Skip to main content

Advertisement

SpringerLink
Log in

Doping with anabolic androgenic steroids (AAS): Adverse effects on non-reproductive organs and functions

  • Published:
Reviews in Endocrine and Metabolic Disorders Aims and scope Submit manuscript

Abstract

Since the 1970s anabolic androgenic steroids (AAS) have been abused at ever increasing rates in competitive athletics, in recreational sports and in bodybuilding. Exceedingly high doses are often consumed over long periods, in particular by bodybuilders, causing acute or chronic adverse side effects frequently complicated by additional polypharmacy. This review summarizes side effects on non-reproductive organs and functions; effects on male and female reproduction have been recently reviewed in a parallel paper. Among the most striking AAS side effects are increases in haematocrit and coagulation causing thromboembolism, intracardiac thrombosis and stroke as well as other cardiac disturbances including arrhythmias, cardiomyopathies and possibly sudden death. 17α-alkylated AAS are liver toxic leading to cholestasis, peliosis, adenomas and carcinomas. Hyperbilirubinaemia can cause cholemic nephrosis and kidney failure. AAS abuse may induce exaggerated self-confidence, reckless behavior, aggressiveness and psychotic symptoms. AAS withdrawal may be accompanied by depression and suicidal intentions. Since AAS abuse is not or only reluctantly admitted physicians should be aware of the multitude of serious side effects when confronted with unclear symptoms,

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Pope Jr HG, Wood RI, Rogol A, Nyberg F, Bowers L, Bhasin S. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocr Rev. 2014;35:341–75.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  2. Geyer H, Schänzer W, Thevis M. Anabolic agents: recent strategies for their detection and protection from inadvertent doping. Br J Sports Med. 2014;48:820–6.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Sagoe D, Molde H, Andreassen CS, Torsheim T, Pallesen S. The global epidemiology of anabolic-androgenic steroid use: a meta-analysis and meta-regression analysis. Ann Epidemiol. 2014;24:383–98.

    Article  PubMed  Google Scholar 

  4. Brennan BP, Kanayama G, Pope Jr HG. Performance-enhancing drugs on the web: a growing public-health issue. Am J Addict. 2013;22:158–61.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Striegel H, Simon P, Frisch S, Roecker K, Dietz K, Dickhuth HH, et al. Anabolic ergogenic substance users in fitness-sports: a distinct group supported by the health care system. Drug Alcohol Depend. 2006;81:11–9.

    Article  PubMed  Google Scholar 

  6. Hecker A. Der Schmerz blüht. Frankfurter Allgemeine Zeitung 18.10.2014 Nr. 242, p. 40.

  7. Fischer-Solms H. Spitzensport: Doping in Ost und West. In: Wir gegen uns: Sport im geteilten Deutschland. Darmstadt: Primus-Verlag; 2009. pp. 111–21.

  8. Nieschlag E, Vorona E. Medical consequences of doping with anabolic androgenic steroids (AAS): effects on reproductive functions. Eur J Endocrinol. 2015.03.24.

  9. Shahidi NT. A review of the chemistry, biological action, and clinical applications of anabolic-androgenic steroids. Clin Ther. 2001;23:1355–90.

    Article  PubMed  CAS  Google Scholar 

  10. Turillazzi E, Perilli G, Di Paolo M, Neri M, Riezzo I, Fineschi V. Side effects of AAS abuse: an overview. Mini Rev Med Chem. 2011;11:374–89.

    Article  PubMed  CAS  Google Scholar 

  11. Hero M, Wickman S, Hanhijärvi R, Siimes MA, Dunkel L. Pubertal upregulation of erythropoiesis in boys is determined primarily by androgen. J Pediatr. 2005;146:245–52.

    Article  PubMed  CAS  Google Scholar 

  12. Coviello AD, Kaplan B, Lakshman KM, Chen T, Singh AB, Bhasin S. Effects of graded doses of testosterone on erythropoiesis in healthy young and older men. J Clin Endocrinol Metab. 2008;93:914–9.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  13. Zitzmann M, Nieschlag E. Androgen receptor gene CAG repeat length and body mass index modulate the safety of long-term intramuscular testosterone undecanoate therapy in hypogonadal men. J Clin Endocrinol Metab. 2007;92:3844–53.

    Article  PubMed  CAS  Google Scholar 

  14. Wang C, Nieschlag E, Swerdloff R, Behre HM, Hellstrom WJ, Gooren LJ, et al. Investigation, treatment and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA and ASA recommendations. Eur J Endocrinol. 2008;15:507–14.

