Anabolic-androgenic Steroids Consumption Research Articles

Anabolic-androgenic steroids. Mechanism of action and clinical effects

Introduction and aim. Anabolic-androgenic steroids (AAS) are used for the rapid enhancement of muscular mass and optimization of athletic performance. Their administration is frequently linked with a plethora of adverse health implications. The primary objective of this study is to provide a comprehensive analysis of multifaceted impacts of anabolic-androgenic steroids on the human body. Material and methods. A review of literature was performed by searching PubMed and GoogleScholar databases using the following key words: anabolic-androgenic steroids, muscular hypertrophy, female masculinization. Analysis of the literature. Anabolic-androgenic steroids are synthetically manufactured derivatives of testosterone. Given the widespread distribution of the androgen receptor, the effects of these steroids are broad, influencing almost all bodily functions. Their impacts include, promoting muscular hypertrophy including that of the cardiac muscle, premature epiphyseal closure, liver diseases, masculinization in females, feminization in males, and degradation in sperm quality. Conclusion. AAS consumption is a significant public health problem. While they may appeal to users by enhancing their physical attractiveness they carry multiple health consequences. Patients should be educated about the adverse effects of taking AAS so they can make informed decision about starting or stopping their use.

Impaired cardiac structure and systolic function in athletes using supra-physiological doses of anabolic androgenic steroids

ObjectivesAthletes are increasingly using supra-physiological doses of anabolic androgenic steroids without weighing health side effects. This study aims to conjointly evaluate the effect of supraphysiological doses of anabolic androgenic steroids on global cardiovascular structure and functional capacity. DesignCross-sectional study. Methods92 males enrolled in the study, including 18 sedentary subjects, 26 anabolic androgenic steroid non-user athletes, and 48 anabolic androgenic steroid-user athletes. Two-dimensional echocardiography was done to evaluate the cardiovascular structure and function. ResultsAnabolic androgenic steroid-users presented increased cardiac remodeling of the left ventricle and left atrium compared to control groups (p < 0.001). Anabolic androgenic steroid-users showed increased left ventricular mass/body surface area versus control groups (p < 0.001), with 28 steroid-users (58.3 %) having cardiac remodeling, which is more than control groups (p < 0.001). Anabolic androgenic steroid-users presented lower diastolic function (E and E/A) compared to non-users (p = 0.003 and <0.001, respectively). Ejection fraction was decreased among anabolic androgenic steroid-users versus the sedentary group only (p = 0.020), while anabolic androgenic steroid-users presented reduced global longitudinal strain of 15.43 % compared to both control groups (p < 0.001). Moreover, anabolic androgenic steroid-users experienced more tricuspid valve regurgitation (p = 0.001). ConclusionsAnabolic androgenic steroid consumption is associated with global cardiac remodeling with increased dimensions of the left ventricle, and atrium. Anabolic androgenic steroid-users present left ventricular hypertrophy with reduced subclinical systolic function. Moreover, anabolic androgenic steroid consumption is correlated with valve regurgitation and dilation of the sino-tubular junction.

Chronic anabolic androgenic steroid administration reduces global longitudinal strain among off-cycle bodybuilders

BackgroundSupra-physiologic doses of anabolic androgenic steroids (AAS) lead to multiple cardiovascular complications. The long-term clinical effect of AAS overuse on cardiac structure and function, which persists during off-cycle periods, remains unclear. MethodsA total of 15 sedentary subjects and 79 bodybuilders (26 AAS non-users and 53 AAS-users), matched for age and male gender, were assessed in a cross-sectional design for echocardiography measures. AAS-users were included during an off-cycle phase, abstained from AAS for at least 1 month. 2D standard M-mode and speckle tracking echocardiography were used to measure cardiac dimensions and functions. ResultsInter-ventricular septum and posterior wall thickness were significantly higher among chronic off-cycle AAS-users compared to AAS non-users and sedentary group. Off-cycle AAS-users showed lower E/A ratio of the diastolic function. Left ventricular systolic function was not affected in terms of ejection fraction, but significant subclinical systolic dysfunction, assessed by GLS, was observed for chronic off-cycle AAS-users compared to AAS non-users (GLS = -16.8% vs. -18.5%, respectively; p = 0.001). Diameter of left atrium and right ventricle were significantly enlarged among off-cycle AAS-user bodybuilders (p = 0.002 and 0.040). TAPSE and RV S′, and cardiac vasculature of aorta were comparable in all groups. ConclusionsThis study demonstrates that during off-cycle phase, AAS-users show long-term impaired GLS, even after considerable AAS abstain, despite normal LVEF. It highlights the importance of following GLS to predict hypertrophy and heart failure events, and not relying on LVEF alone. In addition, the hypertrophic effect of chronic AAS consumption is transitional during AAS washout periods.

