Anabolic Androgenic Steroids Usage Research Articles

Assessment of Anabolic Androgenic Steroids Use Among Professional CrossFit® Athletes: Motives, Perception, and Safety

Background Anabolic androgenic steroids (AAS) are traditionally used for the treatment/control of various diseases; however, they are being used for non-therapeutic and indiscriminate purposes to enhance sports performance and physical appearance. This study aimed to assess the prevalence and associated factors of AAS use among professional CrossFit® competitors. Methods We conducted an observational cross-sectional survey in which an anonymous questionnaire was applied to professional CrossFit® athletes. Results The prevalence of AAS usage was 33.3%. Most users were male (74.2%), aged between 30 and 39 years (51.6%), with completed higher education (83.9%), and had been training for more than 5 years (77.4%); the primary motivation for AAS use was performance enhancement (77.4%). Individuals who were older (p < 0.05) and more experienced in competitions (p < 0.01) are more likely to use AAS. Testosterone was the most employed AAS (71.0%); CrossFit® athletes typically used an average of 2 different AAS. The majority of users had notably sought advice from a physician (74.2%), and AAS were acquired from either drugstores (80.6%) or through illicit channels (29.0%). Moreover, 61.3% of AAS users reported experiencing adverse effects. Conclusions Our results demonstrated a higher prevalence of AAS users among professional competitors in CrossFit ® compared to the general population; older age and greater experience in official competitions were decisive factors for a greater inclination toward AAS use. A significant percentage of athletes seek drugs through illegal channels. Despite the majority of users experiencing adverse effects, athletes report satisfaction with use, believing that the benefits still outweigh the drawbacks.

Abusive use of anabolic androgenic steroids, male sexual dysfunction and infertility: an updated review.

The evolving prevalence of anabolic androgenic steroids (AAS) abuse among nonathletes is alarming because of the known harm to an individual's health. Among the adverse effects of AAS abuse, male infertility and sexual dysfunction have been often reported in the literature, but little is known regarding its actual prevalence, possible underpinning mechanisms, and potential treatments either during or post-AAS usage. Thus, the current narrative review summarizes the state-of-art regarding the effects of AAS on male fertility and sexual function. Evidence was gathered from the latest reviews and recent original studies, specifically from prospective cohorts and clinical trials, ultimately resulting in five main topics of discussion. First, AAS usage is briefly characterized by its historical background, main physiological mechanisms, and the most frequently used AAS substances. Second, data on the prevalence of AAS-induced male infertility and sexual dysfunction are described. Third, some new insights on possible underpinning mechanisms of AAS-induced male infertility and sexual dysfunction are thoroughly discussed, with particular attention to histological data derived from animal models and the latest insights from prospective cohorts in humans. Fourth, the potential treatments during and after the AAS usage are presented, highlighting the odds of resolving male infertility and sexual dysfunction. Fifth, future directions on this topic are discussed, focusing on the methodological robustness of scientific studies.

The assessment of liver function test and fertility hormones in Saudi athletes using anabolic androgenic steroids

BackgroundA growing number of athletes are using synthetic anabolic–androgenic steroids (AAS), comprised of testosterone and other derivatives, to enhance athletic performance and muscle mass. Over the years, numerous reports elucidated the side effects of the illegal use of AAS, such as infertility, and liver disorders. The effect of AAS on the hepatic and reproductive systems in Saudi athletes has not yet been studied. Therefore, this study examined the liver function and sex hormone parameters of AAS users as compared to non-users. MethodsFasting blood samples were collected from 16 male Saudi athletes, 10 AAS-users (cases) and 6 non-users (controls) to measure liver function tests (ALT, AST, GGT, ALP, total protein, albumin, direct and total bilirubin) and muscle enzymes (CK, LDH), Fertility hormones (LH, FSH, total testosterone, estradiol, and prolactin) were included also. Furthermore, a self-reported questionnaire was obtained to identify the type of AAS used, the dosage, and the length of the course before sample collection. ResultsThe results show a statistically significant increase in ALT (P < 0.001), AST (P < 0.001), CK (P < 0.05), and a significant decrease (P < 0.05) in albumin (P < 0.001) and total bilirubin levels (P < 0.01) in AAS-users. Total testosterone increased significantly among AAS (P < 0.05), along with a significant decrease in LH (P < 0.01), and FSH (P < 0.001) levels, while serum prolactin and estradiol levels were significantly increased (P < 0.05). ConclusionAAS can enhance physical performance and appearance, its potential adverse effects on the hepatic and reproductive systems necessitate careful consideration. Our research demonstrates an increase in the liver-specific enzyme ALT in AAS users relative to non-users and the possibility that short-term AAS usage increases the risk of liver injury.

