Long-term Use Of Anabolic-androgenic Steroids Research Articles

A study of long-term supraphysiologic-dose anabolic-androgenic steroid use on cognitive function in middle-aged men

ABSTRACT Background: Long-term use of supraphysiologic doses of anabolic-androgenic steroids (AAS) has been associated with impaired visuospatial memory in young men but little is known about its cognitive effects in middle-aged men. Objectives: We compared cognition in middle-aged men with histories of long-term AAS use and age-matched non-users. Methods: We administered cognitive tests from the CANTAB battery to 76 weightlifters aged 37–60 years (mean [SD] 48.5 [6.5] years), of whom 51 reported at least 2 years of cumulative AAS use and 25 reported no AAS exposure. Results: We found no significant AAS user versus non-user group differences on visuospatial, verbal memory, emotional recognition, or executive function tasks (corrected p’s ≥ .00089; effect sizes ≤ .5). Conclusions: Our null visuospatial task findings contrast with our prior younger cohort study (mean age 37.1 [7.1] years), in which we found impaired visuospatial task performance in people who use AAS, and with other reports of cognitive impairments in younger men use AAS. Men who use AAS may develop early visuospatial memory deficits that stabilize by middle age while middle-aged non-users’ performance may “catch up” due to normal age-related visuospatial declines. Similar effects could contribute to our null findings on other tasks. Between-study cohort substance use differences or environmental factor differences that modify cognition, such as study geographical location and time of year, also could contribute to our discordant findings. Since young adult male AAS users experience increased mortality from unnatural causes, improving our understanding of AAS cognitive effects in this age group is important.

Impaired vascular function among young users of anabolic–androgenic steroids

Supraphysiological doses of anabolic–androgenic steroids (AAS) is popular among recreational weightlifters and bodybuilders due to the performance-enhancing properties but is also associated with adverse cardiovascular effects. The knowledge about how AAS affect the vasculature is limited, although results from previous studies suggest alterations in vasoreactivity and morphology. In the present study we investigate the association between long-term use of AAS and vascular function. Hundred and twenty-three males were included in the study, 56 of them current AAS users and 67 weightlifting controls. Vascular function was evaluated by carotid artery reactivity and flow-mediated dilation. AAS users had significantly reduced carotid artery reactivity (p < 0.001) and flow-mediated dilation (p < 0.001) compared to weightlifting controls. Results from the present study indicate that long-term use of AAS affect the cardiovascular system negatively, measured as reduced carotid artery reactivity and flow-mediated dilation. These findings could partly explain sudden cardiovascular events among young long-term users of AAS.

Clomiphene citrate and optional human chorionic gonadotropin for treating male hypogonadism arising from long-term anabolic-androgenic steroid use—A pilot study

IntroductionLong-term anabolic-androgenic steroid (AAS) use poses several health risks, including secondary hypogonadism. There is a knowledge gap on treatment targeting the hypothalamic-pituitary-gonadal (HPG) axis among men with anabolic steroid-induced hypogonadism (ASIH). This study aims to gain insights into the potential utility of endocrine therapy to restore endogenous testosterone levels and alleviate ASIH symptoms in AAS dependent men. MethodsIn this proof-of-concept, single-site, open longitudinal pilot study, AAS dependent men with continuous AAS use and a desire to permanently discontinue use, were given endocrine therapy. The treatment included 25 mg clomiphene citrate (CC) every second day for 16 weeks, transdermal testosterone daily during the first four weeks, and if indicated, human chorionic gonadotropin (hCG) injections for a maximum of eight weeks. Physical exams including blood collection and online questionnaires were completed every four and two weeks, respectively. ResultsTen participants, with median age 32 years (interquartile range 30–45), with mean ± standard deviation AAS use of 11 ± 4 years, completed the CC intervention. Seven participants received hCG as part of their treatment protocol. Mild adverse events included headaches, dizziness, and mood swings, and no serious adverse events occurred. During the intervention, there was a decrease in levels of hematocrit, hemoglobin and ALT (alanine aminotransferase), as well as an increase in serum FSH (follicle stimulating hormone), LH (luteinizing hormone) and SHBG (sex hormone binding globulin). Five of ten participants reached a total testosterone level within normal range (9–30 nmol/l). The HPG axis response varied greatly among participants, and was not aligned with the severity of ASIH related withdrawal symptoms. ConclusionsThe findings from this proof-of-concept study may guide future randomized controlled trials aiming to investigate potential endocrine therapeutic approaches to ASIH.