Anabolic Androgenic Steroid Use Patterns and Steroid Use Disorders in a Sample of Male Gym Visitors

Introduction: The use of anabolic androgenic steroids (AAS) and other image- and performance-enhancing drugs is a growing public health concern. AAS use is associated with various physical and mental harms, including cardiovascular risks, cognitive deficiencies, and dependence. The aim of this study was to determine whether patterns of AAS use and other variables are associated with the presence of an AAS use disorder (AASUD). Methods: An online survey was completed by 103 male AAS consumers visiting gyms. The association of different patterns of AAS consumption (cycling vs. continuous forms of AAS use), psychoactive substance use, mental health disorders, and sociodemographic variables with moderate-severe AASUD (fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ≥4 criteria) was investigated. The associations between duration of AAS use and the AAS dose with moderate-severe AASUD were investigated using logistic regression analysis with moderate-severe AASUD as the dependent variable. Results: Moderate-severe AASUD was present in 25 (24.3%) of the participants. AAS consumers meeting criteria for moderate-severe AASUD, compared to those that did not, in the last 12 months reported a longer duration of AAS use (in weeks), a higher average AAS dose (mg/week), and a greater number of AAS side effects. Duration of AAS use and the AAS dose were the only independent predictors, with an increase of 3.4% in the probability of moderate-severe AASUD with every week increase of the duration of AAS use in the last year (p < 0.05) and an increase in moderate-severe AASUD of 0.1% with every 10 mg increase in the average AAS dose per week (p < 0.05), respectively. Conclusion: Our findings show that moderate-severe AASUD is relatively frequent among male AAS consumers and is positively associated with the duration and average dose of AAS use in the last 12 months.

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

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

The Frequency &amp; Determinants of the Use of Nutritional Supplements and Hormones among Selected Gym Users in Karachi, Pakistan

Purpose: The use of hormones/ anabolic androgenic steroids (AAS) and nutritional supplements (NS) has gained popularity worldwide for improving physical appearance and sports performance. There have been limited studies that examine the frequency and determinants of their use among gym users in Pakistan. Our objective was to estimate the frequency of NS and AAS consumption among gym users of Karachi and to determine the determinants of NS and AAS consumption. &#x0D; Methodology: An analytical cross-sectional study was conducted on 435 gym users from five districts of Karachi using non-probability quota sampling and gyms were selected on a convenience basis. Data were collected on a pre-tested validated tool and the association of outcome with variables was assessed by applying multivariate logistic regression using Statistical Package for the Social Sciences (SPSS) version 20.0. &#x0D; Findings: The frequencies of AAS and NS were 9.2% (n=40) and 42.5% (n=185) respectively. Reasons for use included increasing muscle size and strength, impressing the opposite gender, getting popularity on TikTok videos, and getting a boyfriend/girlfriend. Male gender (p=0.000) and gym users who were businessmen were more inclined to using hormones (p=0.033). Gym users of district Central were less likely to consume AAS (p =0.004).&#x0D; Contribution to literature and practical implications: The study concludes that male gender and occupation are positively associated with NS consumption and the dwelling of gym attendees is also significantly associated with AAS intake. These findings can help policymakers to make decisions for improvement in addressing public health issues.

Use, Misuse and Abuse of Testosterone and Other Androgens.