"They sent it away for testing and it was all bunk": Exploring perspectives on drug checking among steroid consumers in Queensland, Australia.

Research supports the feasibility and acceptance of drug checking among nightlife and festival attendees. Interest in expanding drug checking to other groups of people who use drugs, including those who inject drugs, has grown. However, understanding the acceptability and feasibility of drug checking among specific cohorts, like anabolic-androgenic steroids (AAS) consumers, remains a research gap. This study explores AAS consumers' perspectives on drug checking and service preferences, aiding the preparation for drug checking delivery in Queensland, Australia. A purposive sampling technique was used to recruit 15 AAS consumers (9 males, 6 females; Mage=36.80 years, SD=6.12) from Australia. One-on-one semi-structured qualitative interviews were conducted with questions exploring participants' views on drug checking/testing and their preferences for AAS analysis. Thematic analysis was conducted with final themes established through iterative consensus. Consumers expressed frustration with the prevailing stereotypes, social stigma, and the perception of criminality associated with the use of AAS. There was a strong dependence on personal connections and trusted suppliers, with coaches exerting significant influence. Participants expressed concerns about the widespread availability of counterfeit products and underground operations. The act of using unknown AAS was likened to a game of Russian roulette, underscoring the importance of obtaining accurate information and access to reliable drug checking services. Consumers expressed a preference for a web-based platform that enables individuals to access their own test results while contributing to a comprehensive database of brand-specific testing outcomes. AAS consumers recognise the significance of monitoring their AAS use and seek a service that can not only assist them in making informed decisions regarding AAS usage but also potentially contribute to the knowledge of the wider AAS-consuming community. These findings underscore the importance of tailored education, drug checking services, and harm reduction measures to address the diverse needs of AAS consumers.

An observational human study investigating the effect of anabolic androgenic steroid use on the transcriptome of skeletal muscle and whole blood using RNA-Seq

BackgroundThe effects of Anabolic Androgenic Steroids (AAS) are largely illustrated through Androgen Receptor induced gene transcription, yet RNA-Seq has yet to be conducted on human whole blood and skeletal muscle. Investigating the transcriptional signature of AAS in blood may aid AAS detection and in muscle further understanding of AAS induced hypertrophy.MethodsMales aged 20–42 were recruited and sampled once: sedentary controls (C), resistance trained lifters (RT) and resistance trained current AAS users (RT-AS) who ceased exposure ≤ 2 or ≥ 10 weeks prior to sampling. RT-AS were sampled twice as Returning Participants (RP) if AAS usage ceased for ≥ 18 weeks. RNA was extracted from whole blood and trapezius muscle samples. RNA libraries were sequenced twice, for validation purposes, on the DNBSEQ-G400RS with either standard or CoolMPS PE100 reagents following MGI protocols. Genes were considered differentially expressed with FDR < 0.05 and a 1.2- fold change.ResultsCross-comparison of both standard reagent whole blood (N = 55: C = 7, RT = 20, RT-AS ≤ 2 = 14, RT-AS ≥ 10 = 10, RP = 4; N = 46: C = 6, RT = 17, RT-AS ≤ 2 = 12, RT-AS ≥ 10 = 8, RP = 3) sequencing datasets, showed that no genes or gene sets/pathways were differentially expressed between time points for RP or between group comparisons of RT-AS ≤ 2 vs. C, RT, or RT-AS ≥ 10. Cross-comparison of both muscle (N = 51, C = 5, RT = 17, RT-AS ≤ 2 = 15, RT-AS ≥ 10 = 11, RP = 3) sequencing (one standard & one CoolMPS reagent) datasets, showed one gene, CHRDL1, which has atrophying potential, was upregulated in RP visit two. In both muscle sequencing datasets, nine differentially expressed genes, overlapped with RT-AS ≤ 2 vs. RT and RT-AS ≤ 2 vs. C, but were not differentially expressed with RT vs. C, possibly suggesting they are from acute doping alone. No genes seemed to be differentially expressed in muscle after the long-term cessation of AAS, whereas a previous study found long term proteomic changes.ConclusionA whole blood transcriptional signature of AAS doping was not identified. However, RNA-Seq of muscle has identified numerous differentially expressed genes with known impacts on hypertrophic processes that may further our understanding on AAS induced hypertrophy. Differences in training regimens in participant groupings may have influenced results. Future studies should focus on longitudinal sampling pre, during and post-AAS exposure to better control for confounding variables.