Platelet activity, coagulation, and fibrinolysis in long-term users of anabolic-androgenic steroids compared to strength-trained athletes

IntroductionUse of anabolic-androgenic steroids (AAS) is associated with adverse cardiovascular (CV) effects, including potential prothrombotic effects. This study aimed to assess platelet activation and aggregation, coagulation, and fibrinolysis, in long-term AAS users compared to non-using strength-trained athletes. Materials and methodsThirty-seven strength-trained men using AAS were compared to seventeen non-using professional strength-trained athletes at similar age (median 33 years). AAS use was verified by blood and urine analyses. Platelet Function Analyzer 100 (PFA-100) and whole blood impedance aggregometry with thrombin, arachidonic acid, and ADP as agonists, were performed to evaluate platelet aggregation. ELISA methods were used for markers of platelet activation. Fibrinogen, D-dimer, the coagulation inhibitors protein S and C activity, and antithrombin were measured by routine. Fibrinolysis was evaluated by Plasminogen Activator Inhibitor-1 (PAI-1) activity. ResultsThere were no significant differences in platelet aggregation between the two groups. Von Willebrand factor was lower among the AAS users (p < 0.01), and P-Selectin was slightly higher (p = 0.05), whereas CD40 Ligand, β-thromboglobulin, and thrombospondin did not differ significantly. No differences were found in the assessed coagulation inhibitors. Higher D-dimer levels (p < 0.01) and lower PAI-1 activity (p < 0.01) were found among the AAS users. ConclusionsThe investigated long-term users of AAS did not exhibit elevated platelet activity compared to strength-trained non-using athletes. However, AAS use was associated with higher D-dimer levels and lower PAI-1 activity. These findings suggest that any prothrombotic effect of long-term AAS use may predominantly involve other aspects of the hemostatic system than blood platelets.

Sleep pathology and use of anabolic androgen steroids among male weightlifters in Norway

Use of anabolic androgenic steroids (AAS) causes drastic changes in hormonal milieu and is associated with a range of medical and psychological consequences. Sleep pathology is a common side-effect of AAS use but few have studied these relations. This study examined the relationship between AAS use, psychological distress and sleep quality, and how phases of heavy use and abstinence influence sleep. The Pittsburgh-Sleep-Quality-Index (PSQI) and Jenkins Sleep Scale (JSS) were used to assess sleep quality, and psychological distress was measured with the Hopkins Symptoms Checklist (HSCL). Participants comprised men who have previous or current long-term use of AAS (n = 68) and non-using weightlifting controls (WLC) (n = 58), where a subgroup of participants (n = 22) was monitored over ~ 6 months during phases of AAS use and withdrawal. Group differences on PSQI and JSS were evaluated with Kruskal-Wallis H tests, and the mediating role of psychological distress was evaluated using structural equation modeling. Linear mixed models were used to assess the role of AAS use and withdrawal on sleep quality. Among the AAS group, 66% reported sleep problems as a side effect, and 38% had used sleep medication. PSQI scores showed significantly lower sleep quality in the AAS group compared to WLC (p < 0.001) on all subscales except “sleep latency”. Furthermore, sleep quality was significantly poorer during withdrawal-phases than periods with AAS use (p < .001). Our findings provide key insight into sleep disturbances among men who use AAS, suggesting a link between sleep disturbances and hormone levels that deviate from physiologically normal levels in both directions.