For several decades, testosterone and its synthetic derivatives have been used for anabolic and androgenic purposes. Initially restricted to professional bodybuilders, these substances gradually became more popular with recreational weightlifters. Considering its increasing prevalence, the consumption of anabolic androgenic steroids (AAS) has become a matter of great concern. Although most side effects are mild and reversible, some of them can cause permanent damage or can be potentially life threatening. To review and summarize medical literature regarding misuse and abuse of testosterone and other androgens, in order to provide evidence-based information on the main topics related to this subject, such as how to identify and how to deal with these patients, and to elucidate the multiple possible adverse effects secondary to this practice. Key studies were retrieved from PubMed (1989-2021) with reference searches from relevant articles. Search terms included "hypogonadism", "anabolic androgenic steroids", "androgens", "misuse AND testosterone", "abuse AND testosterone", and "side effects AND testosterone". There is a significant lack of information in the peer-reviewed literature describing demographic data, implications for different organ systems and the management of current or former AAS users; however, androgen abuse has been already linked to a wide variety of cardiovascular diseases, metabolic, endocrine, neurological, psychiatric and liver disorders. Despite all this, most physicians still feel uncomfortable and hesitate to discuss the issue with patients. The chronic use of high doses of AAS is associated with adverse effects in several organ systems; however, there are still many gaps in our knowledge about the long-term consequences of this practice and how to deal with these patients. Healthcare professionals have a crucial role in combating this public health problem, recognizing and preventing the spread of androgen abuse.

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.

Anabolic-androgenic steroid use among bodybuilders in Erbil city

Background and objective: Anabolic-androgenic steroids are synthetic testosterone derivatives with a longer duration of action than physiological androgens. They are abused by bodybuilders because of their potential to enhance muscle strength. Serious medical and psychological complications may be associated with their non-medical use. This study aimed to determine the prevalence of anabolic androgenic steroids among bodybuilders and their awareness of health-related risks. Methods: A cross-sectional study was carried out from the 1st of January 2019 to the end of July 2019 in 18 randomly selected gym centers in Erbil city, Iraq using stratified random sampling. A self-administered questionnaire was distributed to 400 bodybuilders to assess the prevalence and knowledge of using Anabolic-androgenic steroids. Results: The study showed a high prevalence of Anabolic-androgenic steroid consumption (26.3%) among gym users in Erbil city. Anabolic-androgenic steroid use was significantly higher among participants with a longer duration of bodybuilding practice ≥4 years (P = 0.001). Anabolic-androgenic steroid abuse was significantly associated with drinking alcohol, smoking cigarettes, and using growth hormones. Trainers were the commonest source of recommendation. Conclusion: The prevalence of anabolic androgenic steroids abuse is high among bodybuilders in Erbil city. Public health awareness is essential and may help avoid the propagation of the problem. Keywords: Anabolic steroids; Gym users; Bodybuilders; Knowledge, Erbil.

Biventricular dysfunction and lung congestion in athletes on anabolic androgenic steroids: a speckle tracking and stress lung echocardiography analysis

The real effects of the chronic consumption of anabolic-androgenic steroids (AASs) on cardiovascular structures are subjects of intense debate. The aim of the study was to detect by speckle tracking echocardiography (STE) right ventricular (RV) and left ventricular (LV) dysfunction at rest and during exercise stress echocardiography (ESE) in athletes abusing AAS. One hundred and fifteen top-level competitive bodybuilders were selected (70 males), including 65 athletes misusing AAS for at least 5 years (users), 50 anabolic-free bodybuilders (non-users), compared to 50 age- and sex-matched healthy sedentary controls. Standard Doppler echocardiography, STE analysis, and lung ultrasound at rest and at peak supine-bicycle ESE were performed. Athletes showed increased LV mass index, wall thickness, and RV diameters compared with controls, whereas LV ejection fraction was comparable within the groups. left atrial volume index, LV and RV strain, and LV E/Em were significantly higher in AAS users. Users showed more B-lines during stress (median 4.4 vs. 1.25 in controls and 1.3 in non-users, P < 0.01 vs. users). By multivariable analyses, LV E/Ea (beta coefficient = 0.35, P < 0.01), pulmonary artery systolic pressure (beta = 0.43, P < 0.001) at peak effort and number of weeks of AAS use per year (beta = 0.45, P < 0.001) emerged as the only independent determinants of resting RV lateral wall peak systolic two-dimensional strain. In addition, a close association between resting RV myocardial function and VO2 peak during ESE was evidenced (P < 0.001), with a powerful incremental value with respect to clinical and standard echocardiographic data. In athletes abusing steroids, STE analysis showed an impaired RV systolic deformation, closely associated with reduced functional capacity during physical effort, and-during exercise-more pulmonary congestion.

