Anabolic androgenic steroid abuse in young males

Ronde, Willem de; Smit, Diederik L.

doi:10.1530/ec-19-0557

Cited by 72 publications

(42 citation statements)

References 23 publications

(29 reference statements)

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“…Even more concerning is that 7.42% of men reported AAS use prior to age 18, indicating a significant need for improved AAS education and awareness directed toward adolescents. The prevalence of body image disorders serving as a motivation to use AAS in our data (29.5%) supports the multidisciplinary challenges noted in prior studies ( de Ronde & Smit, 2020 ; Goldman et al, 2019 ; Pope et al, 2017 ). The combination of easily accessed AAS compounds via the internet, early onset of use with high-dose androgens, and prevalence of body image disorders has created a greater need than ever for medical resources for these patients.…”

Section: Discussionsupporting

confidence: 89%

“…Direct hepatoxicity is only seen with 17-alpha alkylated oral AAS ( Niedfeldt, 2018 ). Commonly used accessory performance enhancing drugs (PEDs) include aromatase inhibitors (AIs), selective estrogen receptor modulators (SERMs), human chorionic gonadotropin (hCG), thyroid hormone, insulin, and human growth hormone (hGH), among others ( de Ronde & Smit, 2020 ). AIs and SERMs (particularly tamoxifen) are used to mitigate the estrogenic side effects of supraphysiologic androgen levels, while hCG is used to maintain testicular volume ( Anawalt, 2019 ).…”

Section: Anabolic Androgenic Steroids: the State Ofthe Artmentioning

confidence: 99%

“…AIs and SERMs (particularly tamoxifen) are used to mitigate the estrogenic side effects of supraphysiologic androgen levels, while hCG is used to maintain testicular volume ( Anawalt, 2019 ). Many men using AAS utilize the SERM clomiphene and/or hCG while temporarily stopping AAS in an attempt to normalize the hypothalamic-pituitary-testicular (HPT) axis ( Anawalt, 2019 ; de Ronde & Smit, 2020 ; Smit & de Ronde, 2018 ; Smit et al, 2020 ), a practice commonly known as “post-cycle therapy” or “PCT.”…”

Section: Anabolic Androgenic Steroids: the State Ofthe Artmentioning

confidence: 99%

“…Men using AAS often hesitate to seek out physicians for help, viewing them as both unknowledgeable on AAS and disrespectful to those taking these substances ( Pope et al, 2004 ; Zahnow et al, 2017 ). Instead, these patients default to friends, online forums, and self-proclaimed coaches or gurus for advice that is often inaccurate and dangerous ( de Ronde & Smit, 2020 ; Fink et al, 2019 ). A 2019 review highlights the lack of data, guidelines, and clinical preparedness to assist these patients (Goldman et al).…”

mentioning

confidence: 99%

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Characteristics and Attitudes of Men Using Anabolic Androgenic Steroids (AAS): A Survey of 2385 Men

2020

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Additional characterization of patients using anabolic androgenic steroids (AAS) is needed to improve harm reduction and cessation resources for patients. Our group sought to expand upon the currently limited data regarding AAS use by performing a web-based survey assessing experiences of males using AAS. Participants included men over the age of 18 with history of AAS use within the past 5 years. Data were collected between August 2019 and April 2020. Primary outcome measures included age when starting AAS, dose of AAS, motivations for use, experiences with health-care professionals, and rate of successful cessation. The survey was accessed 3640 times, resulting in 2385 completed surveys meeting the inclusion criteria (68.93% participation rate). Average participant age was 31.69 ± 10.09 years. Over half of respondents were from the United States ( n = 1271, 53.3%). Motives to use AAS included improving appearance ( n = 1959, 82.2%), strength gain ( n = 1192, 50%), and self-esteem/body image issues ( n = 712, 29.87%). Participants rated physicians poorly, regarding knowledge of AAS (4.08 ± 2.23). Most participants did not reveal AAS use to their health-care providers ( n = 1338, 56.1%); of those that did, 55.30% ( n = 579) reported feeling discriminated against for their use. Of 46.16% ( n = 1101) attempting AAS cessation, 60.22% ( n = 663) were unsuccessful. Challenges in the management of AAS use include early onset of use, supraphysiologic doses used, and frequently present body image disorders stress. Distrust of health-care providers, poor cessation rates, and lack of physician training further exacerbate this. These findings should serve to reinforce previous calls to action for further research on the treatment of AAS use disorder.

