History and Epidemiology of Anabolic Androgens

History and Epidemiology of Anabolic Androgens

Written by Ben Bunting: BA, PGCert. (Sport & Exercise Nutrition) // British Army Physical Training Instructor // S&C Coach.


In recent years, there has been increased media and policy attention to the use of drugs that can increase muscle mass or strength. This includes the anabolic androgenic steroids (AAS) family.

They work by stimulating the body’s testosterone receptors to increase the production of hormones that help build muscle mass and reduce fat. They are also used to treat various diseases, including cancer.


Testosterone is a hormone made mainly in the testes (part of the male reproductive system). It is needed to develop and maintain sex characteristics, such as facial hair, a deep voice, and muscle growth. It is also made in the laboratory to treat certain medical conditions.

It is present in the bloodstream of both men and women. However, testosterone concentrations can vary widely within and between individuals. This is due to the dynamic regulation of endogenous production, and may be influenced by competition and exercise. It is unclear whether testosterone concentrations can convey a competitive advantage to affected athletes.

Various disorders of sexual development (DSDs), including androgen insensitivity syndrome (AIS), can produce elevated levels of endogenous testosterone. These athletes are considered to be hyperandrogenic because of the increased production of testosterone in the body, which leads to a more muscular appearance and bone mineral density.

Although the relationship between testosterone and athletic performance is complex, it is widely acknowledged that testosterone increases physical strength and endurance. It also promotes male behavior, such as competitive and dominant behaviors. Moreover, testosterone enhances spatial ability in men and women.

The use of exogenous androgens to enhance sports performance is prohibited in most competitive sports. However, some athletes use these substances to improve their performance in training. This practice is often called doping, and these substances are classified as banned drugs by the World Anti-Doping Agency.

Since the late 1950s, several studies have shown that exogenous androgens increase power, strength and training capacity in men. These substances are now banned by most sports governing bodies because they can lead to severe health problems, including high blood pressure, prostate cancer and erectile dysfunction. 


Gonadotropin-releasing hormone (GnRH)

GnRH (pronounced gon-ROH) is a pulsatile hormone secreted by the hypothalamus. It stimulates the pituitary gland to make and secrete follicle-stimulating hormone and luteinizing hormone. These hormones affect how much testosterone and other male sex hormones your body makes and how your ovaries work.

The function of GnRH is to help your sex glands mature and work correctly. In females, it helps your ovaries (gonadal glands) make and release an egg (ovulation). Your ovaries then secrete the other sex hormones, estrogen and progesterone, contributing to fertility.

In men, it also stimulates your testicles to make testosterone. It can help your sperm make a single, strong, healthy sperm.

It also increases the level of another sex hormone, estradiol. This estrogen makes your body produce more luteinizing hormone, which affects how much testosterone and androgens (male sex hormones) your body makes.

Your endocrine system controls how much of this hormone your body makes and when it's made. It's naturally low in children and rises during puberty. After puberty, your body makes less of this hormone and more of the other sex hormones.

During your menstrual cycle, you have periods of low GnRH levels and high levels of the sex hormones testosterone and estrogen. These sex hormones control how many ovaries you have, if you're fertile and if you have a good libido.

This sex hormone imbalance can cause problems during your menstrual cycle. You may have irregular menstrual periods, cramps, hot flashes and depression. You can also have a hard time conceiving.

The main way to reduce your sex hormone levels is by stopping a lot of exercise, especially high-intensity physical activity. It's important to do this for the health of your body and for your sexual and reproductive health.

In a study of athletes, female power athletes had the highest androgen levels while endurance athletes had the lowest levels. The higher levels of androgens were associated with greater performance in 400 m, 800 m, 400 m hurdles, hammer throw and pole vault. The androgens increased oxygen-carrying capacity and non-bicarbonate extracellular buffering ability, which may have contributed to better performance in these sports.

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Human luteinizing hormone (LH)

LH is part of a communication network between your brain and your sex organs, where it controls sexual development, fertility and reproduction. It signals your ovaries or testes to make hormones needed for reproductive processes and helps control the menstrual cycle in women.

In women, LH stimulates ovulation and the production of estrogen, progesterone and testosterone in the ovary, while in men, LH causes the testicles to produce testosterone for sperm production.

A high LH level is not necessarily bad, but it can be a sign that your ovaries and testes have exhausted their ability to produce estrogen and testosterone, from genetic, autoimmune, surgical, or physiologic reasons. This can cause problems with your menstrual cycle, including irregular periods or infertility.

