SAT-154 Delineating Pharmacological and Psychological Components of Androgen Abuse Withdrawal Symptoms: Results of a Prospective, Observational Study in 286 Men

Abstract Disclosure: B. Grant: None. J. Kean: None. N. Lakshitha de Silva: None. M. Gumssani: None. O. Quinton: None. W.S. Dhillo: None. A. Lingford-Hughes: None. C.N. Jayasena: None. Context: Thirty percent of men have androgen abuse dependency. Men ceasing androgen abuse commonly report reduced sexual dysfunction, low mood, low quality of life (QoL), anxiety and fatigue. Some androgen withdrawal symptoms may be hypogonadism-driven, but other symptoms may be psychologically driven. Factors associated with symptoms within the first year of androgen-withdrawal have not been investigated previously. Methods: A cross-sectional, observational study of 286 men: non-users (n=50); current-users (n=125); past-users 1 year (n=111). All participants completed questionnaires on androgen use, sexual function (International Index Erectile Function-15; IIEF-15), depression (Beck Depression Inventory-II; BDI-II), anxiety (Generalised Anxiety Disorder-7; GAD-7), quality of life (Short-Form-36; SF-36) and underwent fasted, morning blood testing with urine toxicology. Results: Psychiatric comorbidities were higher in current-users compared with non-users (5/50, 10%, non-users; 36/125, 28.8%, current-users; p=0.01). Illicit non-androgenic drug use was also higher in current-users and past-users compared with non-users (11/50, 22%, non-use; 61/125, 48.8%; p=0.001; 51/111, 45.9%, past use; p=0.0049). Serum total testosterone (TT) levels mildly and positively correlated with improved sexual function: (1) IIEF-15 total: r=0.19 [95% CI 0.07, 0.31], p=0.03; (2) erectile function: r=0.19 [95% CI 0.07, 0.31], p=0.03; (3) sexual desire: r=0.21 [95% CI 0.09, 0.33], p=0.01; (4) overall satisfaction: r=0.22 [95% CI 0.1, 0.34], p=0.01. In past-users, sexual dysfunction (IIEF-15 <62) moderately predicted hypogonadism (PPV for TT<8nmol/l=75%), but moderate-severe depression (BDI score 20) poorly predicted hypogonadism (PPV for TT<8nmol/l=16.6%). Multivariable analysis in past-users suggested that psychiatric comorbidity was associated with either sexual function (coefficient -13 [95% CI -23, -2.6], p=0.01) or depressive symptoms (coefficient 12.6 [95% CI 7.3, 17.8], p<0.0001. TT was not independently associated with symptoms in past-users. Discussion: This is the first comprehensive study of acute androgen withdrawal. Our data suggest a strong influence of psychiatric comorbidity on interpretation of androgen withdrawal symptoms, even in the presence of hypogonadism among affected men. Presentation: Saturday, July 12, 2025