    Article  CAS  Google Scholar 

  15. Rochira V, Zirilli L, Madeo B, Maffei L, Carani C. Testosterone action on erythropoiesis does not require its aromatization to estrogen: insights from the testosterone and estrogen treatment of two aromatase-deficient men. J Steroid Biochem Mol Biol. 2009;113:189–94.

    Article  PubMed  CAS  Google Scholar 

  16. Sakhri S, Gooren LJ. Safety aspects of androgen treatment with 5α-dihydrotestosterone. Andrologia. 2007;39:216–22.

    Article  PubMed  CAS  Google Scholar 

  17. Maggio M, Snyder PJ, Ceda GP, Milaneschi Y, Luci M, Cattabiani C, et al. Is the haematopoietic effect of testosterone mediated by erythropoietin? The results of a clinical trial in older men. Andrology. 2013;1:24–8.

    Article  PubMed  CAS  Google Scholar 

  18. Bachman E, Travison TG, Basaria S, Davda MN, Guo W, Li M, et al. Testosterone induces erythrocytosis via increased erythropoietin and suppressed hepcidin: evidence for a new erythropoietin/hemoglobin set point. J Gerontol A Biol Sci Med Sci. 2014;69:725–35.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  19. Palacios A, Campfield LA, McClure RD, Steiner B, Swerdloff RS. Effect of testosterone enanthate on hematopoiesis in normal men. Fertil Steril. 1983;40:100–4.

    PubMed  CAS  Google Scholar 

  20. De Caro L, Ghizzi A. Effect of testosterone on the in vitro proliferation of bone marrow granulocyte-macrophage cells (CFU-GM). II. Observations in hypogonadal subjects. Boll Soc Ital Biol Sper. 1989;65:203–10.

    PubMed  Google Scholar 

  21. Ferenchick GS, Hirokawa S, Mammen EF, Schwartz KA. Anabolic-androgenic steroid abuse in weight lifters: evidence for activation of the hemostatic system. Am J Hematol. 1995;49:282–8.

    Article  PubMed  CAS  Google Scholar 

  22. Shapiro J, Christiana J, Frishman W. Testosterone and other anabolic steroids as cardiovascular drugs. Am J Ther. 1999;6:167–74.

    Article  PubMed  CAS  Google Scholar 

  23. Zitzmann M, Junker R, Kamischke A, Nieschlag E. Contraceptive steroids influence the hemostatic activation state in healthy men. J Androl. 2002;23:503–11.

    PubMed  CAS  Google Scholar 

  24. Kahn NN, Sinha AK, Spungen AM, Bauman WA. Effects of oxandrolone, an anabolic steroid, on hemostasis. Am J Hemato. 2006;81:95–100.

    Article  CAS  Google Scholar 

  25. Alén M. Androgenic steroid effects on liver and red cells. Br J Sports Med. 1985;19:15–20.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Nieschlag E, Behre HM, Nieschlag S, editors. Andrology: male reproductive health and dysfunction. 3rd ed. Heidelberg: Springer; 2010. p. 437–55.

    Google Scholar 

  27. Clasing D, Müller RK. Dopingkontrolle. Sportverlag Strauß. 2008;5. Auflage.

  28. Sjöqvist F, Garle M, Rane A. Use of doping agents, particularly anabolic steroids, in sports and society. Lancet. 2008;371:1872–82.

    Article  PubMed  CAS  Google Scholar 

  29. Lippi G, Banfi G. Doping and thrombosis in sports. Semin Thromb Hemost. 2011;37:918–28.

    Article  PubMed  CAS  Google Scholar 

  30. Youssef MY, Alqallaf A, Abdella N. Anabolic androgenic steroid-induced cardiomyopathy, stroke and peripheral vascular disease. BMJ Case Rep. 2011;2011. doi:10.1136/bcr.12.2010.3650.

  31. Shamloul RM, Aborayah AF, Hashad A, Abd-Allah F. Anabolic steroids abuse-induced cardiomyopathy and ischaemic stroke in a young male patient. BMJ Case Rep. 2014;2014. doi:10.1136/bcr-2013-203033.

  32. Schollert PV, Bendixen PM. Dilated cardiomyopathy in a user of anabolic steroids. Ugeskr Laeger. 1993;155:1217–8.

    PubMed  CAS  Google Scholar 

  33. Ferrera PC, Putnam DL, Verdile VP. Anabolic steroid use as the possible precipitant of dilated cardiomyopathy. Cardiology. 1997;88:218–20.

