Anabolic-Androgenic Steroid Use in Sports, Health, and Society

Abstract

This consensus statement is an update of the 1987 American College of Sports Medicine (ACSM) position stand on the use of anabolic-androgenic steroids (AAS). Substantial data have been collected since the previous position stand, and AAS use patterns have changed significantly. The ACSM acknowledges that lawful and ethical therapeutic use of AAS is now an accepted mainstream treatment for several clinical disorders; however, there is increased recognition that AAS are commonly used illicitly to enhance performance and appearance in several segments of the population, including competitive athletes. The illicit use of AAS by competitive athletes is contrary to the rules and ethics of many sport governing bodies. Thus, the ACSM deplores the illicit use of AAS for athletic and recreational purposes. This consensus statement provides a brief history of AAS use, an update on the science of how we now understand AAS to be working metabolically/biochemically, potential side effects, the prevalence of use among athletes, and the use of AAS in clinical scenarios.

Social Media, Body Image and Resistance Training: Creating the Perfect ‘Me’ with Dietary Supplements, Anabolic Steroids and SARM’s

“…In their quest for fast or unrealistic results, some gym users are also attracted to other, more active compounds than dietary supplements, such as anabolic androgenic steroids (AAS) [ 6 , 9 , 10 ], that result in fast and significant increases in muscle mass [ 11 ]. Although highly effective, using AAS can have severe negative health consequences, including an increased risk of cardiovascular incidents [ 12 – 15 ]. In addition to AAS, there are some indications, mainly based on analysis of online sales of doping substances [ 16 ], that gym users also started using more experimental drugs, such as selective androgen receptor modulators (SARM) [ 17 , 18 ].…”

Manipulation of Dietary Intake on Changes in Circulating Testosterone Concentrations

“…They are important hormones for various biological processes and are vital for the development and maintenance of secondary male characteristics. They are also crucial for reproductive functions, body composition, and muscle and bone health [1,2].…”

“…The adrenal glands also produce small amounts (~5%) of androgens [5]. In women, testosterone is produced in much smaller amounts, primarily from the adrenal glands and the ovaries [2,6]. There are two metabolic pathways, the progesterone (delta-4) and dehydroepiandrosterone (DHEA) (delta-5) pathways [6].…”

“…These are the last key steps in the catalyzation of androgens into estrogens, hence inhibition of aromatase activity can elevate androgen concentrations. There are numerous natural substances that have been scientifically tested or suggested to inhibit aromatase activity, alongside pharmaceutical compounds whose non-medical use is considered illegal [2,6].…”

“…Manipulation of testosterone concentrations without the use of anabolic steroids has been a highly investigated topic because of the known effect testosterone has on enhancing athletic performance [2,6]. While the use of androgens in competitive athletics is illegal, it has not stopped the search for "natural" ways to increase testosterone concentrations.…”