Challenges recruiting men with a desire to cease anabolic-androgenic steroid use to a pilot involving hormone therapy intervention

Introduction Long-term use of anabolic-androgenic steroids (AAS) might lead to distressing withdrawal symptoms following cessation. This paper aims to share challenges in recruiting patients to a pilot intervention study with parallel substance use disorder (SUD) treatment and to explore barriers to participation among AAS forum members. Methods Eligible AAS-dependent men were recruited to receive hormone therapy for 16 weeks, and exclusion reasons were registered. Audience engagement from social media advertisements was measured. Information about the study was posted in an AAS online forum, and discussion among forum members was thematically analyzed. Results Twelve of 81 potential participants were included, whereas ten completed the intervention. Participants were excluded due to residency outside the study area, illicit substance use or severe medical conditions. Challenges in recruitment were linked to the COVID-19 pandemic, funding and advertisements on social media. AAS forum members suggested modifications to the intervention, were skeptical to the SUD-patient requirement, feared prosecution or other negative outcomes and/or preferred to seek online advice on self-initiated testosterone replacement therapy or post cycle therapy. Conclusion AAS-related online recommendations among peers, criminalized AAS use setting and obligatory SUD treatment might have affected recruitment. Based on lessons learned, recommendations for future similar studies are presented.

Anabolic androgenic steroid-induced liver injury: An update.

Anabolic androgenic steroids (AASs) are a group of molecules including endogenous testosterone and synthetic derivatives that have both androgenic and anabolic effects. These properties make them therapeutically beneficial in medical conditions such as hypogonadism. However, they are commonly bought illegally and misused for their anabolic, skeletal muscle building, and performance-enhancing effects. Supraphysiologic and long-term use of AASs affects all organs, leading to cardiovascular, neurological, endocrine, gastrointestinal, renal, and hematologic disorders. Hepatotoxicity is one of the major concerns regarding AASs treatment and abuse. Testosterone and its derivatives have been most often shown to induce a specific form of cholestasis, peliosis hepatis, and hepatic benign and malignant tumors. It is currently believed that mechanisms of pathogenesis of these disorders include disturbance of antioxidative factors, upregulation of bile acid synthesis, and induction of hepatocyte hyperplasia. Most toxicity cases are treated with supportive measures and liver function normalizes with discontinuation of AAS. However, some long-term consequences are irreversible. AAS-induced liver injury should be taken in consideration in patients with liver disorders, especially with the increasing unintentional ingestion of supplements containing AAS. In this paper, we review the most current knowledge about AAS-associated adverse effects on the liver, and their clinical presentations, prevalence, and pathophysiological mechanisms.

Cardiovascular risk associated with long-term anabolic-androgenic steroid abuse: an observational study from Norway

Abstract Background The use of anabolic-androgenic steroids (AAS) has become highly prevalent among recreational weightlifters. Numerous case reports have suggested an association between AAS use and a vast range of different cardiovascular diseases, including sudden cardiac death (SCD) and coronary artery disease (CAD). Few clinical studies have evaluated the risk of SCD and the prevalence of CAD in individuals with long-term AAS use. Purpose To evaluate the risk of ventricular arrhythmias and the prevalence of CAD among men with long-term AAS use. Methods Strength-trained men with at least three years of cumulative AAS use were recruited from recreational gyms. The control group consisted of strength-trained competing athletes who self-reported never using any performance enhancing drugs (non-users). AAS use was verified by sophisticated blood and urine analyses. Study participants went through a comprehensive cardiovascular evaluation including exercise ECG, 24 h ECG, heart rate variability (HRV) measures, signal averaged ECG (SAECG) and QT dispersion (QTd). Coronary computed tomography angiography (CCTA) was performed in AAS users. Not all participants had all tests. Results We included 51 AAS users and 21 non-users. Median age (25th-75th percentile) was 33 (29–37) years in the user group and 33 (29–42) years in the non-user group. Forty-eight (94%) of the users had been using AAS for five years or more. Characteristics are presented in the table. AAS users had significantly lower HDL values compared to non-users (p&amp;lt;0.001). No signs of ischemia or arrhythmias were detected during exercise ECG, however maximal exercise capacity was lower than in the control group and also compared to age-standardized values. A considerable, but statistically non-significant reduction was seen in overall HRV estimated as the standard deviation of the RR intervals for normal sinus beats (SDNN) (p=0.05). No difference was seen regarding left ventricular late potentials or QTd (table). Eight (19%) of the forty-two AAS users undergoing CCTA had at least a mild degree of CAD, and four of them three-vessel disease. Conclusion No ECG-findings indicated an increased risk of ventricular arrhythmias among the long-term AAS users. However, their maximal exercise capacity was lower than in controls, and one fifth of the long-term AAS users had verified CAD on CT coronary angiography. Funding Acknowledgement Type of funding sources: None. Table 1