    Article  PubMed  CAS  Google Scholar 

  34. Vogt AM, Geyer H, Jahn L, Schänzer W, Kübler W. Cardiomyopathy associated with uncontrolled self medication of anabolic steroids. Z Kardiol. 2002;91:357–62.

    Article  PubMed  CAS  Google Scholar 

  35. Clark BM, Schofield RS. Dilated cardiomyopathy and acute liver injury associated with combined use of ephedra, gamma-hydroxybutyrate and anabolic steroids. Pharmacotherapy. 2005;25:756–61.

    Article  PubMed  Google Scholar 

  36. Kistler L. Todesfälle bei Anabolikamissbrauch. Todesursache, Befunde und rechtsmedizinische Aspekte. Dissertation zum Erwerb des Doktorgrades der Medizin an der medizinischen Fakultät der Ludwig-Maximilians-Universität zu München. 2006.

  37. Stergiopoulos K, Brennan JJ, Mathews R, Setaro JF, Kort S. Anabolic steroids, acute myocardial infarction and polycythemia: a case report and review of the literature. Vasc Health Risk Manag. 2008;4:1475–80.

    PubMed  PubMed Central  Google Scholar 

  38. Ahlgrim C, Guglin M. Anabolics and cardiomyopathy in a bodybuilder: case report and literature review. J Card Fail. 2009;15:496–500.

    Article  PubMed  Google Scholar 

  39. Bispo M, Valente A, Maldonado R, Palma R, Glória H, Nóbrega J, et al. Anabolic steroid-induced cardiomyopathy underlying acute liver failure in a young bodybuilder. World J Gastroenterol. 2009;15:2920–2.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Fanton L, Belhani D, Vaillant F, Tabib A, Gomez L, Descotes J, et al. Heart lesions associated with anabolic steroid abuse: comparison of post-mortem findings in athletes and norethandrolone-induced lesions in rabbits. Exp Toxicol Pathol. 2009;61:317–23.

    Article  PubMed  CAS  Google Scholar 

  41. Montisci M, El Mazloum R, Cecchetto G, Terranova C, Ferrara SD, Thiene G, et al. Anabolic androgenic steroids abuse and cardiac death in athletes: morphological and toxicological findings in four fatal cases. Forensic Sci Int. 2012;217:e13–8.

    Article  PubMed  CAS  Google Scholar 

  42. Thiblin I, Mobini-Far H, Frisk M. Sudden unexpected death in a female fitness athlete, with a possible connection to the use of anabolic androgenic steroids (AAS) and ephedrine. Forensic Sci Int. 2009;184:e7–11.

    Article  PubMed  CAS  Google Scholar 

  43. Elashoff JD, Jacknow AD, Shain SG, Braunstein GD. Effects of anabolic-androgenic steroids on muscular strength. Ann Intern Med. 1991;115:387–93.

    Article  PubMed  CAS  Google Scholar 

  44. Bhasin S, Storer TW, Berman N, Callegari C, Clevenger B, Phillips J, et al. The effects of supraphysiologic doses of testosterone on muscle size and strength in normal men. N Engl J Med. 1996;335:1–7.

    Article  PubMed  CAS  Google Scholar 

  45. Bhasin S, Ravi J, Serra C, Singh R, Storer TW, Guo W, Travison TG, Basaria S. Androgen effects on the skeletal muscle. In: Nieschlag E, Behre HM, editors. Testosterone: action, deficiency, substitution. Cambridge University Press; 2012. Pp. 191–206.

  46. Yu JG, Bonnerud P, Eriksson A, Stål PS, Tegner Y, Malm C. Effects of long term supplementation of anabolic androgen steroids on human skeletal muscle. PLoS ONE. 2014;9:1–11.

    Article  Google Scholar 

  47. Nielsen TL, Hagen C, Wraae K, Bathum L, Larsen R, Brixen K, et al. The impact of the CAG repeat polymorphism of the androgen receptor gene on muscle and adipose tissues in 20-29-year-old Danish men: Odense Androgen Study. Eur J Endocrinol. 2010;162:795–804.

    Article  PubMed  CAS  Google Scholar 

  48. Esteban E, Rodon N, Via M, Gonzalez-Perez E, Santamaria J, Dugoujon JM, et al. Androgen receptor CAG and GGC polymorphisms in Mediterraneans: repeat dynamics and population relationships. J Hum Genet. 2006;51:129–36.

    Article  PubMed  CAS  Google Scholar 

  49. Ackerman CM, Lowe LP, Lee H, Hayes MG, Dyer AR, Metzger BE, et al. Ethnic variation in allele distribution of the androgen receptor (AR) (CAG)n repeat. J Androl. 2012;33:210–5.

