Michael S. Bahrke

Anabolic-androgenic steroids: current issues

SummaryThe use of drugs to enhance physical performance has been observed for thousands of years. Today, individuals continue to use a variety of substances, including anabolic-androgenic steroids, in the hope of enhancing their performance and appearance. Rumours persist regarding the incidence of the nonmedical use of anabolic steroids by athletes and nonathletes: however, true estimates are now available based on the results of systematic surveys.Although the vast majority of the athletic community accepts that anabolic steroids enhance performance and appearance, the extent to which this occurs and the factors influencing such effects remain incompletely understood and documented. Refinement of our knowledge of the ergogenic effects of anabolic steroids is not without merit; however, the existing scientific evidence coupled with an overwhelming number of anecdotal accounts argues against devoting significant resources to this area of investigation at present. The short term health effects of anabolic steroids have been increasingly studied and reviewed, and while anabolic steroid use has been associated with several adverse and even fatal effects, the incidence of serious effects thus far reported has been extremely low.The long term effects of anabolic steroid use are generally unknown. Unfortunately, the lack of scientific information on long term health effects has impeded, if not precluded, the formation of effective health education and drug abuse prevention strategies. Consequently, efforts should be expanded in the areas of prevention and education.

Evaluation of the Ergogenic Properties of Ginseng

Ginseng has been used in the Orient for several thousand years as an ‘adaptogenic’ as well as a ‘restorative’ agent. It has been used to treat nervous disorders, anaemia, wakefulness, dyspnoea, forgetfulness and confusion, prolonged thirst, decreased libido, chronic fatigue, angina and nausea. Although the mechanisms underlying the alleged effects of ginseng remain to be elucidated, there is an extensive animal literature dealing with the effects of ginseng on the cardiovascular system, central nervous system, endocrine system, metabolism, and immune system. In our previous review dealing with the efficacy of ginseng, we concluded that while studies with animals show that ginseng, or its active components, may prolong survival to physical or chemical stress, there is generally a lack of controlled research demonstrating the ability of ginseng to improve or prolong performance in fatigued humans. In this review, we extend our earlier analysis on the potential efficacy of ginseng use in the enhancement of physical performance and modification of fatigue states. Our analysis reveals that published literature appearing since our earlier review has not resolved the equivocal nature of research evidence involving animals or humans. Also, the lack of unanimity in this research can be explained on the basis of various methodological problems such as inadequate sample size and lack of double-blind, control and placebo paradigms. In addition, the absence of acceptable approaches to the problem of ‘sourcing’, in concert with an absence of compliance data in human research, further complicates the interpretation of this research literature. Nevertheless, the use of ginseng continues to grow, and current sales are estimated to be over

Risk Factors Associated With Anabolic-Androgenic Steroid Use Among Adolescents

US300 million annually. There is clearly a need for systematic research dealing with the efficacy of ginseng, and this research needs to take into account basic, fundamental design considerations if there is to be any hope of establishing whether or not ginseng possesses efficacy.

Psychological and Behavioural Effects of Endogenous Testosterone Levels and Anabolic-Androgenic Steroids Among Males

AbstractTo identify risk factors associated with anabolic-androgenic steroid (AAS) use among adolescents, computerised and manual literature searches were performed and the resultant local, state, national and international reports of illicit AAS use by adolescents that referenced risk factors were reviewed. Results indicate that adolescent AAS users are significantly more likely to be males and to use other illicit drugs, alcohol and tobacco. Student athletes are also more likely than non-athletes to use AAS, and football players, wrestlers, weightlifters and bodybuilders have significantly higher prevalence rates than students not engaged in these activities. Currently, only a partial profile can be created to characterise the adolescent AAS user. Further research will be needed before associations can be made with a reasonable degree of confidence regarding risk factors such as athletic participation, ethnicity, socioeconomic status and educational level. More importantly, to improve prevention and intervention strategies, a better understanding of the process involved in initiating AAS use is needed, including vulnerability factors, age of initiation and the use of other illicit drugs.

Psychological moods and subjectively perceived behavioral and somatic changes accompanying anabolic-androgenic steroid use.

SummaryThe psychological and behavioural effects of endogenous testosterone levels and anabolic-androgenic steroids in males have been investigated for over 50 years in both clinical and nonmedical uses, including the influence of anabolic-androgenic steroids on the nervous system and neuromuscular expression as a mechanism for behavioural and ergogenic effects. The relationship between moods, behaviour and endogenous plasma testosterone levels, as well as anabolic steroids and corticosteroid administration has been studied, including psychological dependence, withdrawal effects, and major methodological issues. While a relationship between endogenous testosterone levels and aggressive behaviour has been observed in various animal species, it is less consistent in humans. It can be concluded that, although the use of exogenous anabolic-androgenic steroids may have psychological and behavioural effects in some patients and athletes, the effects are variable, transient upon discontinuation of the drugs, and appear to be related to type (17α-alkalated rather than 17β-esterified), but not dose, of anabolic-androgenic steroids administered. The roles of genetic factors, medical history, environmental and peer influences, and individual expectations are likewise unclear. In general, the evidence at present is limited and much additional research will be necessary for a complete understanding of this relationship.