ANABOLIC-ANDROGENIC STEROIDS ARE ASSOCIATED WITH MAJOR DEPRESSIVE DISORDER AND SUICIDE ATTEMPT: ANALYSIS OF A MULTI-NATIONAL DATABASE

Anabolic-androgenic steroids (AAS), synthetic derivatives of the male sex hormone testosterone, are often abused to enhance athletic performance and physical appearance. Long term use of AAS can be associated with mood destabilizing effects and psychotic behavior. We hypothesized that extended AAS use or abuse is an independent risk factor for body dysmorphic disorder, depression, and suicidality. We investigated AAS abuse and associations with major depressive disorder (MDD), suicide attempt, and body dysmorphic disorder (BDD) by querying TriNetX, a global health research network that provides data on large cohort of patients from multiple centers across the United States.

MiRNAs as Novel Biomarkers of Chronic Kidney Injury in Anabolic-Androgenic Steroid Users: An Experimental Study.

miRNAs are a family of 20–22 non-coding nucleotides that control gene expression by inhibiting the translation of their target messenger RNAs (mRNAs). Two models have been proposed to elucidate the mechanism of action: they act either hindering mRNA translation or enhancing mRNA degradation. Anabolic-Androgenic Steroids (AASs) represent a class of drugs used to treat several diseases. In the last few years, AASs have frequently been used for aesthetic purposes, indeed, they form part of the larger group called image- and performance-enhancing drugs (IPEDs). Long-term AAS use can lead to serious health consequences. In this regard, the present study aimed to analyze the role of several microRNAs (miRNAs) in renal damage after AAS use, to better understand the underlying mechanisms. For this purpose, two miRNAs (miR-21 and miR-205) were tested in two groups: AAS group (seven males, mean age 33.28 ± 4.68 years; mean body mass index (BMI) 27.04 ± 1.07), and chronic kidney disease (CKD) group (seven males, mean age 66.2 ± 5.4 years; mean BMI 24.75 ± 1.35). Finally, the same miRNAs were tested in the “Control” group (seven males, mean age 44.85 ± 5.75 years; mean BMI 26.5 ± 1.88). Kolmogorov-Smirnov Test was used to determine the normality of data distribution. All variables were normally distributed. Student’s t-test was used for comparisons between two groups. Analyzing the results of the present study, the two tested miRNAs (miR-21 and miR-205) were significantly higher in the CKD group compared to the AAS group, with mir-21 being much more expressed than miR-205. This study represents a pilot study to define if these expression patterns could be studied in other biological samples (plasma, urine) in subjects with different kidney injury linked to chronic kidney diseases and AAS use, to identify reliable biomarkers that could be applied in clinical and forensic diagnostics, as well as a target for toxicological investigations or therapeutic treatments.

P2545Long-term use of anabolic-androgenic steroids in male weightlifters is associated with left ventricular systolic dysfunction

Abstract Background Illicit use of anabolic-androgenic steroids (AAS) is widespread and has adverse psychological and cardiovascular effects. Few well-powered studies have explored the effect of long-term AAS-use on left ventricular systolic function. Purpose To explore the relationship between long-term use of AAS and left ventricular mass and systolic function. Methods We included male weightlifters with a history of &gt;1 year of cumulative AAS-use and male weightlifters unexposed to AAS. We performed echocardiography in all and assessed left ventricular mass using 2D echocardiographic linear measurements and Cube formula, left ventricular ejection fraction (EF) ad modum Simpson, and left ventricular global longitudinal strain (GLS) by speckle-tracking echocardiography. Results We recruited 100 male weightlifters, 58 of whom were previous or current AAS-users with mean±SD AAS-use of 10.4±7.0 years, and 42 unexposed weightlifters. There were no difference in age (35.5±9.2 vs. 35.3±7.5 years, p=0.8) nor body mass index (BMI) (BMI 31.4±5.0 vs. 30.1±3.5, p=0.6) between AAS-exposed and unexposed weightlifters. Compared with unexposed weightlifters, AAS-exposed weightlifters demonstrated thicker interventricular septum (11.2±2.4 vs. 9.2±1.3 mm, p&lt;0.001), thicker left ventricular posterior wall dimension (10.1±2.1 vs. 8.9±1.3 mm, p&lt;0.001), and higher left ventricular mass index (99.7±25.4 vs. 78.4±12.1 g/m2, p&lt;0.001). Both left ventricular EF and left ventricular GLS were decreased in AAS-exposed weightlifters compared with unexposed weightlifters (49±9 vs. 53±6%, p=0.02, and −15.6±2.6 vs. −18.3±2.1%, p&lt;0.001) (Figure). Conclusion AAS use in male weightlifters was associated with increased left ventricular mass and impaired left ventricular systolic function. Our results suggest considerable adverse cardiac effects of AAS use, but the results need confirmation in prospective observational trials.