    Article  PubMed  CAS  Google Scholar 

  50. Egner IM, Bruusgaard JC, Eftestøl E, Gundersen K. A cellular memory mechanism aids overload hypertrophy in muscle long after an episodic exposure to anabolic steroids. J Physiol. 2013;591:6221–30.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  51. Vanderschueren D, Vandenput L, Boonen S, Lindenberg M, Bouillon R, Ohlsson C. Androgens and bone. Endocr Rev. 2004;25:389–425.

    Article  PubMed  CAS  Google Scholar 

  52. Vanderschueren D, Sinnesael M, Gielen E, Claessens F, Boonen S. Testosterone and bone. In: Nieschlag E, Behre HM, editors. Testosterone: action, deficiency, substitution. Cambridge University Press; 2012. Pp. 177–99

  53. Rolf C, Nieschlag E. Potential adverse effects of long-term testosterone therapy. Bailliere Clin Endocrinol Metab. 1998;12:521–34.

    Article  CAS  Google Scholar 

  54. Przkora R, Jeschke MG, Barrow RE, Suman OE, Meyer WJ, Finnerty CC, et al. Metabolic and hormonal changes of severely burned children receiving long-term oxandrolone treatment. Ann Surg. 2005;242:384–9.

    PubMed  PubMed Central  Google Scholar 

  55. Farkash U, Shabshin N, Pritsch Perry M. Rhabdomyolysis of the deltoid muscle in a bodybuilder using anabolic-androgenic steroids: a case report. J Athl Train. 2009;44:98–100.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Hall RC, Hall RC. Abuse of supraphysiologic doses of anabolic steroids. South Med J. 2005;98:550–5.

    Article  PubMed  Google Scholar 

  57. Horn S, Gregory P, Guskiewicz KM. Self-reported anabolic-androgenic steroids use and musculoskeletal injuries: findings from the center for the study of retired athletes health survey of retired NFL players. Am J Phys Med Rehabil. 2009;88:192–200.

    Article  PubMed  Google Scholar 

  58. Schutzel MM, Johnson MH, Rosenthal HG. Bilateral deltoid myositis ossificans in a weightlifter using anabolic steroids. Orthopedics. 2014;37:844–7.

    Article  Google Scholar 

  59. Channer KS, Jones TH. Testosterone and cardiovascular disease. In: Nieschlag E, Behre HM, editors. Testosterone: action, deficiency, substitution. Cambridge University Press; 2012. pp 207–34.

  60. Corona G, Maseroli E, Rastrelli G, Isidori AM, Sforza A, Mannucci E, et al. Cardiovascular risk associated with testosterone-boosting medications: a systematic review and meta-analysis. Expert Opin Drug Saf. 2014;13:1327–51.

    Article  PubMed  CAS  Google Scholar 

  61. Morgentaler A, Miner MM, Caliber M, Guay AT, Khera M, Traish AM. Testosterone therapy and cardiovascular risk: advances and controversies. Mayo Clin Proc. 2015;90:224–51.

    Article  PubMed  CAS  Google Scholar 

  62. Hartgens F, Rietjens G, Keizer HA, Kuipers H, Wolffenbuttel BH. Effects of androgenic-anabolic steroids on apolipoproteins and lipoprotein (a). Br J Sports Med. 2004;38:253–9.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  63. Kindermann W. Kardiovaskuläre Nebenwirkungen von anabol-androgenen Steroiden. Herz. 2006;31:566–73.

    Article  PubMed  Google Scholar 

  64. Bonetti A, Tirelli F, Catapano A, Dazzi D, Dei Cas A, Solito F, et al. Side effects of anabolic androgenic steroids abuse. Int J Sports Med. 2008;29:679–87.

    Article  PubMed  CAS  Google Scholar 

  65. Carson P, Hong CJ, Otero-Vinas M, Arsenault EF, Falanga V. Liver enzymes and lipid levels in patients with lipodermatosclerosis and venous ulcers treated with a prototypic anabolic steroid (stanozolol): a prospective, randomized, double-blinded, placebo-controlled trial. Int J Low Extrem Wounds. 2015;14:11–8.

    Article  PubMed  CAS  Google Scholar 

  66. Singh AB, Hsia S, Alaupovic P, Sinha-Hikim I, Woodhouse L, Buchanan TA, Shen R, Bross R, Berman N, Bhasin S. The effects of varying doses of T on insulin sensitivity, plasma lipids, apolipoproteins, and C-reactive protein in healthy young men. J Clin Endocrinol Metab. 2002;136–43.