Anabolic-androgenic steroids: Considerations for forensic psychiatry, sports psychiatry, and the law

Anabolic-androgenic steroids: Considerations for forensic psychiatry, sports psychiatry, and the law

Anabolic-androgenic steroid use among Iranian male gym-goers

ABSTRACT Background Anabolic-androgenic steroids (AAS) have positive anabolic effects on muscle mass. Some bodybuilders use high doses of AAS to build more muscle mass and strength. This study was conducted to measure the extent of AAS use among Iranian male bodybuilders and associated risk factors. Methods A cross-sectional study was carried out among 588 male bodybuilders from July to August 2020 in Isfahan. Isfahan city was divided into 15 clusters according to Isfahan municipal districts. In each cluster, three clubs were randomly selected. A self-administered questionnaire including demographic information and AAS usage data was completed by a consecutive sample of bodybuilders. Results One hundred and seventy-one (29.1%) participants were current users and 32 (7.7%) planned to use AAS in the future. AAS users had higher incomes, longer gym memberships, and more weekly sessions. They significantly used more supplements and other substances including growth hormone, caffeine, insulin, and glucocorticoid. The most prevalent AAS was testosterone enanthate. Income, length, and frequency of workouts could predict AAS use. Conclusion Increasing AAS consumption seems to become a public health concern that suggests the need to develop some new policies and programs which would educate and inform bodybuilders and coaches about the adverse effects of AAS use.

EVALUATION OF PTEN AND PI3K/AKT EXPRESSIONS IN STANOZOLOL-TREATED RAT KIDNEYS

Objective: Stanozolol is an anabolic androgenic steroid (AAS) that is widely used by teenagers and athletes in bodybuilding, sports, and athletics. The potential effects of stanozolol in kidney functions have not been defined. In this study we investigated the expression of tumor suppressor protein phosphatase and tensin homolog (Pten) and mRNA levels of phosphatidylinositol 4,5-bisphosphate 3 kinase (Pi3k) and the protein kinase B (Akt1) signaling pathway in rat kidneys treated by stanozolol. Material and Method: Rats were randomized to 5 groups as control, solvent control, steroid (stanozolol), solvent-exercise, and steroid-exercise. Subcutaneous injection of stanozolol (5 mg/kg) was applied for 28 days and swimming exercise was performed 20 min/day, 5 days/week in exercise groups. Expression of PTEN was evaluated by immunohistochemistry. Also, Pten, Pi3k, and Akt1 mRNA expressions were analyzed via RT-PCR. Results: Mesangial cells and renal tubules in the control, solvent control, and solvent exercise groups showed strong (+++) PTEN reactivity against weak PTEN reactivity in the steroid group. Moderate PTEN reactivity was detected in cells of the steroid exercise group. Pten mRNA expression was significantly decreased, and Pi3k and Akt1 mRNA expression were significantly increased in the steroid group versus other groups (p&lt;0.001). Pten expression showed increase while Pi3k and Akt1 expression showed decrease with exercise treatment (p&lt;0.05). Conclusion: Our findings suggest that AAS usage may inhibit PTEN expression in kidneys, which can be associated with increased Pi3k and Akt1 mRNA levels. Exercise performed with AAS usage can be protective on stanozolol-exposed kidneys due to increased levels of PTEN expression and decreased levels of Pi3k and Akt1.

