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Andrologie

, 13:367 | Cite as

Actions et effets secondaires de l’abus de Stéroïdes Anabolisants dans le sport et la vie sociale

  • Alan James George
Article de Revue Androgènes et Sports
  • 883 Downloads

Resume

Les stéroïdes anabolisants (SA) dérivés de la testostérone ont à la fois des effets anabolisants (augmentation du muscle et de la force) et androgéniques (caractères sexuels primaires et secondaires). Les efforts entrepris pour limiter les effets androgéniques tout en augmentant les effets anabolisants n’ont pas été couronnés de succès. Les altérations de la structure de la testostérone, induites pour augmenter la pharmacocinétique des SA, ont donné naissances à des produits pharmaceutiques qui sont actifs par voie orale, ont une demivie plasmatique accrue et peuvent être administrés sous forme d’injections retards. Des doses thérapeutiques de SA produisent des effets statistiquement significatifs sur la force et la performance athlétique dans des essais cliniques et scientifiquement bien contrôlés. A faibles doses thérapeutiques, l’alimentation et un entraînement intensif sont également importants pour produire une augmentation statistiquement significative de la force. Des doses supérieures à 6 à 7000 mg par semaine sont régulièrement utilisées dans le sport et produisent la plus grande augmentation de la force musculaire, de l’érythropoïèse et de la masse corporelle maigre. Les profils d’utilisation abusive de stéroïdes peuvent être complexes, reflétant un désir de minimiser les effets secondaires et d’échapper à la détection. Les effets secondaires des stéroïdes anabolisants sont de plusieurs types. Les SA augmentent la rétention d’eau et de sel, conduisant à une expansion du volume sanguin, mais les effets des stéroïdes sur la pression artérielle sont équivoques et la plupart des effets cardiovasculaires secondaires semblent être réversibles.

L’abus de SA entraîne une augmentation des taux sanguins de triglycérides et de cholestérol, et ceci est associé à une diminution des Lipoprotéines de Haute Densité (HDL) et à une augmentation des Lipoprotéines de Faible Densité (LDL). Bien que ces effets soient réversibles, ils sont associés à un risque accru de pathologie cardiovasculaire à la fois aiguë et chronique. Les effets secondaires irréversibles les plus sérieux des stéroïdes anabolisants concernent des cancers, principalement du foie, de la prostate et du rein. Les carcinomes hépatiques sont fortement liés à l’abus des formes actives de stéroïdes substituées en 17-alphaméthyl qui provoquent aussi une jaunisse réversible. Chez les hommes, l’abus de stéroïdes anabolisants entraîne la suppression de la libération de LH et FSH conduisant à une inhibition de la production de testostérone souvent accompagnée d’une atrophie testiculaire, et à une azoospermie. Des doses élevées et régulières de produits peuvent aussi causer des effets, modérés à sévères, de féminisation sous la forme de gynécomastie. L’apparition de caractères sexuels secondaires de type masculin est un effet secondaire de l’abus de SA chez les femmes. Une résistance augmentée à l’insuline et une hyperglycémie à jeun constituent les effets secondaires non gonadiques les plus courants des SA.

L’abus de SA amène des modifications comportementales et psychiatriques contradictoires et complexes. On a rapporté une augmentation de la fréquence des maladies mentales chez les utilisateurs abusifs de stéroïdes anabolisants, incluant la schizophrénie paranoïde, la manie et la dépression. Une dépendance physique et psychologique survient chez certains utilisateurs abusifs, et des troubles psychiatriques sévères peuvent apparaître lors du sevrage, conduisant dans quelques cas à la criminalité et même au suicide. Des études plus nombreuses sont nécessaires quant aux effets à long terme des SA. Les implications de l’abus de SA pendant les 50 dernières années sont discutées dans la revue.

Mots clés

stéroïdes anabolisants stéroïdes anabolisants androgéniques testostérone effets secondaires sport athlètes dépendance revue réversibilité chronique 

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© Société d’Andrologie de Langue Française 2003

Authors and Affiliations

  • Alan James George
    • 1
  1. 1.Liverpool John Moores UniversityLondon

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