Anabolic steroid use disorder
Summary
Definition
History and exam
Key diagnostic factors
- 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
Other diagnostic factors
- 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
Risk factors
- 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
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
Novos exames
- nuclear medicine cardiovascular imaging
Algoritmo de tratamento
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.
Declarações
NS, MJC, and JRKG declared that they had no competing interests.
Revisores
Fred Hartgens, MD, PhD
Department of Epidemiology
Maastricht University Medical Centre
Department of Surgery
Outpatient Clinic Sports Medicine
Maastricht
Netherlands
Declarações
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
Declarações
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).
Créditos aos pareceristas
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Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
Anawalt BD. Diagnosis and management of anabolic androgenic steroid use. J Clin Endocrinol Metab. 2019 Jul 1;104(7):2490-500.Texto completo Resumo
Handelsman DJ. Androgen misuse and abuse. Endocr Rev. 2021 Jul 16;42(4):457-501.Texto completo Resumo
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.Texto completo Resumo
National Institute on Drug Abuse. Anabolic steroids and other appearance and performance enhancing drugs (APEDs). May 2023 [internet publication].Texto completo
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. Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Use of other ergogenic compounds
- Polycystic ovarian syndrome (PCOS)
- Drug-induced hirsutism
Mais Diagnósticos diferenciaisGuidelines
- Anabolic steroids and other appearance and performance enhancing drugs (APEDs)
- Performance enhancing anabolic steroid abuse in women
Mais GuidelinesPatient information
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