Effects of androgenic-anabolic steroids in athletes.
Level 5 - mechanism / opinion, no new human data
Narrative review with mechanism-based reasoning and no systematic search protocol.
PubMed 15248788 · doi:10.2165/00007256-200434080-00003
What was done
Narrative literature review assessing the physical, physiological, behavioural, and adverse effects of androgenic-anabolic steroid (AAS) administration and abuse in athletes across published scientific and laboratory studies.
What was found
Short-term AAS administration increased baseline strength by 5% to 20% and bodyweight by 2 to 5 kg (attributed to increased lean body mass), with no reduction in fat mass and no observed effect on endurance performance. Adverse physiological changes included suppression of endogenous testosterone and gonadotrophins lasting months after withdrawal, elevated blood pressure, and decreased serum HDL-, HDL2-, and HDL3-cholesterol. Human athlete studies showed no liver damage and no echocardiographic alterations in cardiac structure or function. Common self-reported effects included increased sexual drive, acne vulgaris, increased body hair, and heightened aggression or mood disturbances.
Why it matters
This review compiles the performance gains and multi-system health risks associated with AAS use, while highlighting that clinical trials using lower doses may underestimate real-world athletic toxicity.
Limits
Most reviewed laboratory studies evaluated doses substantially lower than those used in illicit athletic practice. Data on metabolic responses during exercise and recovery were limited, and many behavioural and adverse effects relied on athlete self-reports rather than objective clinical trials.