EVALUATION OF PTEN AND PI3K/AKT EXPRESSIONS IN STANOZOLOL-TREATED RAT KIDNEYS

Objective: Stanozolol is an anabolic androgenic steroid (AAS) that is widely used by teenagers and athletes in bodybuilding, sports, and athletics. The potential effects of stanozolol in kidney functions have not been defined. In this study we investigated the expression of tumor suppressor protein phosphatase and tensin homolog (Pten) and mRNA levels of phosphatidylinositol 4,5-bisphosphate 3 kinase (Pi3k) and the protein kinase B (Akt1) signaling pathway in rat kidneys treated by stanozolol. Material and Method: Rats were randomized to 5 groups as control, solvent control, steroid (stanozolol), solvent-exercise, and steroid-exercise. Subcutaneous injection of stanozolol (5 mg/kg) was applied for 28 days and swimming exercise was performed 20 min/day, 5 days/week in exercise groups. Expression of PTEN was evaluated by immunohistochemistry. Also, Pten, Pi3k, and Akt1 mRNA expressions were analyzed via RT-PCR. Results: Mesangial cells and renal tubules in the control, solvent control, and solvent exercise groups showed strong (+++) PTEN reactivity against weak PTEN reactivity in the steroid group. Moderate PTEN reactivity was detected in cells of the steroid exercise group. Pten mRNA expression was significantly decreased, and Pi3k and Akt1 mRNA expression were significantly increased in the steroid group versus other groups (p&lt;0.001). Pten expression showed increase while Pi3k and Akt1 expression showed decrease with exercise treatment (p&lt;0.05). Conclusion: Our findings suggest that AAS usage may inhibit PTEN expression in kidneys, which can be associated with increased Pi3k and Akt1 mRNA levels. Exercise performed with AAS usage can be protective on stanozolol-exposed kidneys due to increased levels of PTEN expression and decreased levels of Pi3k and Akt1.

Differences in Nervous Autonomic Control in Response to a Single Session of Exercise in Bodybuilders Using Anabolic Androgenic Steroids.

Considering the role of autonomic nerve activity in blood pressure control, this study aimed to investigate the cardiac autonomic nerve responses after an aerobic exercise session in Anabolic Androgenic Steroids (AAS) users. Twenty men (AAS, n = 9; control group, n = 11) performed an aerobic exercise session (60 min, 70 to 80% of HRmax). Heart rate variability (HRV) was assessed before and during a 60-min post-exercise recovery period. RMSSD (root mean square successive difference of the RR intervals) and the LF/HF ratio (low frequency/high frequency spectra) were also evaluated. The Student's t-test for independent samples was used to compare differences between initial group characteristics. Repeated measures ANOVA was used to compare pre- and post-exercise HRV recovery (p < 0.05). AAS had a lower SDNN (standard deviation of the intervals) (40.8 ± 16.8 vs. 71.6 ± 24.7 ms; p = 0.04, d = 1.4) and a higher LF/HF (3.4 ± 2.1 vs. 1.8 ± 0.9%; p = 0.03, d = 0.9) before exercise. AAS and controls had similar RMSSD (14.0 ± 15.8 vs. 18.9 ± 12.1 ms; p = 0.20) and a LF/HF (2.8 ± 1.6 vs. 2.4 ± 1.2 ms; p = 0.41) immediately post-exercise. The between-groups comparison revealed a higher HF/LF at 30 min (4.3 ± 1.4 vs. 2.5 ± 1.3%; p = 0.008, d = 1.3) and 60 min (5.0 ± 2.2 vs. 2.3 ± 0.8%; p = 0.001, d = 1.6) for the AAS group in the recovery time. This study demonstrated impaired parasympathetic activity at rest and immediately after the exercise session as an adverse effect of AAS usage, but similar behavior regarding the restoration of sympathetic activity.