Influence of different training methods on cardiovascular disease risk markers after cessation of anabolic steroids abuse in bodybuilders at risk

Evidence suggests that anabolic-androgenic steroid (AAS) abuse induces adverse effects on cardiovascular disease (CVD). However, it is unclear whether different training methods are effective in reducing these consequences. This study aims to compare the effects of aerobic training (AT), resistance training (RT), and combined training (CT) on CVD risk markers in professional bodybuilders at risk after cessation of AAS abuse. Forty bodybuilders were randomly assigned to one of four groups: control (n=10), AT (n=10), RT (RT, n=10), and CT (n=10) groups. Before and after eight weeks of training, the high sensitivity C-reactive protein (hs-CRP), haematocrit (HCT), homocysteine (HCY), N-terminal prohormone of brain natriuretic peptide (NT-proBNP), and blood pressure (BP) were measured. Significant decreases within groups in HCY and CRP were observed (P&lt;0.05). However, decreases were greater in training groups, and there was a significant difference between control and training groups (P&lt;0.05). Increase in NT-proBNP, and decreases in systolic blood pressure (SBP), and diastolic blood pressure (DBP) levels were significant only in training groups (P&lt;0.005). The increase of NT-proBNP was significant in the CT when compared to the RT (P&lt;0.05). The present study found that discontinuing AAS consumption can improve some CVD risk markers in professional bodybuilders, but this effect could be improved if various modalities of training were performed. Accompanying AT with RT was also discovered to have a greater impact on some markers (including NT-proBNP).

Investigation of the Chronic Effects of Winstrol and Oxandrolone Anabolic Steroids on Liver Enzymes in Male Bodybuilding Athletes

Background: Chronic use of anabolic-androgenic steroids (AAS) by athletes can cause detrimental effects on the liver, heart and arteries, kidneys, and hormonal systems. Besides, it may cause mental health problems. Objectives: The current study aimed to investigate the chronic effects of Winstrol and Oxandrolone anabolic steroids on liver enzymes in male bodybuilding athletes. Methods: This causal-comparative study was conducted on 30 bodybuilding athletes living in Yasuj City in 2019. Participants were included using the available and non-random sampling technique. Then, were divided into three groups (each with 10 members), including: (1) athletes with no history of AAS; (2) athletes with a history of AAS (three months away from consumption); and (3) athletes with current AAS consumption. After 12 hours of fasting, blood samples were taken in the morning to measure liver enzymes (AST, ALT, and ALP). Data were analyzed by one-way analysis of variance (ANOVA) and Tukey post hoc test using SPSS version 21 at a significance level of &lt; 0.05. Results: The results showed higher degradation of the two enzymes aspartate aminotransferase (AST) and alanine aminotransferase (AST) in the third group compared to the other two groups (P = 0.001, F = 130.84). Also, the damage of AST and ALT enzymes was more in the second group than the first group (P = 0.001, F = 188.178). Also, the results of one-way analysis of variance showed no significant difference between groups concerning serum ALP level (P = 0.227, F = 1.349). Conclusions: Steroid drugs have devastating effects on liver cells, even after three months of discarding their use, and the effects never get fully remedy, as they continue to affect consumers after quitting; However, it appears that the adverse effects on some liver enzymes significantly reduce over time.

A focused netnographic study exploring experiences associated with counterfeit and contaminated anabolic-androgenic steroids

BackgroundA primary consequence of illicit drug markets and the absence of regulation is the variable quality or purity of the final product. Analysis of anabolic-androgenic steroid seizures shows that these products can contain adulterated products, product not included on the label, or product of unsatisfactory standard. While the potential negative effects of counterfeit anabolic-androgenic steroids (AAS) use is a recognised risk associated with use, no study has explored personal experiences associated with use. The aim of the present study was to use online discussion forums to investigate and explore the experiences associated with the purchase and consumption of counterfeit AAS among consumers.MethodsAn online search was conducted to identify online forums that discussed counterfeit or contaminated AAS; three were deemed suitable for the study. The primary source of data for this study was the ‘threads’ from these online forums, identified using search terms including ‘counterfeit’, ‘tampered’, and ‘fake’. Threads were thematically analysed for overall content, leading to the identification of themes.ResultsData from 134 threads (2743 posts from 875 unique avatars) was included. Two main themes were identified from the analysis: (1) experiences with counterfeit product and (2) harms and benefits associated with counterfeit product.ConclusionsThe use of counterfeit or contaminated substances represents a public health concern. Those who report using performance and image enhancing drugs such as AAS for non-medical purposes report consuming these substances and experiencing harm as a result. Consumers take steps to limit coming into contact with counterfeit or contaminated product, though recognise that many of these have limitations. The implementation of accessible drug safety checking services may provide an opportunity to provide consumers with information to assist them with making healthier choices.

