Navigating non-medical androgen use: Towards a harm reduction paradigm

Non-medical androgen use is on the rise, with short-term side effects being well-documented whereas long-term consequences remain less understood but are likely to entail cardiovascular illness and permanent endocrine disruptions. Current educational initiatives are falling short in curbing this significant increase, signaling the need for a different approach. In this context, harm reduction emerges as a promising secondary prevention strategy. The key principles of the harm reduction approach outlined in this article emphasize educating individuals about side effects, limiting androgen use, and monitoring health closely. Successful implementation of this strategy hinges upon healthcare providers possessing expertise in the field, fostering non-judgmental interpersonal relationships, and securing cooperation of the athlete. The efficacy of this strategy will be rigorously evaluated in the HARNAS trial, comparing its outcomes with those of a historical control group. The findings from this trial are anticipated to be published in the coming years, shedding light on the effectiveness of this pioneering approach.