In addition to helping regulate your menstrual cycle, LH also stimulates the ovaries to form a substance called luteinizing hormone-releasing hormone (LH-RH). The luteinizing hormone-releasing hormone signaling system is part of the ovulation process in females, and it triggers the release of an egg from the ovary.

It also helps in the formation of the corpus luteum, which is a collection of cells that secretes steroid hormones like progesterone and estradiol. In addition, it signals your pituitary gland to release follicle-stimulating hormone (FSH), another chemical messenger that stimulates the ovaries to develop more mature follicles.

As with other hormones, levels of LH can fluctuate. This is typical of conditions and disorders involving your ovaries or testes, or the hormone production in your brain.

If you think you may have a condition or disorder that affects your LH levels, talk to your doctor about testing for it. Your doctor may order a blood test to measure your LH levels.

Some people are born with a gene that makes V-LH, a variant form of LH that increases bioactivity in vitro but shortens its half-life in vivo. This condition is known as cryptorchidism, and it occurs in 2-9% of newborn boys.

The 1930s and 40s: the birth of anabolic androgenic steroids

The 1930s saw the discovery that steroids could be used to treat hypogonadism, which is a condition in which the testes do not produce enough testosterone. Scientists also discovered that steroids could stimulate the growth of skeletal muscles in laboratory animals. These discoveries led to their widespread use in bodybuilding and athletics.

Steroids have been found to increase muscle size, improve athletic performance and enhance a person's appearance, but long-term use or high doses can cause serious health problems. These include harmful changes in the cholesterol levels (increased low-density lipoprotein and decreased high-density lipoprotein), acne, liver damage, and a risk for heart attacks and strokes.

In addition to negative physical effects, anabolic steroid abusers can develop serious psychological problems, such as aggression, depression and narcissism. They may also experience withdrawal symptoms such as mood swings, fatigue, restlessness and loss of appetite.

Abuse can lead to life-threatening diseases, including HIV/AIDS and hepatitis B or C. It is possible for abusers to contract these diseases from sharing contaminated needles or using nonsterile injection techniques.

Athletes who abuse anabolic steroids may also develop a dangerous bacterial infection called infective endocarditis, which can lead to inflammation of the inner lining of the heart. These infections can be fatal, and some abusers have died as a result of their anabolic-steroid use.

Laws regarding the posession, use and sale of AAS vary from country-to-country, but in Canada for instance, it is illegal to purchase or sell anabolic steroids without a prescription, and possession of anabolic steroids is punishable under the Controlled Drugs and Substances Act. Athletes can be imprisoned for up to 18 months if they are caught in possession of anabolic steroids.

The 1950s to the 1970s: Anabolic steroids propagate through elite athletics

During the 1950s, a series of powerful changes occurred in American society. First, the Cold War brought to an end a decade of peace and prosperity, which in turn created great fear and anxiety among many Americans.

Second, a dramatic growth in wealth transformed many of America's citizens. Third, a restless left was emerging from the staid culture of the 1950s and began to critique its values.

Fourth, a new subversive culture was growing beneath the smooth surface of the decade that would explode in the 1960s and beyond. It was a culture that could be seen in the first polio vaccine, in the US test of a thermonuclear bomb code named Ivy Mike, and in the rock and roll music of Elvis Presley.

One of the most prominent examples of this subversive culture was the use of anabolic steroids. The drugs were a powerful and addictive stimulant that, if abused, can produce a host of harmful side effects.

Athletes abuse anabolic steroids for several reasons: to enhance their strength, speed, and endurance; to build muscle mass; to increase body weight; to promote aggressiveness; or to enhance performance. Some athletes use two or more anabolic steroids in a practice called "stacking."

Anabolic steroids are classified as Schedule I substances under the United States Federal Controlled Substances Act, which makes possession of these drugs a felony with up to five years in prison and a $250,000 fine. They are also on the World Anti-Doping Agency (WADA) list of banned substances.

The 1980s & 1990s: anabolic steroid use spills into the general population

Steroid abuse, which is the misuse of steroids to enhance muscle bulk and strength, is a growing problem. This is especially true among teenagers, whose bodies are still developing.

Teens who are abusing steroids can have a range of health problems, including extreme mood swings, depression, impulsiveness and irritability. They can also be more aggressive and prone to violence.

Researchers have also seen a link between steroid use and some types of criminal behavior. They found that people who used steroids were twice as likely to be convicted of weapons crimes and 1-1/2 times more likely to be accused of fraud. 

A new study from Sweden has shown that steroid use is linked to some types of criminal behavior. They found that steroid users were more likely to be convicted of some types of crimes, such as armed robberies and debt collection.

