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Anabolic steroid use disorder

  • Visão geral
  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
  • Recursos
Última revisão: 22 Jul 2025
Última atualização: 15 Aug 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • increased weight gain and muscular build
  • increased appetite
  • consumption of nutritional supplements
  • use of other drugs to counteract adverse effects of AAS use
  • aggression and mood swings
  • gynecomastia
  • hirsutism
  • voice pitch alterations
  • clitoral hypertrophy
  • testicular atrophy
Detalhes completos

Outros fatores diagnósticos

  • acne and/or oily skin
  • temporal hairline recession/male pattern baldness
  • striae or keloids
  • menstrual irregularities
  • changes in libido
  • erectile dysfunction
  • infertility
  • premature masculinization/feminization (adolescents)
  • cognitive impairment
  • short stature (adolescents)
  • needle marks
  • decreased breast size
Detalhes completos

Fatores de risco

  • male sex
  • participation in competitive sports or bodybuilding
  • history of muscle dysmorphia or other body image disorder
  • employment as nightclub security officer, professional male dancer, professional wrestler, or law enforcement officer
  • history of childhood physical or sexual abuse
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • urine toxicology testing
  • testosterone to epitestosterone ratio
  • serum testosterone, LH, and FSH
  • sex hormone binding globulin (SHBG)
  • CBC
  • serum glucose
  • serum electrolytes
  • lipid panel
  • LFTs
  • creatine kinase
  • hepatitis serology
  • HIV serology
Detalhes completos

Novos exames

  • nuclear medicine cardiovascular imaging

Algoritmo de tratamento

CONTÍNUA

elite athlete: anabolic-androgenic steroid (AAS) use

general population: anabolic-androgenic steroid (AAS) use

Colaboradores

Autores

Thozhukat Sathyapalan, MBBS, MD, FRCP, FACP, SFHEA

Professor

Chair in Academic Endocrinology, Diabetes and Metabolism

Hull York Medical School

York

UK

Declarações

TS has received travel grants from Novo Nordisk and Rhythm Pharmaceuticals and consultancy fees from Rhythm Pharmaceuticals.

​Emmanuel Ssemmondo, MBChB, MSc, MRCP

Clinical Research Fellow

Academic Diabetes Endocrinology and Metabolism

University of Hull

Hull University Teaching Hospitals NHS Trust

Hull

UK

Declarações

ES declares that he has no competing interests.

Agradecimentos

Professor Thozhukat Sathyapalan and Dr Emmanuel Ssemmondo would like to gratefully acknowledge Dr Najeeb Shah, Dr Marcel J. Casavant and Dr Jill R. K. Griffith, previous contributors to the topic.

Disclosures

NS, MJC, and JRKG declared that they had no competing interests.

Peer reviewers

Fred Hartgens, MD, PhD

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 topic.

Harrison G. Pope Jr, MD, MPH

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 topic. HGP has received research grant funding from the US National Institute on Drug Abuse to investigate neuropsychological effect of long-term anabolic steroid use (NIDA R01 DA-041866).

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Anawalt BD. Diagnosis and management of anabolic androgenic steroid use. J Clin Endocrinol Metab. 2019 Jul 1;104(7):2490-500.Full text  Abstract

Handelsman DJ. Androgen misuse and abuse. Endocr Rev. 2021 Jul 16;42(4):457-501.Full text  Abstract

American College of Obstetricians and Gynecologists. ACOG committee opinion no. 484 (reaffirmed 2021): performance enhancing anabolic steroid abuse in women. Obstet Gynecol. 2011 Apr;117(4):1016-8.Full text  Abstract

National Institute on Drug Abuse. Anabolic steroids and other appearance and performance enhancing drugs (APEDs). May 2023 [internet publication].Full text

Pope HG Jr, Kanayama G. Body image disorders and anabolic steroid withdrawal hypogonadism in men. Endocrinol Metab Clin North Am. 2022 Mar;51(1):205-16. Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

  • Differentials

    • Use of other ergogenic compounds
    • Polycystic ovarian syndrome (PCOS)
    • Drug-induced hirsutism
    More Differentials

  • Guidelines

    • Anabolic steroids and other appearance and performance enhancing drugs (APEDs)
    • Performance enhancing anabolic steroid abuse in women
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