Anabolic Androgenic Steroid Use Prevalence, Knowledge, and Practice&amp;nbsp;Among Male Athletes in Eastern Province of Saudi Arabia

Background: Anabolic androgenic steroids (AAS) are synthetic testosterone like hormones. AAS usage by athletes has increased dramatically over the past decade. Material and Methods: This study was designed to examine the prevalence, attitude and awareness of AAS abuse among athletes n the Eastern province of Saud Arabia. This was a cross-sectional survey that was conducted among male athletes attending twenty fitness centres in the Eastern Province. It was done during the period from April to August, 2018. Results: A total of 573 questionnaires were distributed but only 503 participants were included n the final analysis. The frequency of AAS use was 17.69%. The man reason for AAS use was muscle building (68.54%). The man source of AAS was the coaches. 56.18% of the users recognize the harmful effects of AAS. The most commonly used oral AAS form was oxandrolone (61.80%). The most commonly used substance for post cycle therapy was Tamoxifen citrate n 67.42% of the users. Conclusions: 17.69% of the participants use AAS. Coaches were the man source for AAS. In our study, around half of the gym users have inadequate knowledge about AAS and ts harmful effects. More regulation laws and educational programs are needed.

Social Work Implications of Anabolic–Androgenic Steroid Use, Particularly Among Young People: A Literature Review

Non-prescribed anabolic–androgenic steroid (AAS) use has increased during recent years. Often used ‘recreationally’ and for aesthetic purposes, AAS are easily purchased over the internet and informally from gym-using peers. Social workers have a responsibility to support service users, to identify and manage risks and AAS use raises some noteworthy challenges to social work practice. This literature review aims to identify AAS-related knowledge social workers might require and consider its implications for social work practice. Although some of the evidence is inconclusive, particularly in relation to causal relationships between AAS use and behavioural change or polysubstance use implications, there are consequences that could cause significant short- and long-term harm to physical and/or psychological health to young people. Social workers should consider the possibility that a young person may be vulnerable to using AAS without being fully aware of the risks, as this could result in harm reduction and enhanced outcomes among this easily overlooked population. While rarely addressed in the existing social work literature, the risks associated with AAS usage, particularly in young people, necessitate more awareness and attention from social work practitioners particularly in today’s image conscious society.

Symptoms of Muscle Dysmorphia Between Users of Anabolic Androgenic Steroids With Varying Usage and Bodybuilding Experience

Abstract. Anabolic Androgenic Steroids (AAS) usage has been repeatedly linked with a body image disorder called Muscle Dysmorphia (MD). However, evidence for how this relationship manifests is currently inconclusive. This study focused on the extent to which MD may precipitate or perpetuate the use of AAS. Utilizing a cross-sectional design, the sample consisted of 57 users (current and lifetime) and 51 non-using (never used AAS) bodybuilders recruited from two bodybuilding dedicated gymnasiums located in Wales, UK. Significantly higher levels of MD were found in users compared to non-users across training experience duration (0–2, 3–5, and 6+ years). MD levels irrespective of AAS usage (users vs. non-users) were consistent between 0–2 and 3–5 years of training declining however between those of 6+ years training experience. No differences were reported in symptoms of MD between users of AAS with varying lengths of AAS use exposure. This provides preliminary evidence suggesting MD may influence both initiation and maintenance of AAS use; however, neither regular gym attendance nor prolonged AAS usage may exacerbate MD symptoms.

Anabolic-androgenic Steroid Use Among Gynecomastia Patients: Prevalence and Relevance to Surgical Management.

Anabolic-androgenic steroids (AAS) are widely implicated in gynecomastia development. Surgery is the definitive treatment for cases persisting after cessation of AAS use. Currently, the relevance of AAS use to the surgical approach of gynecomastia has not been well explored. This study aims to compare patient characteristics, surgical outcomes, and surgical management of gynecomastia correction in AAS users versus nonusers. A retrospective cohort study was performed with patients who underwent bilateral gynecomastia reduction surgery between January 2005 and August 2015 by a single surgeon at an academic hospital. Demographic data, AAS usage details, operative documentation, and follow-up outcomes were reviewed. A total of 964 cases were reviewed. Eleven percent (n = 105) of the patients had a history of AAS use. Compared with non-AAS users, AAS users were older at time of gynecomastia onset (15 years vs 13 years, P < 0.001) and surgery (28 years vs 25 years, P < 0.001). The AAS users had higher body mass index (27.3 kg/m vs 25.7 kg/m, P < 0.001) and a greater proportion of patients self-identified as bodybuilders (40.0% vs 22.4%, P = 0.002). Although no difference was found in the excised bilateral mastectomy volume (92.1 cm vs 76.4 cm, P = 0.20), The AAS users had significantly less lipoaspirate fat volume (250 mL vs 300 mL, P = 0.005). No difference was found in total complication rates. However, AAS users had significantly more revision mastectomy surgeries (3.8% vs 1.1%; P = 0.02). The unique breast composition of AAS users necessitates a surgical approach with meticulous intraoperative hemostasis and careful glandular excision to minimize recurrence and achieve comparable low complication rates.

