Award-winning urologist - and pioneer in Men’s Health - Dr. Paul Turek blogs weekly about issues such as infertility, vasectomy and vasectomy reversal, sexual and hormonal dysfunction and more. Keep up with latest in this fascinating field of medicine.

Ramirez: A Lesson in Steroid Biology

Build muscles naturally, like Joe Wieder in the 1970's.

Build muscles naturally, like Joe Wieder in the 1970′s.

When a record-breaking athlete gets caught for doping, it’s not news anymore. It shouldn’t be. People have been taking drugs to increase physical prowess since ancient times. We’ve recently seen it with Barry Bonds, Jason Giambi, and now LA Dodger’s star Manny Ramirez, whose urine tested positive for a medication on MLB’s banned substance list.

The MLB was questioning the discovery of synthetic testosterone in Ramirez’s lab tests. Ramirez had been planning on waving that suspicion away by saying he had been using DHEA, a supplement made in the adrenal gland that is weaker than testosterone and that is currently not banned. What sealed the deal was his positive test for hCG (human chorionic gonadotropin). It occurs naturally in a woman’s body when she’s pregnant, and is a drug that is only federally approved for use as a fertility medication. In women, it is used to induce ovulation, the release of an egg from the ovary. For boys, it is used to induce natural testosterone production in the testicles to help with puberty. For men, the only medical reason a man might use it is to boost testosterone levels for fertility purposes. It is not commonly given for erectile dysfunction, as Viagra, Cialis or Levitra are more effective treatments and are less painful to administer. hCG can only be given by injection, while both Cialis and Viagra come in handy dandy pills.

So why hCG? Well, testosterone supplements are taken by athletes because they are anabolic: they increase muscle mass and performance. However, steroids effectively shut down a man’s own testosterone production. Because the body is being supplied with a steroid that serves testosterone’s purpose, the testicles see no need to continue to produce their own testosterone and cease production. Fertility is wiped out too while men are taking anabolic steroids. Because of these effects, the testicles actually shrink. HCG is commonly used by steroid users when coming off of anabolic steroids, to normalize the hormone signaling and prevent testicle shrinkage. It stimulates the testicles to start testosterone production again, after being told to turn it off. This makes the system able to respond to the next cycle of anabolic steroids. And on and on it goes, the process of steroid stacking and cycling.

So, the fact that hCG was found in Ramirez’s blood suggests that he was doing other things with other supplements as well. Another star now fallen off the pedestal…

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About Dr. Turek

A founder of the male fertility and male sexual healthcare movement, Dr. Paul Turek is also an internationally recognized master microsurgeon who specializes in vasectomy and vasectomy reversal, FNA testicular mapping, sperm retrieval and male erectile and sexual dysfunction.

He is a former Academy of Medical Educators Endowed Chair Professor of Urology, Obstetrics & Gynecology at UCSF and while there, directed a National Institutes of Health (NIH) grant for training new leaders in men's reproductive health. He has authored more than 175 publications on genetic, urological and epidemiological issues in men's reproductive health and regularly consults for the Centers for Disease Control and Prevention (CDC) and the NIH and other branches of the US government and industry on matters relating to men's reproductive health. He currently holds an NIH grant to create a human artificial testicle to make sperm.

He is Past-President of the American Society of Andrology, a Fellow of the American College of Surgeons, the Société Internationale d'Urologie and the Royal Society of Medicine (London). Dr Turek is also Editor of the Reproductive Volume of Netter's Images, 2nd Edition. His hobbies include vintage cars and long board surfing.

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    Here are some common, basic reasons why men have a lower sex drive and that have nothing to do with testosterone... http://t.co/he94nCCt

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    Wow. Israel’s IVF rate per citizen is almost 10 times ours in the US! Why? The State pays for it. http://t.co/h3Eh9Com

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    Happy early Valentine’s Day everyone! Next time, consider the surest form of contraception ever developed- vasectomy! http://t.co/InHZa4yS

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