A published 1988 study discovered that 6.6% of 12th grade male students had used AAS with the majority saying that they had initiated use before they were 16 years old. The research also noted that medical professionals at the time were the primary supplier.

Further data collection published during this period showed that around 4.5% of males accross Nebraska were users of AAS of which 72.6% of users were involved in schools sports. Yet, tese users were also more likey to use other drugs such as alcohol and tobacco.

Additional research noted that adolescent use ranged from 4% to 12% amongst males and 0.5% to 2% among females. Users were likely to be strength sport participants.

As such, during the 1990s the Anabolic Steroid Act of 1990 was passed by Congress to stem the flow of illicit AAS. The Act classified over 24 drugs as controlled substances.  

This may have had a positive effect because the overall trend of adolescent AAS use did decline between the period of 1988 and 1996 according to data published in the Archives of Pediatrics & Adolescent Medicine journal.

Anabolic steroid becomes a major world substance abuse problem

In the 21st century, the use of anabolic steroids, a class of drugs that includes testosterone, has become a major substance abuse problem worldwide. These drugs have become widely available and are now being used by men of all ages to gain muscle mass, increase strength and reduce body fat. This may be fueled by issues such as body dysmorphia and widely spread images of unrealistic portrayals of men in magazines, films and other media.

The effects of anabolic steroids on the body are both beneficial and harmful, depending upon how much is taken, what combination of drugs and when they are taken. Some studies have shown that steroid use can lead to increased bone density, decreased body fat, improved cardiovascular health and better mood, among other benefits.

There are also risks associated with long-term steroid use, such as heart failure and psychiatric disorders. Some side effects may occur without any prior indication of steroid use, such as increased appetite and changes in hair color.

A growing number of men are abusing anabolic steroids, despite the fact that they have been banned in sport since 1975. The International Olympic Committee (IOC) and World Anti-Doping Agency (WADA) formed to fight PEDs in sports, but these organizations aren't perfect.

As it stands, many professional sports leagues are still trying to figure out how to protect their athletes from steroid use and to comply with WADA's drug regulations. But the most important thing is to preserve integrity in sport and to protect athlete's health. That's why it is crucial that the "law" about when and how these drugs can be used is very clear, and that if there are any loopholes or exceptions, they are quickly closed.

The Future For Anabolic Steroid Use Around the World

Increasing use of steroids for sports training

Athletes around the world, especially professional athletes, are using anabolic steroids to improve their performance and muscle growth. These drugs are illegal in most countries and they can affect a person's health in a number of ways.

Increased red blood cell count (which increases the amount of oxygen carried throughout the body) - Steroids have been shown to increase the production of red blood cells, which help transport oxygen to tissues and organs. This increases endurance and helps the athlete work harder for longer periods of time.

'Blood doping' to speed up recovery from exercise

A growing number of athletes are taking blood-boosting steroids to boost their recovery and repair damaged muscles after an exercise session. They have also been known take a blood-building drug called erythropoietin (EPO) to increase the amount of red blood cells in their bodies. The body then regenerates the blood, giving it the ability to recover faster from exercise.

A famous case of an athelete using EPO (amongst other banned drugs) was Lance Armstrong's admission in 2012. This led to him being stripped of his 7 consecutive Tour de France tiles and 1 Olympic medal.

Abuse and dependency on steroids

The prolonged use of anabolic steroids can lead to abuse or addiction, which can include physical dependence and a need for medical supervision. Athletes and others who inject these drugs are also at risk of contracting needle-borne diseases, including HIV. 



The use of anabolic androgenic steroids (AAS) was originally the domain of elite athletes and competitive body-builders. It has now spread into the general population, mainly among young men. Despite their potential to promote muscle growth and strength, they can also lead to serious side effects including gynaecomastia, testicular dysfunction, infertility and cardiac disease.


The global prevalence of AAS use is not well documented. The majority of studies concern the USA, Canada and Brazil, although some research has been conducted in Europe and Asia.

Predictors of AAS use

Health concerns related to AAS misuse are significant. The use of AAS can be highly addictive and difficult to break. In addition, prolonged AAS abuse can contribute to adverse behavioural patterns such as negative body image and dysmorphia that negatively impact on social and occupational functioning.

Physical therapy is an important treatment option for patients abusing AAS and should be considered in those with comorbid psychiatric disorders or substance use disorder that may be contributing to their prolonged AAS misuse. The main focus of physical therapy treatment should be the prevention and management of these negative health effects relating to AAS misuse.

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