Recognition and treatment of anabolic androgenic steroid use: literature review

Viktorija Antonova-Šiaudvytė1

1Vilnius University, Faculty of Medicine, Vilnius, Lithuania


Introduction. Anabolic androgenic steroids are used by athletes to improve performance and/or gain muscle mass. The most common adverse effects are acne and reproductive problems (testicular atrophy, impotence, azoospermia, male infertility, hypogonadism). Abuse increases the risk of cardiovascular and liver damage. Long-term users develop mental and behavioural disorders. Initial treatment is steroid discontinuation.

Steroid use leads to the development of a wide range of health problems and it is important to know the clinical presentation and to treat appropriately.

Aim. To review the clinical and laboratory features and treatment of anabolic steroid abuse reported in the literature.

Methods: the international database „Pubmed“ was used for the literature review. 27 articles were selected using the following keywords or a combination of keywords: anabolic androgenic steroids, toxicity, clinical signs, and effects on the body. More than 50 English-language articles were analysed between 2008 and 2022. The most relevant and publishable scientific articles were selected to illustrate the topic.

Results. Steroid use causes liver, cardiovascular, endocrine, reproductive, mental and behavioural disorders. Gynaecomastia, hirsutism and acne are the first signs that lead to suspicion of use. Testosterone levels normalise within 6 months of cessation of use.

Conclusions. Steroid use is common among athletes and causes adverse effects. It is recommended to discontinue use and treat the underlying pathology. There is insufficient information on addiction, guidelines and interventions.  Due to the potential multi-systemic manifestation, steroid use should be suspected by professionals in different health care fields.

Keywords: anabolic steroids, athletes, toxicity.