Attitudes, knowledge, and consumption of anabolic-androgenic steroids by recreational gym goers in Israel

The purpose of this study was to shed light on the consumption of anabolic-androgenic steroids (AAS) by gym goers in Israel and to learn about their attitudes toward AAS and their knowledge about it. This research is based on a structured, self-reported anonymous online questionnaire distributed to 665 gym goers. 4.6% of participants reported using steroid, 48.9% of participants knew gym goers who used steroids, 21.3% reported that they had been offered to use steroids, and 26% of respondents expressed curiosity about the effect of steroids on them. Acquaintance with gym goers who used steroids found to be revealed to the level of knowledge and to the level of attitudes toward AAS. Research and application recommendations were given at the end of the article.

The epidemiology of anabolic-androgenic steroids use among secondary students (Valencia-Spain)

AbstractBackground/Aims: The consumption of anabolic-androgenic steroids (AAS) is continuously growing in recent years among young people. The purpose of the current study was to examine the proportion of students who reported AAS use, explore other drug use among them and finally to determine the sociodemographic profile of the AAS consumption amongst a sample of students in the Valencian Region (Spain).Methods: Data was taken from a self-administrated survey of a representative sample of 11,162 Valencian students. A total of 252 schools participated in the study. In this group, 47.6% were male and 52.4% were female, with a median age of 16.26 years (DT= 1.33).Results: The 3,3% of surveyed students reported that they had consumed AAS. Males reported to take anabolic more frequently than females (86,2% of males, 13,8% of females; p&lt;0.001). The older they are the more frequent the reporting of consumption -increasing from 2.5% in those aged 14, to 4.3% in those aged 18-. Among users of AAS it exists a higher prevalence of consumption of cannabis 64.2%, cocaine 23.8%, hypnotics 22.9%, ecstasy 16.8%, LSD 14% or heroine 4.1%, compare to nonusers.Conclusion: The study shows that the consumption of steroids is mainly masculine, a clear association with polyconsumption, frequent scheming as the main source of getting them and that the consumption of these substances is bigger between those students whose family situation is characterized by the absence of a masculine figure (single mother or widow) in comparison with those whose parents are married.

Neuropsychiatric and Behavioral Involvement in AAS Abusers. A Literature Review.

Background and Objectives: Anabolic androgenic steroids (AASs) are a complex group of molecules that include both steroidal androgens and synthetic compounds, derived from testosterone. AASs are commonly used to support pharmacological therapy in cases of primary or secondary hypogonadism, major burns, and neoplastic cachexia. Their prolonged and supra-physiological consumption can provoke several adverse effects on various organs and systems. Among these, the physiopathological mechanisms that induce neuropsychiatric disorders related to AAS abuse are poorly known. For this reason, the proposed review aims to retrace the pathway of action of testosterone to focus on the effects on the central nervous system and specifically highlight the effects of AASs on neuropsychiatric and behavioral functions, as well as on lifestyle. Materials and Methods: This review was conducted using PubMed and Google Scholar databases. On these database websites, we searched for articles from 1 January 1980 to March 2019 using the key terms: “AAS,” “Anabolic Androgenic Steroids,” “brain,” and “neurology.” Results: The use of AASs through self-administration yields circulating androgens levels, inducing neuron apoptosis, which is linked to thinner cortex and, in general, less cortical volume. The same alterations affect the putamen. These differences were more evident when correlated with longer use. From a functional point of view, prolonged AAS consumption seemed to be related to lower connectivity between amygdala and frontal, striatal, limbic, hippocampal and visual cortical areas. On the other hand, AAS use seems to negatively condition the positive effects of the sport exercise, reducing its important anti-apoptotic and pro-proliferative functions on the hippocampus, implicated in anxiolytic control. Conclusion: This review clarifies the major aspects of the side effects related to AAS use/abuse highlighting the complex mechanisms on neuropsychiatric and cognitive pathological alterations and also the emotional and behavioral dysfunctions.

