Studies of athlete biological passport biomarkers and clinical parameters in male and female users of anabolic androgenic steroids and other doping agents

Abstract

The use of anabolic androgenic steroids (AAS) and other performance enhancing substances can change over time, so there is a need to constantly update what substances are used and can be detected. Six women and 30 men anabolic androgenic steroid users were recruited who filled out an anonymous questionnaire about their use of performance enhancing substances during the past year. Sampling took place on a single occasion and included blood and urine collection. Our aim was to identify which doping agents can be detected in men and women self‐reporting AAS use. The first choice of substances differed between men (testosterone) and women (oxandrolone). The use of growth hormones was reported among men (10%) and women (50%). Growth hormone releasing factors/secretagogs were reported by about ~ 20% in both genders. Nandrolone was the most frequently detected anabolic androgenic steroid even in those who did not report use in the past year. Of the current male testosterone users, 82% exhibited testosterone/epitestosterone (T/E) ratios of > 4. Men with current testosterone use displayed 4‐fold and 6‐fold higher median T/E, respectively, when compared with recent and previous testosterone users (P = 0.0001). Dermal testosterone use in women (n = 2) was not associated with a T/E ratio of > 4, but with supra‐physiological total serum testosterone concentrations. Changes in gonadotropins and hematological parameters were associated with the time of the last anabolic androgenic steroid intake in men, whereas in women these biomarkers were within the normal range. This highlights gender specific differences and indicates the need for additional biomarkers in female athletes.

Annual banned‐substance review: Analytical approaches in human sports drug testing 2019/2020

“…The relevance and routine applicability of testing serum T in routine doping controls was highlighted by Handelsman and Bermon, who reported on two cases of serial serum T measurements in female athletes, where the pattern of T concentrations was not found to be consistent with any normal physiological profile. 80 The corresponding urinary steroid profile remained unremarkable, a phenomenon also reported by Börjesson, 46…”

“…The relevance and routine applicability of testing serum T in routine doping controls was highlighted by Handelsman and Bermon, who reported on two cases of serial serum T measurements in female athletes, where the pattern of T concentrations was not found to be consistent with any normal physiological profile 80 . The corresponding urinary steroid profile remained unremarkable, a phenomenon also reported by Börjesson, 46 thus underlining the importance of complementing urinary steroidal module of the ABP with serum steroid profile data or, at least, with blood T values determined, for example, from dried blood spots (DBS) 81 …”

“…AAS can affect users on various levels, ranging from muscle-tissue physiological aspects where alterations of structural proteins are reported, 36 increased aggressiveness associated with violent behavior, 37 to severe cardiovascular and hepatic health issues [38][39][40][41][42] with presumably causal coherence to fatalities. 43 And yet, AAS appear to remain popular amongst recreational athletes [44][45][46] and elite athletes as supported by WADA's annually published anti-doping testing figures. 47 Consequently, much effort was invested also during the past 12 months into improving test methods concerning AAS (and anabolic agents in general), aiming at enhanced initial testing procedures (ITPs) as well as further insights into the drugs' metabolism that, consequently, allow for optimized selection of target analytes in routine sports drug testing programs.…”

Male Anabolic Androgenic Steroid Users with Personality Disorders Report More Aggressive Feelings, Suicidal Thoughts, and Criminality

“…Finally, this study was conducted around 20 years ago. However, as the AAS use pattern appears to be similar in Sweden today [49] (daily communication with AAS users via the Anti-Doping Hot-Line), we believe that the results are still representative, although there is a tendency towards continuous AAS use [49] rather than AAS use in cycles.…”

Urinary steroid profile in relation to the menstrual cycle

“…In addition to the large intra‐individual variation seen in E concentrations in women, another gender dilemma is that after T administration, urinary E excretion is not down‐regulated in women in contrary to men, regardless of UGT2B17 genotype 33,34 . Consequently, T administration in women is not necessarily associated with elevated T/E 35,36 . In addition to monitoring the urinary T/E ratio, future testing programs should consider monitoring serum T and/or other serum markers, 37 which may improve the chance to identify women doping with T 35 …”