Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • consumption of nutritional supplements
  • use of other drugs to counteract adverse effects of steroids
  • increased weight gain and muscular build
  • increased appetite
  • aggression and mood swings
  • hirsutism
  • voice pitch alterations
  • clitoral hypertrophy
  • disproportionate muscular development of upper torso
  • testicular atrophy

Other diagnostic factors

  • acne and/or oily skin
  • temporal hairline recession/male pattern baldness
  • striae or keloids
  • menstrual irregularities
  • changes in libido
  • scrotal pain
  • impotence
  • infertility
  • premature masculinisation/feminisation (adolescents)
  • cognitive impairment
  • GI upset
  • short stature (adolescents)
  • needle marks
  • enlarged prostate
  • gynaecomastia
  • narcissistic personality

Risk factors

  • male sex
  • participation in sports and athletics or bodybuilding
  • hx of muscle dysmorphia or other body image disorder
  • employment as nightclub bouncer, professional male dancer, professional wrestler, or law enforcement officer
  • hx of childhood physical or sexual abuse

Diagnostic investigations

1st investigations to order

  • urine toxicology testing
  • testosterone to epitestosterone ratio
  • serum LH and FSH
  • FBC
  • serum glucose
  • serum electrolytes
  • lipid panel
  • LFTs
  • CK
  • hepatitis serology
  • HIV serology
Full details

Emerging tests

  • nuclear medicine cardiovascular imaging
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Marcel J. Casavant

Chief

Division of Toxicology

Nationwide Children's Hospital

Clinical Professor

The Ohio State University

Colleges of Medicine and Pharmacy

Columbus

OH

Disclosures

MJC declares that he has no competing interests.

Clinical Assistant Professor

The Ohio State University

College of Pharmacy

Clinical Pharmacist

Mount Carmel Medical Center West

Columbus

OH

Disclosures

JRKG declares that she has no competing interests.

Peer reviewers VIEW ALL

Department of Epidemiology

Maastricht University Medical Centre

Department of Surgery

Outpatient Clinic Sports Medicine

Maastricht

Netherlands

Disclosures

FH is an author of a reference cited in this monograph.

Professor of Psychiatry

Psychiatrist

Director

Biological Psychiatry Laboratory

McLean Hospital

Belmont

MA

Disclosures

HGP is an author of a number of references cited in this monograph.

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