Anabolic Androgenic Steroid Abuse and their Health Impacts: A Cross-sectional Study among Body Builders in a City of Eastern India.

Background:Anabolic-androgenic steroids (AASs), when taken in supraphysiologic doses, increase muscle strength and athletic performance. Evidence suggests that long-term use of AAS in supraphysiologic doses have adverse effects on health. Therefore, the study was conducted to find crude estimate of the prevalence of AAS use among attendees of the gymnasium, the factors that could have influenced them for AAS abuse and to assess the short- and long-term side effects as perceived by them.Methods:A cross-sectional study was conducted in selected gymnasiums of a smart city of India using a predesigned and pretested questionnaire. Snowball sampling method was undertaken. The study was from July 2015 to June 2016. Informed written consent was taken. The analysis was done using SPSS v. 20.0.Results:Of 84 bodybuilders approached, 74 participants used AAS. All users were male with mean age of 26.5 + 0.55 years. The mean age of initiation of AAS abuse was 23 years, and 66.2% (49) were unmarried. Eighty-five percent (63) preferred injectable. Seventy percent (52) abusers were influenced by trainers for abuse. Most commonly abused was Nandrolone decanoate (55.4%). Seventy-three percent were not aware of any legal ban on steroids. Reported benefits include increased strength, muscle size, and power, while harms were increased acne, deepening of voice, swelling of feet, increased irritability, depressive thoughts, impaired judgment, panic disorder, and withdrawal effect.Conclusions:Frequency of ASS use was substantial among young bodybuilders. Awareness about side effects was not a deterrent factor. Abusers were highly influenced by coaches. Efforts should be made for preventing easy access to AAS.

Cardiovascular Toxicity of Illicit Anabolic-Androgenic Steroid Use.

Millions of individuals have used illicit anabolic-androgenic steroids (AAS), but the long-term cardiovascular associations of these drugs remain incompletely understood. Using a cross-sectional cohort design, we recruited 140 experienced male weightlifters 34 to 54 years of age, comprising 86 men reporting ≥2 years of cumulative lifetime AAS use and 54 nonusing men. Using transthoracic echocardiography and coronary computed tomography angiography, we assessed 3 primary outcome measures: left ventricular (LV) systolic function (left ventricular ejection fraction), LV diastolic function (early relaxation velocity), and coronary atherosclerosis (coronary artery plaque volume). Compared with nonusers, AAS users demonstrated relatively reduced LV systolic function (mean±SD left ventricular ejection fraction = 52±11% versus 63±8%; P<0.001) and diastolic function (early relaxation velocity = 9.3±2.4 cm/second versus 11.1±2.0 cm/second; P<0.001). Users currently taking AAS at the time of evaluation (N=58) showed significantly reduced LV systolic (left ventricular ejection fraction = 49±10% versus 58±10%; P<0.001) and diastolic function (early relaxation velocity = 8.9±2.4 cm/second versus 10.1±2.4 cm/second; P=0.035) compared with users currently off-drug (N=28). In addition, AAS users demonstrated higher coronary artery plaque volume than nonusers (median [interquartile range] 3 [0, 174] mL3 versus 0 [0, 69] mL3; P=0.012). Lifetime AAS dose was strongly associated with coronary atherosclerotic burden (increase [95% confidence interval] in rank of plaque volume for each 10-year increase in cumulative duration of AAS use: 0.60 SD units [0.16-1.03 SD units]; P=0.008). Long-term AAS use appears to be associated with myocardial dysfunction and accelerated coronary atherosclerosis. These forms of AAS-associated adverse cardiovascular phenotypes may represent a previously underrecognized public-health problem.

