Adverse Effects of Anabolic-Androgenic Steroids: A Literature Review

Abstract

Anabolic-androgenic steroids (AASs) are a large group of molecules including endogenously produced androgens, such as testosterone, as well as synthetically manufactured derivatives. AAS use is widespread due to their ability to improve muscle growth for aesthetic purposes and athletes’ performance, minimizing androgenic effects. AAS use is very popular and 1–3% of US inhabitants have been estimated to be AAS users. However, AASs have side effects, involving all organs, tissues and body functions, especially long-term toxicity involving the cardiovascular system and the reproductive system, thereby, their abuse is considered a public health issue. The aim of the proposed review is to highlight the most recent evidence regarding the mechanisms of action of AASs and their unwanted effects on organs and lifestyle, as well as suggesting that AAS misuse and abuse lead to adverse effects in all body tissues and organs. Oxidative stress, apoptosis, and protein synthesis alteration are common mechanisms involved in AAS-related damage in the whole body. The cardiovascular system and the reproductive system are the most frequently involved apparatuses. Epidemiology as well as the molecular and pathological mechanisms involved in the neuropsychiatric side-effects of AAS abuse are still unclear, further research is needed in this field. In addition, diagnostically reliable tests for AAS abuse should be standardized. In this regard, to prevent the use of AASs, public health measures in all settings are crucial. These measures consist of improved knowledge among healthcare workers, proper doping screening tests, educational interventions, and updated legislation.

Early Left Ventricular Diastolic Dysfunction, Reduced Baroreflex Sensitivity, and Cardiac Autonomic Imbalance in Anabolic–Androgenic Steroid Users

“…The use of AAS by athletes has been associated with cardiovascular disorders, either acute (such as arrhythmogenic SCD, thromboembolic episodes, or myocardial infarction) or chronic (such as hypertension, atherosclerosis, or LV hypertrophy and dysfunction) [1][2][3][4][5][6][7].…”

“…There are several references in the literature regarding the use of anabolic–androgenic steroids (AAS) as doping substances in sports and particularly their health effects, there are several references in the literature. Most studies on their morphological and functional adverse effects on various functional systems after acute or long-term administration are based on experimental animal results [ 1 ]. For ethical, legal, and methodological reasons, the reports are not very well documented in athletes [ 1 , 2 ].…”

“…Most studies on their morphological and functional adverse effects on various functional systems after acute or long-term administration are based on experimental animal results [ 1 ]. For ethical, legal, and methodological reasons, the reports are not very well documented in athletes [ 1 , 2 ]. A limitation of almost all similar studies regarding the cardiovascular side-effects of AAS in athletes is the fact that the results are based on cross-sectional studies with different subject populations rather than longitudinal data.…”

Multidisciplinary Approach to Suspected Sudden Death Caused by Arteriovenous Malformation Rupture: A Case Report

“…It was a useful tool, which should be applied to the routine autopsy protocol [ 32 , 33 , 34 ]. Autopsy plays a crucial role in identifying the cause of death beyond any doubt [ 35 , 36 , 37 , 38 , 39 ]. Many unexpected deaths are currently associated with cardiovascular diseases and in many cases without any type of confirmation.…”

Effects of nandrolone decanoate on femur morphology. Experimental study

“…According to other authors, nandrolone decanoate can also unleash a variety of changes in several organs, such as cardiac injury, through myocyte hypertrophy, enhancement of matrix type I collagen deposition and hypertension 13 . Besides, it increases the frequency of DNA damage in leukocytes, liver, bone marrow, brain and testicle cells at different tested doses 14 .…”