Harm Reduction in Male Patients Actively Using Anabolic Androgenic Steroids (AAS) and Performance-Enhancing Drugs (PEDs): a Review

Abstract

Anabolic androgenic steroid (AAS) and performanceenhancing drug (PED) use is a prevalent medical issue, especially among men, with an estimated 2.9-4 million Americans using AAS in their lifetime. Prior studies of AAS use reveal an association with polycythemia, dyslipidemia, infertility, hypertension, left ventricular hypertrophy, and multiple behavioral disorders. AAS withdrawal syndrome, a state of depression, anhedonia, and sexual dysfunction after discontinuing AAS use, is a common barrier to successful cessation. Clinical resources for these patients and training of physicians on management of the patient using AAS are limited. Many men are hesitant to seek traditional medical care due to fear of judgment and lack of confidence in physician knowledge base regarding AAS. While proposed approaches to weaning patients off AAS are published, guidance on harm reduction for actively using patients remains sparse. Medical education regarding the management of AAS use disorder is paramount to improving care of this currently underserved patient population. Management of these patients must be non-judgmental and focus on patient education, harm reduction, and support for cessation. The approach to harm reduction should be guided by the specific AAS/ PEDs used.

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“…The objective of this case study was to find out if and arterial and venous thrombosis [1,14,16,32].…”

“…Some PCT regimens are available over the counter as supplements that can be used for several weeks. Others, such as Clomid and Nolvadex (Tamoxifen), are FDAapproved prescription drugs for other conditions but may be used off-label for PCT [16]. As estrogen blockers, SERMs enhance testosterone levels and help counteract some of the unfavorable side effects of steroid use, such as gynecomastia [17].…”

“…As estrogen blockers, SERMs enhance testosterone levels and help counteract some of the unfavorable side effects of steroid use, such as gynecomastia [17]. During PCT, some men combine clomiphene and Nolvadex (Tamoxifen) [16,18].…”

‘Sustaining masculinity’: a scoping review of anabolic androgenic steroid use by older males

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Anabolic-Androgenic Steroid Misuse: Mechanisms, Patterns of Misuse, User Typology, and Adverse Effects

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