Psychological and behavioural effects of endogenous testosterone and anabolic-androgenic steroids. An update.

To assess physiological and psychological states ac companying anabolic-androgenic steroid use, male weight lifters 1) were interviewed regarding their phys ical training and the patterns and effects of any drug use; 2) completed a written physical and medical history questionnaire, a Profile of Mood States questionnaire, and the Buss-Durkee Hostility Inventory; and 3) were physically examined, including a blood sample and uri nalysis. Subjects were divided into current anabolic- androgenic steroid users (N = 12), previous users (N = 14), and nonusers (N = 24). Current and previous users reported the following changes associated with ana bolic-androgenic steroid use: increases in enthusiasm, aggression, and irritability; changes in insomnia, muscle size, muscle strength and density; faster recovery from workouts and injuries; and changes in libido. We were unable to confirm these interview and physical and medical history questionnaire responses using stand ardized and well-accepted psychological inventories. There were no significant differences among groups for any Profile of Moods factor, total mood disturbance, total Buss-Durkee Hostility Inventory score, or any subscale. For current users, there were no significant correlations between either total weekly drug dose or length of time on the current cycle of anabolic-andro genic steroids and any individual scale of the Profile of Mood States, Buss-Durkee Hostility Inventory, Profile of Mood States total mood disturbance, or composite Buss-Durkee Hostility Inventory score. Furthermore, anabolic-androgenic steroid users did not differ in their responses on these inventories from nonusers or from general population norms. The presence of subjectively perceived, anabolic-androgenic steroid-associated be havioral and somatic changes in the absence of signif icant differences in standard psychological inventory responses illustrates the complexity of these relation ships. Our data suggest that while perceived or actual psychological changes may occur in anabolic-andro genic steroid users, either the effects are too subtle or the inventories used were insensitive for detecting them.

Anabolic-androgenic steroids and related substances.

SummaryEndogenous testosterone levels have been linked to aggressive behaviour in both animals and humans. Studies administering moderate doses of exogenous testosterone for contraceptive and clinical purposes reveal essentially no adverse effects on male sexual and aggressive behaviour. However, investigations and case reports of athletes, usually involving higher doses, demonstrate an association between anabolic-androgenic steroid use and affective and psychotic syndromes and psychological dependence. Efforts to study the psychological and behavioural effects of anabolic-androgenic steroids are complicated by a variety of methodological limitations. Only 3 prospective, blinded studies demonstrating aggression or adverse overt behaviour resulting from anabolic-androgenic steroid use have been reported. With estimates of over 1 million past or current users in the US, an extremely small percentage of individuals using anabolic-androgenic steroids appear to experience mental disturbances severe enough to result in clinical treatment and medical case reports. Even among those so affected, the roles of previous psychiatric history, genetic susceptibility to addictions or mental disorders, environmental and peer influences, and individual expectations remain unclear.

Weight training. A potential confounding factor in examining the psychological and behavioural effects of anabolic-androgenic steroids

Testosterone is the primary male sex hormone, and anabolic-androgenic steroids are synthetic derivatives of testosterone. Anabolic steroids are used to enhance athletic performance and appearance. Adverse effects include those on the liver, serum lipids, psyche/behavior, and the reproductive system. Androstenedione is an anabolic-androgenic steroid used to increase blood testosterone levels for the purposes of increasing strength, lean body mass, and sexual performance. However, there is no research indicating androstenedione or its related compounds, significantly increases strength and/or lean body mass by increasing testosterone levels. The long-term health effects of prolonged androstenedione supplementation are unknown. Dehydroepiandrosterone (DHEA) is a weak androgen also used to elevate testosterone levels. DHEA is also advertised as an antiobesity and antiaging supplement capable of improving libido, vitality, and immunity levels. However, research demonstrates that DHEA supplementation does not increase serum testosterone concentrations or increase strength in men, and it may have virilizing effects on women.

Epidemiological and Policy Issues in the Measurement of the Long Term Health Effects of Anabolic-Androgenic Steroids

SummaryPsychological and behavioural changes are associated with anabolic-androgenic steroid (AAS) use. Changes in personality, moods and self-esteem following weight training have also been reported. The fact that nearly all AAS users are also dedicated weight trainers has often been overlooked in studies examining the relationship between AAS use and behavioural change. A triad may exist between AAS use, weight training and behavioural change (including dependence). It is also possible that changes frequently attributed to AAS use may also reflect changes resulting from the concurrent use of other substances such as alcohol, and from dietary manipulation including food supplements. Weight training and related practices should be considered potential confounding factors in future studies designed to examine the psychological and behavioural effects of AAS.

Anabolic steroid and stimulant use in North American sport between 1850 and 1980.

Review of the short term health effects of anabolic-androgenic steroids and description of the methodological issues which must be addressed when studying the long term health impact of these drugs