The Relationship Between the Big Five Personality Traits, Impulsivity, and Anabolic Steroid Use

Background: The increase in the prevalence of anabolic-androgenic steroids (AAS) use has been the subject of study in the last decades. Several studies indicated a strong association between the use of AAS and the performance of risky behaviors mediated by factors such as aggression, impulsivity, depression, and anxiety. Objective: This study aimed to identify differences in personality trait, impulsivity, and the ability to delay gratification between AAS users and non-users that predispose or serve as a buffering mechanism against its usage and whether it is related to an increased likelihood of engaging in infidelity. Methods: Two hundred and twelve male volunteers (88 AAS users), aged between 21 and 36 years (M = 28.22), completed self-report measures of personality, impulsivity, delayed gratification, and attitudes toward infidelity. Multivariate analysis of variance and logistic regression were conducted to establish differences between AAS users and non-users. Results: The results showed that AAS users displayed an inability to delay gratification, a greater impulsivity, and a more benevolent attitude toward infidelity. AAS users obtained higher scores on openness and neuroticism, which was larger “off-cycle,” although they presented lower scores on extraversion compared to the non-users group. Regression analysis revealed that neuroticism, impulsivity, and delaying gratification scores were significant predictors of AAS usage. In addition, impulsivity functioned as a partial mediator in the relationship between neuroticism and AAS use. Conclusion: The results of this research highlight a pivotal implication of impulsivity in AAS use in conjunction with neuroticism, openness, and extraversion traits.

Prevalence and awareness of Anabolic Androgenic Steroids (AAS) among gymnasts in the western province of Riyadh, Saudi Arabia.

BackgroundAnabolic Androgenic Steroids (AAS) are synthetic derivatives of the male sex hormone (testosterone) that are increasingly used by athletes as performance enhancing drugs to increase muscle mass and strength. Multiple health adverse effects may be caused by its non-medical use. Several international and regional studies showed the high prevalence of AAS usage and low level of awareness of it among different populations.ObjectiveTo estimate the prevalence of AAS and to determine the level of awareness toward it among gymnasts in the western province of Riyadh.MethodsThis cross-sectional survey was conducted using a self-administered questionnaire distributed on 400 male gymnasts from 10 different fitness centers which have been chosen randomly from 23 centers in the western province of Riyadh city (Kingdom of Saudi Arabia) during 2016. Data analysis was performed by SPSS version 21, using descriptive statistics and Chi-square test.ResultsAmong the 400 gymnasts who participated in the survey, a total of n=363 questionnaires were received completed. Of the responders, (n=89) were AAS users with a percentage 24.50%. The testosterone was the most commonly used type followed by Methandrostenolone then Stanozolol. The major sources for obtaining AAS were online shopping (45%) and gym-coach (22.5%). Regarding awareness, 74% of AAS users had an inadequate perception about AAS concept versus 55% of non-users with no significant difference (p=0.076). In addition, 82% of AAS users and 83% of non-users had inadequate knowledge of AAS adverse effects with no significant difference between the two categories (p=0.087).ConclusionThe usage of AAS is high amongst gymnasts in the western province of Riyadh city considering they are prohibited. The level of awareness toward AAS is low among most gymnasts. We recommend for educational programs to be established in order to increase public awareness, in addition to a tightening of control by the responsible authorities over the sources of AAS procurement.