Low-intensity endurance exercise plus nandrolone decanoate modulates cardiac adiponectin and its receptors.

Vast adverse effects of anabolic-androgenic steroids (AASs) on athletes' cardiovascular systems have been reported. However, there is still a lack of adequate information regarding the pathways and mechanisms involved. We tested the hypothesis that adiponectin and its receptors in the heart may be affected by long-term use of AASs alongside exercising. Male Wistar rats were randomized into the control (CTL), exercise (EX), nandrolone (Nan), arachis (Arach) group which treated with arachis as vehicle, trained vehicle (EX+Arach) and trained nandrolone (EX+Nan) groups that were treated for 8weeks. One day after the end of the protocol, animals were sacrificed and their hearts were frozen. TNF-α and adiponectin proteins of hearts were evaluated quantitatively by ELISA kits, and Western blot analysis was used for measuring adiponectin receptor protein expression. TNF-α protein increased significantly in the EX+Nan group (P<.05 vs CTL group). The AdipoR1 protein was significantly higher in the presence of nandrolone alongside exercise (P<.05 vs Nan and EX+Arach groups, P<.01 vs CTL and Arach groups). In addition, AdipoR2 protein enhanced in the EX+Nan group when compared with the other groups (P<.05 vs EX and EX+Arach groups, P<.01 vs CTL, Arach and Nan groups). Chronic nandrolone plus mild endurance exercise may be associated with imbalance in pro-/anti-inflammatory cytokines and may induce a positive modulatory effect on cardiac adiporeceptors in rat. Further studies are required before these findings can be generalized to humans.

White matter abnormalities in long-term anabolic-androgenic steroid users: A pilot study

Recent studies of long-term anabolic-androgenic steroid (AAS) users reported amygdala structural and functional connectivity abnormalities. We assessed white matter microstructure in the inferior-fronto-occipital fasciculus (IFOF), a major associative bundle of the amygdala network. Diffusion weighted images acquired from 9 male long-term AAS users and 8 matched controls aged 36–51 years old were processed using a standardized pipeline (Tract-Based Spatial Statistics). Group differences were examined using linear regression with adjustment for age and current testosterone level. Compared to nonusers, AAS users exhibited significantly higher fractional anisotropy (FA) in the IFOF. Users showed markedly greater FA than nonusers on the left IFOF but only a modest, nonsignificant difference on the right IFOF. Moreover, FA was positively associated with lifetime cumulative AAS dose. Our results suggest that long-term AAS use alters IFOF white matter organization and integrity, which in turn might affect amygdala-related processes such as reward system function. Accordingly, further studies are needed to replicate findings in larger subject groups to determine the functional significance of the FA abnormality.

Comparison of Right Ventricle Systolic Function between Long-Term Anabolic-Androgenic Steroid User and Nonuser Bodybuilder Athletes: A Study of Two-Dimensional Speckle Tracking Echocardiography.

Right ventricular (RV) effects of long-term use of anabolic-androgenic steroids (AAS) are not clearly known. The aim of this study was to assess RV systolic functions by two-dimensional speckle tracking echocardiography (2DSTE) in AAS user and nonuser bodybuilders. A total of 33 competitive male bodybuilders (15 AAS users, 18 AAS nonusers) were assessed. To assess RV systolic functions, all participants underwent standard two-dimensional and Doppler echocardiography, and 2DSTE. Interventricular septal thickness, left ventricle posterior wall thickness, relative wall thickness, and left ventricle mass index were significantly higher in AAS users than nonusers. While standard diastolic parameters were not statistically different between the groups, tissue Doppler parameters including RV E' and E'/A' were lower in AAS users than nonusers (10.1 ± 2.0 vs. 12.7 ± 2.1; P = 0.001, 1.1 ± 0.1 vs. 1.5 ± 0.4; P = 0.009, respectively). Tricuspid annular plane systolic excursion, RV fractional area change, and RV S' were in normal ranges. However, RV S' was found to be lower in users than nonusers (12.2 ± 2.2 vs. 14.6 ± 2.8, P = 0.011). RV free wall longitudinal strain and strain rate were decreased in AAS users in comparison with nonusers (-20.2 ± 3.1 vs. -23.3 ± 3.5; P = 0.012, -3.2 ± 0.1 vs. -3.4 ± 0.1; P = 0.022, respectively). In addition, there were good correlations between 2DSTE parameters and RV S', E', and E'/A'. Despite normal standard systolic echo parameters, peak systolic RV free wall strain and strain rate were reduced in AAS user bodybuilders in comparison with nonusers. Strain and strain rate by 2DSTE may be useful for early determination of subclinical RV dysfunction in AAS user bodybuilders.