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Section: Discussionsupporting

confidence: 89%

Section: Anabolic Androgenic Steroids: the State Ofthe Artmentioning

confidence: 99%

Section: Anabolic Androgenic Steroids: the State Ofthe Artmentioning

confidence: 99%

mentioning

confidence: 99%

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Characteristics and Attitudes of Men Using Anabolic Androgenic Steroids (AAS): A Survey of 2385 Men

2020

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“…One of the biggest current problems associated with AAS is that there has been an increasing number of recent reports of AAS abuse by non-professional athletes, mostly young people seeking to improve performance, build muscle and stamina, and have a great looking body [ 5 , 6 ]. Apart from the aforementioned side effects, AAS use may lead to withdrawal symptoms after these drugs have been discontinued.…”

Section: Introductionmentioning

confidence: 99%

Medicinal Use of Testosterone and Related Steroids Revisited

et al. 2021

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Testosterone derivatives and related compounds (such as anabolic-androgenic steroids—AAS) are frequently misused by athletes (both professional and amateur) wishing to promote muscle development and strength or to cover AAS misuse. Even though these agents are vastly regarded as abusive material, they have important pharmacological activities that cannot be easily replaced by other drugs and have therapeutic potential in a range of conditions (e.g., wasting syndromes, severe burns, muscle and bone injuries, anemia, hereditary angioedema). Testosterone and related steroids have been in some countries treated as controlled substances, which may affect the availability of these agents for patients who need them for therapeutic reasons in a given country. Although these agents are currently regarded as rather older generation drugs and their use may lead to serious side-effects, they still have medicinal value as androgenic, anabolic, and even anti-androgenic agents. This review summarizes and revisits the medicinal use of compounds based on the structure and biological activity of testosterone, with examples of specific compounds. Additionally, some of the newer androgenic-anabolic compounds are discussed such as selective androgen receptor modulators, the efficacy/adverse-effect profiles of which have not been sufficiently established and which may pose a greater risk than conventional androgenic-anabolic agents.

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Simultaneous testing for anabolic steroids in human hair specimens collected from various anatomic locations has several advantages when compared with the standard head hair analysis

Kintz

Gheddar

Raul

2021

Drug Testing and Analysis

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Since the late 90s, hair testing for anabolic steroids in humans has found numerous forensic, clinical, and anti-doping applications. In most cases, analyses were performed on head hair, collected in the vertex regions. However, for various reasons (shaved subject, bald subject, religious belief, cosmetic treatment and aesthetic reason), hair collectors can face the lack of head hair, and therefore, body hair can be the unique alternative choice. Although there is no possibility to perform segmental analyses with body hair, their use has two major advantages: (1) In most cases, anabolic steroids are more concentrated in body hair when compared with head hair, which allows detecting abuse at lower frequency and for lower dosages; and (2) the window of drug detection is generally much longer in body hair when compared with head hair, particularly in male athlete presenting short head hair. To document the relevance of simultaneous collection of head and body hair, the authors present eight authentic cases of anabolic steroids abuse, including clostebol (one case), drostanolone (one case), metandienone (one case), 19-norandrostenedione (one case), stanozolol (two cases) and trenbolone (three cases). In all cases, body hair concentrations were higher than head hair concentrations. Even in three cases, no steroid was identified in head hair, although present in body hair.

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Anabolic androgenic steroid abuse in young males

Cited by 72 publications

References 23 publications

Characteristics and Attitudes of Men Using Anabolic Androgenic Steroids (AAS): A Survey of 2385 Men

Characteristics and Attitudes of Men Using Anabolic Androgenic Steroids (AAS): A Survey of 2385 Men

Medicinal Use of Testosterone and Related Steroids Revisited

Simultaneous testing for anabolic steroids in human hair specimens collected from various anatomic locations has several advantages when compared with the standard head hair analysis

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