Androgenic-anabolic steroids inhibited post-exercise hypotension: a case control study

BackgroundThere is evidence of hypertensive effects caused by anabolic androgenic steroids (AAS). A single exercise session promotes the acute reduction of blood pressure, but the effects of AAS on this phenomenon are unknown. ObjectivesTo investigate the post-exercise blood pressure response in androgenic-anabolic steroid users. MethodsThirteen AAS users (23.9±4.3 years old) and sixteen controls (22.1±4.5 years old) performed a session of aerobic exercise. Heart rate and blood pressure were assessed before exercise and during a 60min post-exercise resting period. Repeated ANOVA measures were used to determine differences between the groups. ResultsWhile the control group had a significant reduction in post-exercise systolic blood pressure of up to 13.9±11.6mmHg at 40min, this phenomenon was limited among AAS users who reached a maximum of 6.2±11.5mmHg at 60min. The between groups comparison revealed significant higher post-exercise hypotension (PEH) for the control group at 30min (−12.9±14.1mmHg versus −2.9±7.6mmHg), 40min (−13.9±11.6mmHg versus −2.5±8.3mmHg), 50min (−13.9±13.9mmHg versus −5.0±7.9mmHg) and 60min (−12.5±12.8mmHg versus −6.2±11.5mmHg). There was no significant diastolic PEH in any of the groups. ConclusionsThis study demonstrated impaired systolic post-exercise hypotension as a new adverse effect of AAS usage.

Usage and perceptions of anabolic-androgenic steroids among male fitness centre attendees in Kuwait--a cross-sectional study.

BackgroundConsidering the recent popularity of bodybuilding and the apparent spread of anabolic androgenic steroid (AAS) use amongst bodybuilding enthusiasts in Kuwait, there is a relative lack of scientific investigation into the use, knowledge and attitudes towards AAS amongst the population at risk of abusing it. Therefore, this study aims to investigate the frequency, knowledge, attitudes and practice of AAS use amongst male fitness centre attendees in Kuwait.MethodsA cross sectional survey utilizing a self-administered questionnaire was used. Information on demographics as well as knowledge and attitude about and towards the use of AAS was included in the questionnaire. Ten fitness centres in Kuwait were randomly selected and questionnaires were distributed to all individuals leaving each centre on randomly selected days and periods of time for each centre. Overall n = 400 questionnaires were distributed.ResultsA total of n = 194 questionnaires were returned completed (~49 %). Of the responders, 22.7 % used AAS. The 19–25 age group had the highest occurrence (46.8 %) of first-time AAS use. In contrast with non-users, most (70.5 %) of AAS users believed that having an optimally muscular body can only be achieved by using AAS, and a small minority (6.8 %) believed that AAS usage would have significant harms to health. Only 18.2 % of AAS users had appropriate knowledge regarding the side effects of AAS. Non-users were as much uninformed as AAS users regarding the side effects of AAS.ConclusionThe usage of AAS is high amongst male gym users in Kuwait and is likely to present an additional burden to the health service. An effective initiative to minimize the burden of AAS abuse should focus on changing the attitudes towards AAS rather than spreading awareness of their side effects.

Chronic Anabolic Androgenic Steroid Usage Associated with Acute Coronary Syndrome in Bodybuilder

Chronic Anabolic Androgenic Steroid Usage Associated with Acute Coronary Syndrome in Bodybuilder

Liver Toxicity of Anabolic Androgenic Steroid Use in an Adolescent With Nonalcoholic Fatty Liver Disease

The prevalence of obesity and related morbidities such as nonalcoholic fatty liver disease (NAFLD) is high among adolescents. Current treatment recommendations for NAFLD focus on lifestyle optimization via nutrition and exercise. After encouraging exercise, many adolescents choose to participate in organized sports, which may lead to use of illicit substances such as anabolic androgenic steroids (AAS) to boost athletic performance. Approximately 3,000,000 individuals use non-therapeutic AAS at supra-physiologic doses in the United States.1 In 2012, 5.9% of adolescent boys reported steroid use in the previous year.2 We anticipate adolescents with pre-existing liver disease are at increased risk for AAS induced hepatotoxicity. We present such a case with IRB approval and written individual patient consent.