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Transtorno relacionado ao uso de esteroides anabolizantes

  • Descripción general
  • Teoría
  • Diagnóstico
  • Manejo
  • Seguimiento
  • Recursos
Última revisión: 26 Aug 2025
Última actualización: 15 Aug 2025

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • aumento no ganho de peso e construção muscular
  • aumento de apetite
  • consumo de suplementos nutricionais
  • uso de outras substâncias para neutralizar os efeitos adversos do uso de EAA
  • agressividade e oscilações do humor
  • ginecomastia
  • hirsutismo
  • alterações no tom de voz
  • hipertrofia clitoriana
  • atrofia testicular
Todos los datos

Otros factores de diagnóstico

  • acne e/ou pele oleosa
  • recessão da linha do cabelo temporal/alopecia androgênica
  • estrias ou queloides
  • irregularidades menstruais
  • alterações na libido
  • disfunção erétil
  • infertilidade
  • masculinização/feminização prematura (adolescentes)
  • comprometimento cognitivo
  • baixa estatura (adolescentes)
  • marcas de agulha
  • diminuição do tamanho das mamas
Todos los datos

Factores de riesgo

  • sexo masculino
  • participação em esportes competitivos ou fisiculturismo
  • história de dismorfia muscular ou de outro distúrbio da imagem corporal
  • emprego como segurança de casa noturna, dançarino profissional do sexo masculino, lutador profissional ou agente da lei
  • história de abuso físico ou sexual na infância
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • exames toxicológicos da urina
  • razão de testosterona e epitestosterona
  • testosterona, LH e FSH séricos
  • globulina ligadora de hormônios sexuais (SHBG)
  • Hemograma completo
  • glicose sérica
  • eletrólitos séricos
  • perfil lipídico
  • TFHs
  • creatina quinase
  • sorologia para hepatite
  • sorologia do HIV
Todos los datos

Pruebas emergentes

  • imagens cardiovasculares da medicina nuclear

Algoritmo de tratamiento

En curso

atleta de elite: uso de esteroides anabolizantes androgênicos (EAA)

população em geral: uso de esteroides anabolizantes androgênicos (EAA)

Colaboradores

Autores

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

Professor

Chair in Academic Endocrinology, Diabetes and Metabolism

Hull York Medical School

York

UK

利益声明

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

利益声明

ES declares that he has no competing interests.

鸣谢

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.

利益声明

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

同行评议者

Fred Hartgens, MD, PhD

Department of Epidemiology

Maastricht University Medical Centre

Department of Surgery

Outpatient Clinic Sports Medicine

Maastricht

Netherlands

利益声明

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

利益声明

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).

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

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.

关键文献

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

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

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.全文  摘要

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

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. 摘要

参考文献

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

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