Long-term anabolic androgenic steroid use is associated with increased atrial electromechanical delay in male bodybuilders.

We investigated the effect of long-term supraphysiologic doses of anabolic androgenic steroids (AAS) on atrial electromechanical delay (AEMD) in male bodybuilders. We clearly demonstrated that long-term consumption of supraphysiologic doses of AAS is associated with higher values of inter- and intra-AEMD in healthy young bodybuilders.

Higher Muscle Mass but Lower Gynoid Fat Mass in Athletes Using Anabolic Androgenic Steroids

This study evaluated the relationship between anabolic androgenic steroid (AAS) use and body constitution. Dual-energy x-ray absorptiometry was used to measure bone mineral density (BMD, g·cm(-2)) of the total body, arms, and legs. Total gynoid and android fat mass (grams) and total lean mass (grams) were measured in 10 strength trained athletes (41.4 ± 7.9 years) who had used AASs for 5-15 years (Doped) and 7 strength trained athletes (29.4 ± 6.2 years) who had never used AASs (Clean). Seventeen sedentary men (30.3 ± 2.1 years) served as Controls. Doped athletes had significantly more lean body mass (85.5 ± 3.8 vs. 75.3 ± 2.5 vs. 60.7 ± 1.9, p < 0.001) and a greater index of fat-free/fat mass (5.8 vs. 2.6 vs. 2.5, p < 0.001) compared with Clean athletes and Controls. Doped athletes also had significantly less gynoid fat mass compared with that of Clean athletes (2.8 ± 0.4 vs. 4.8 ± 0.2 kg, p = 0.02). There were no differences in BMD between the athletes (p = 0.39-0.98), but both groups had significantly higher BMDs at all sites compared with that of Controls (p = 0.01 to <0.001). Thus, long-term AAS use seems to alter body constitution, favoring higher muscle mass and reduced gynoid fat mass without affecting BMD.

Letter by Hobai Regarding Article, “Long-Term Anabolic-Androgenic Steroid Use Is Associated With Left Ventricular Dysfunction”

To the Editor: A known manifestation of left ventricular dysfunction is the development of severe hypotension during induction of general anesthesia for surgery.1 A modest decrease in blood pressure is expected in most individuals because the commonly used induction agents (such as propofol, thiopental, etc) are also vasodilators.2 However, this effect is markedly accentuated in …

Body Image and Attitudes Toward Male Roles in Anabolic-Androgenic Steroid Users

The authors sought to expand on previous observations suggesting that body-image pathology is associated with illicit use of anabolic-androgenic steroids (AAS). In particular, the authors compared current versus past AAS users and short-term versus long-term users in this respect. The authors assessed 89 heterosexual men who lifted weights regularly-48 AAS users and 41 nonusers-on measures of self-esteem, attitudes toward male roles, body image, eating-related attitudes and behaviors, and muscle dysmorphia ("reverse anorexia nervosa"). AAS users as a whole showed few differences from nonusers on most measures but showed greater symptoms of muscle dysmorphia (e.g., not allowing their bodies to be seen in public, giving up pleasurable activities because of body-appearance concerns). The current and past AAS users each differed only modestly from nonusers on most measures. Short-term AAS "experimenters" were also largely indistinguishable from nonusers, but the long-term AAS users showed striking and significant differences from nonusers on many measures, including marked symptoms of muscle dysmorphia and stronger endorsement of conventional male roles. Both body-image pathology and narrow stereotypic views of masculinity appear to be prominent among men with long-term AAS use. Although our cross-sectional observations cannot confirm that these factors help to cause or perpetuate AAS use, a causal hypothesis is certainly plausible and deserving of further testing in longitudinal studies. If these factors are indeed causal, then AAS users might respond to cognitive behavior approaches that simultaneously take aim at both types of maladaptive beliefs.