen by his GP for problems of subfertility.


He and his wife have tried unsuccessfully to conceive a pregnancy despite 18 months of regular, unprotected intercourse.

The patient underwent a normal puberty starting at age of 11 and has always been otherwise healthy. On physical examination, he was well virilised with a normal distribution of body hair and a very muscular physique.

Active acne lesions were present on his back and in the midline of his chest. Examination of external genitalia revealed bilateral