The hypothalamic-pituitary-gonadal axis dysfunction in men practicing competitive sports

Abstract

Regular physical activity is widely recommended for primary and secondary prevention of many diseases. Among others, it has been proven to reduce the risk of coronary heart disease, stroke, diabetes, hypertension, colorectal cancer, breast cancer and depression. In addition, physical activity plays an important role in regulating the body's energy balance, and therefore controls body weight. Physical inactivity was identified as the fourth leading risk factor for global mortality (6% of deaths worldwide) after factors such as elevated blood pressure (13%), smoking (9%) and high blood glucose (6%). The purpose of this article is to illustrate the physiological and pathological changes that occur in the hypothalamic-​-pituitary-gonadal axis (HPG) secondary to exercise and training. Relatively short and intensive exercise usually increases, while more prolonged exercise usually decreases serum testosterone concentrations. Reduced or low-normal circulating testosterone levels involve health consequences such as an increased risk of abnormal spermatogenesis, infertility problems, and compromised bone mineralization. In addition, the administration of prohibited substances, such as anabolic androgenic steroids, to competitive and non-competitive athletes is an important cause of iatrogenic andrological diseases.