Reproduction: exogenous androgen effects: practice question

A Physiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Physiology · Reproduction: exogenous androgen effects

Sample item

A 24-year-old bodybuilder using testosterone esters has small, soft testes, a very low sperm count, low LH and FSH, and breast tenderness. What best explains the infertility?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Negative feedback suppresses LH and FSH, lowering intratesticular testosterone and spermatogenesis

Exogenous androgens suppress hypothalamic GnRH and pituitary LH and FSH. Loss of LH reduces Leydig cell production and the high intratesticular testosterone that spermatogenesis needs, and loss of FSH impairs Sertoli cell support; the testes atrophy. Aromatisation of excess testosterone causes gynaecomastia.

Option by option

  • A. Negative feedback suppresses LH and FSH, lowering intratesticular testosterone and spermatogenesis (correct)

    Correct. Feedback suppression of gonadotropins explains atrophy and oligospermia.

  • B. Raised inhibin B suppressing FSH release

    Inhibin B falls when Sertoli cell function declines.

  • C. A pituitary adenoma secreting excess prolactin

    Prolactinomas are not suggested by the history and would not explain the exogenous source.

  • D. Direct toxic destruction of seminiferous tubules with high FSH

    Primary tubular damage would raise FSH, whereas here FSH is low.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Physiology question

What is the answer to this Physiology question?

The best answer is A, Negative feedback suppresses LH and FSH, lowering intratesticular testosterone and spermatogenesis. Exogenous androgens suppress hypothalamic GnRH and pituitary LH and FSH.

Why is "Raised inhibin B suppressing FSH release" not the answer?

Inhibin B falls when Sertoli cell function declines.

Why is "A pituitary adenoma secreting excess prolactin" not the answer?

Prolactinomas are not suggested by the history and would not explain the exogenous source.

Why is "Direct toxic destruction of seminiferous tubules with high FSH" not the answer?

Primary tubular damage would raise FSH, whereas here FSH is low.

What concept does this question test?

It tests Reproduction: exogenous androgen effects in Physiology. Loss of LH reduces Leydig cell production and the high intratesticular testosterone that spermatogenesis needs, and loss of FSH impairs Sertoli cell support; the testes atrophy. Aromatisation of excess testosterone causes gynaecomastia.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Reproduction: exogenous androgen effects?

For each system, sketch the key graph (pressure–volume loop, oxygen dissociation curve, nephron handling) and explain it aloud. Then use the flashcards and the other Physiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.