Anabolic-androgenic steroids (AAS), also known as androgens, encompass testosterone and its synthetic derivatives which require a legal prescription for medical purposes 1'2. Testosterone replacement therapy (TRT) is indicated for organic hypogonadism resulting from pathological disorders affecting the hypothalamo-pituitary testicular axis 3'4 and medical treatment for transgender men 5'6. TRT is justified when irreversible defects in the reproductive system impede androgen-sensitive tissue functions 2'4. The diagnostic process involves clinical assessments, hormonal assays, and a reproductive hormone profile to determine the need for lifelong testosterone replacement 3.

However, androgens are often used for off-label indications, with or without a prescription for a variety of reasons including wellness, aesthetics, and management of libido and depression 7ˉ9. See Table 1 for some of the compounds commonly used in circulation.