Boosting bodily capital: Maintaining masculinity, aesthetic pleasure and instrumental utility through the consumption of steroids

Anabolic-androgenic steroid consumption is considered a significant public health issue in a number of countries but particularly in the northeast of England. Informed by ongoing ethnographic work on steroid use, this article aims to explore two particular dimensions of bodily capital within the overarching context of hyper-masculinity. Towards this end we focus on aesthetic pleasure as the ‘boosted’ body becomes a site of contemporary consumption before taking a look at the instrumental utility derived from a sufficiently primed and tuned body. Accordingly, and with a view towards the changing currency of bodily capital, we explore the contemporary importance attached to both attaining and maintaining both elements of a ‘boosted’ bodily capital. The significant role steroids play in facilitating this is then discussed; yet rather than locating its consumption in the realm of ‘deviancy’, we view it as a means of hyper-conforming to neoliberalism’s cultural norms and values. By drawing upon a range of perspectives, we hope to offer up new insights into the demand for steroids apropos the pursuit for an aesthetically pleasing and instrumentally effective body.

Hepatotoxicidad por esteroides anabólicos androgénicos, reporte de 2 casos en Uruguay

Illicit consumption of anabolic-androgenic steroids for aesthetic purposes has increased in recent years. Hepatocellular damage is more frequent, but cholestasis is more dangerous and may be associated with renal failure. The clinical records of two young men, amateur athletes who consulted for jaundice in the last year and initially denied its consumption, are described. Except for the drug interruption, hepatotoxicity by anabolics has no specific treatment. Usually presented as cholestatic liver disease and renal failure, case reports are fundamental to characterize its clinical-evolutionary presentation. This may also allow clinicians to firmly consider diagnosis even when the patient denies consumption.

Left atrial myocardial dysfunction after chronic abuse of anabolic androgenic steroids: a speckle tracking echocardiography analysis.

Anabolic-androgenic steroids (AAS) are used by power athletes to improve performance. However, the real effects of the chronic consumption of AAS on cardiovascular structures are subjects of intense debate. To detect by speckle tracking echocardiography (STE) underlying left atrial (LA) dysfunction in athletes abusing AAS and assess possible correlation between LA myocardial function and exercise capacity during cardiopulmonary stress test. 65 top-level competitive bodybuilders were selected (45 males), including 35 athletes misusing AAS for at least 5 years (users), 30 anabolic-free bodybuilders (non-users), compared to 40 age- and sex-matched healthy sedentary controls. Standard Doppler echocardiography, STE analysis and bicycle ergometric test were performed to assess LA myocardial function and exercise capacity. Athletes showed increased left ventricular (LV) mass index, wall thickness and stroke volume compared with controls, whereas LV ejection fraction, LV end-diastolic diameter and transmitral Doppler indexes were comparable between the three groups. Conversely, LA volume index, LV and LA strain and LV E/Em were significantly increased in AAS users. By multivariate analyses, LV E/Em (beta = - 0.30, p < 0.01), LA volume index (- 0.42, p < 0.001) and number of weeks of AAS use per year (- 0.54, p < 0.001) emerged as the only independent determinants of LA lateral wall peak STE. In addition, a close association between LA myocardial function and VO2 peak during cardiopulmonary exercise testing was evidenced (p < 0.001), showing a powerful incremental value with respect to clinical and standard echocardiographic data. STE represents a promising technique to assess LA myocardial function in athletes abusing steroids. AAS users showed a more impaired LA deformation, associated with reduced functional capacity during physical effort.

Anabolic steroids abuse and male infertility.

For several decades, testosterone and its synthetic derivatives have been used with anabolic and androgenic purposes. These substances were first restricted to professional bodybuilders, but become more and more popular among recreational athletes. Up to date, 3,000,000 anabolic-androgenic steroids (AAS) users have been reported in the United States with an increasing prevalence, making AAS consumption a major public health growing concern. Infertility is defined by the WHO as the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse and a male factor is present in up to 50 % of all infertile couples. Several conditions may be related to male infertility.Substance abuse, including AAS, is commonly associated to transient or persistent impairment on male reproductive function, through different pathways. Herein, a brief overview on AAS is offered. Steroids biochemistry, patterns of use, physiological and clinical issues are enlightened. A further review about fertility outcomes among male AAS abusers is also presented, including the classic reports on transient anabolic steroid-induced hypogonadism (ASIH), and the more recent experimental reports on structural and genetic sperm damage.