Public health impact of androgens

Kanayama, Gen; Kaufman, Marc J.; Pope, Harrison G.

doi:10.1097/med.0000000000000404

Cited by 47 publications

(35 citation statements)

References 48 publications

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“…The most reported long-term side effects affect the cardiovascular system, such as cardiomyopathy and atherosclerotic disease. Hypogonadism is a frequent finding in AAS abusers and need to be taken into consideration when AAS use is suspected in order to undertake aggressive treatment [ 8 , 120 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, AAS use is still very popular and 1–3% of US inhabitants have been estimated to be AAS users [ 6 ]. Moreover, in younger subjects’ higher estimates have been reported [ 7 , 8 ]. However, AASs have side effects involving all organs, tissues and body functions, especially long-term toxicity involving the cardiovascular system and the reproductive system, therefore, their abuse is considered a public health issue [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Adverse Effects of Anabolic-Androgenic Steroids: A Literature Review

et al. 2021

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adverse Effects of Anabolic-Androgenic Steroids: A Literature Review

et al. 2021

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“…While AAS doping remains a concern for sport, both at elite and recreational levels [15–17], the wider societal impact is now apparent [4, 18, 19]. Although prevalence estimates of clandestine behaviours such as AAS are notoriously difficult, a growing body of evidence has indicated that while well established in North America, northern Europe and Australia, there are concerns across the globe [6, 19].…”

Section: Introductionmentioning

confidence: 99%

Treatments for people who use anabolic androgenic steroids: a scoping review

et al. 2019

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Background: A growing body of evidence suggests that anabolic androgenic steroids (AAS) are used globally by a diverse population with varying motivations. Evidence has increased greatly in recent years to support understanding of this form of substance use and the associated health harms, but there remains little evidence regarding interventions to support cessation and treat the consequences of use. In this scoping review, we identify and describe what is known about interventions that aim to support and achieve cessation of AAS, and treat and prevent associated health problems.Methods: A comprehensive search strategy was developed in four bibliographic databases, supported by an iterative citation searching process to identify eligible studies. Studies of any psychological or medical treatment interventions delivered in response to non-prescribed use of AAS or an associated harm in any setting were eligible. Results: In total, 109 eligible studies were identified, which included case reports representing a diverse range of disciplines and sources. Studies predominantly focussed on treatments for harms associated with AAS use, with scant evidence on interventions to support cessation of AAS use or responding to dependence. The types of conditions requiring treatment included psychiatric, neuroendocrine, hepatic, kidney, cardiovascular, musculoskeletal and infectious. There was limited evidence of engagement with users or delivery of psychosocial interventions as part of treatment for any condition, and of harm reduction interventions initiated alongside, or following, treatment. Findings were limited throughout by the case report study designs and limited information was provided.Conclusion: This scoping review indicates that while a range of case reports describe treatments provided to AAS users, there is scarce evidence on treating dependence, managing withdrawal, or initiating behaviour change in users in any settings. Evidence is urgently required to support the development of effective services for users and of evidence-based guidance and interventions to respond to users in a range of healthcare settings. More consistent reporting in articles of whether engagement or assessment relating to AAS was initiated, and publication within broader health-or drug-related journals, will support development of the evidence base.

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“…For instance, considering a parenteral dose of testosterone enanthate or cypionate of 150–200 mg every two week in men with hypogonadism [ 13 ], the aforementioned abus dose is 6 to 500 times higher than that recommended in testosterone replacement therapy. AAS abuse is widespread and extending, becoming an alarming public health issue [ 10 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…The negative impact of AAS excess is a consequence of their numerous side effects, including endocrine dysfunctions, alterations of the cardiovascular system, liver toxicity, behavioral changes and even psychiatric disorders, some of them with severe endpoints [ 10 , 12 , 14 , 15 , 16 , 17 ]. The negative effects on the cardiovascular function have classically been divided into four categories: thrombotic, atherogenic, vasospastic, and cardiomyocyte direct toxicity [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Exogenous Androgens on Platelet Activity and Their Thrombogenic Potential in Supraphysiological Administration: A Literature Review

Roşca

Vlădăreanu

Mititelu

et al. 2021

JCM

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Anabolic androgenic steroids (AAS), simply called “androgens”, represent the most widespread drugs used to enhance performance and appearance in a sporting environment. High-dosage and/or long-term AAS administration has been associated frequently with significant alterations in the cardiovascular system, some of these with severe endpoints. The induction of a prothrombotic state is probably the most life-threatening consequence, suggested by numerous case reports in AAS-abusing athletes, and by a considerable number of human and animal studies assessing the influence of exogenous androgens on hemostasis. Despite over fifty years of research, data regarding the thrombogenic potential of exogenous androgens are still scarce. The main reason is the limited possibility of conducting human prospective studies. However, human observational studies conducted in athletes or patients, in vitro human studies, and animal experiments have pointed out that androgens in supraphysiological doses induce enhanced platelet activity and thrombopoiesis, leading to increased platelet aggregation. If this tendency overlaps previously existing coagulation and/or fibrinolysis dysfunctions, it may lead to a thrombotic diathesis, which could explain the multitude of thromboembolic events reported in the AAS-abusing population. The influence of androgen excess on the platelet activity and fluid–coagulant balance remains a subject of debate, urging for supplementary studies in order to clarify the effects on hemostasis, and to provide new compelling evidence for their claimed thrombogenic potential.

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Public health impact of androgens

Abstract: Recent studies have demonstrated marked adverse effects of long-term androgen abuse. As increasing numbers of androgen abusers reach middle age, these effects will likely represent an emerging public health problem.

Cited by 47 publications

References 48 publications

Adverse Effects of Anabolic-Androgenic Steroids: A Literature Review

Adverse Effects of Anabolic-Androgenic Steroids: A Literature Review

Treatments for people who use anabolic androgenic steroids: a scoping review

Effects of Exogenous Androgens on Platelet Activity and Their Thrombogenic Potential in Supraphysiological Administration: A Literature Review

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