  67. Gåverik N, Strahm E, Garlw M, Lundmark J, Ståhle L, Ekström L, et al. Long term perturbation of endocrine parameters and cholesterol metabolism after discontinued abuse of anabolic androgenic steroids. J Steroid Mol Biol. 2011;127:295–300.

    Article  CAS  Google Scholar 

  68. Achar S, Rostamian A, Narayan SM. Cardiac and metabolic effects of anabolic-androgenic steroid abuse on lipids, blood pressure, left ventricular dimensions, and rhythm. Am J Cardiol. 2010;106:893–901.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  69. Urhausen A, Albers T, Kindermann W. Are the cardiac effects of anabolic steroid abuse in strength athletes reversible? Heart. 2004;90:496–501.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  70. Sculthorpe N, Grace F, Jones P, Davies B. Evidence of altered cardiac electrophysiology following prolonged androgenic anabolic steroid use. Cardiovasc Toxicol. 2010;10:239–43.

    Article  PubMed  CAS  Google Scholar 

  71. Akçakoyun M, Alizade E, Gündoğdu R, Bulut M, Tabakci MM, Açar G, et al. Long-term anabolic androgenic use is associated with increased atrial electromechanical delay in male bodybuilders. Biomed Res Int. 2014;2014:1–8.

    Article  CAS  Google Scholar 

  72. Alizade E, Avcı A, Fidan S, Tabakçı M, Bulut M, Zehir R, Simsek Z, Evlice M, Arslantaş U, Çakır H, Emiroglu MY, Akçakoyun M. The effect of chronic a nabolic-androgenic steroid use on Tp-E interval, Tp-E/Qt ratio, and Tp-E/Qtc ratio in male bodybuilders. Ann Noninvasive Electrocardiol. 2015. doi:10.1111/anec.12256.

  73. Dickerman RD, Shaller F, McConathy WJ. Left ventricular wall thickening does occur in elite power athletes with or without anabolic steroid use. Cardiology. 1998;90:145–8.

    Article  PubMed  CAS  Google Scholar 

  74. Karila TA, Karjalainen JE, Mäntysaari MJ, Viitasalo MT, Seppälä TA. Anabolic androgenic steroids produce dose-dependant increase in left ventricular mass in power athletes, and this effect is potentiated by concomitant use of growth hormone. Int J Sports Med. 2003;24:337–43.

    Article  PubMed  CAS  Google Scholar 

  75. Lind JM, Chiu C, Ingles J, Yeates L, Humphries SE, Heather AK, et al. Sex hormone receptor gene variation associated with phenotype in male hypertrophic cardiomyopathy patients. J Mol Cell Cardiol. 2008;45:217–22.

    Article  PubMed  CAS  Google Scholar 

  76. De Piccoli B, Giada F, Benettin A, Sartori F, Piccolo E. Anabolic steroid use in body builders: an echocardiographic study of the left ventricle morphology and function. Int J Sports Med. 1991;12:408–12.

    Article  PubMed  Google Scholar 

  77. Di Bello V, Giorgi D, Bianchi M, Bertini A, Caputo MT, Valenti G, Furioso O, Alessandri L, Paterni M, Giusti C. Effects of anabolic-androgenic steroids on weight-lifters’ myocardium: an ultrasonic videodensitometric study. Med Sci Sports Exerc. 1999;514–21.

  78. Caso P, D’Andrea A, Caso I, Severino S, Calabrò P, Allocca F, et al. The athlete’s heart and hypertrophic cardiomyopathy: two conditions which may be misdiagnosed and coexistent. Which parameters should be analysed to distinguish one disease from the other? J Cardiovasc Med (Hagerstown). 2006;7:257–66.

    Article  Google Scholar 

  79. Luijkx T, Velthuis BK, Backx FJG, Buckens CFM, Prakken NHJ, Rienks R, et al. Anabolic androgenic steroid use is associated with ventricular dysfunction on cardiac MRI in strength trained athletes. Int J Cardiol. 2013;167:664–8.

    Article  PubMed  Google Scholar 

  80. Baumann S, Jabbour C, Huseynov A, Borggrefe M, Haghi D, Papavassiliu T. Myocardial scar detected by cardiovascular magnetic resonance in a competitive bodybuilder with longstanding abuse of anabolic steroids. Asian J Sports Med. 2014;5, e24058.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Nascimento AD, de Lima E, Boёchat G, Meyrelles S, Bissoli N, Lenz D, Endringer D, de Andrade T. Testosterone induces apoptosis in cardiomyocytes by increasing proapoptotic signaling involving tumor necrosis factor-α and renin angiotensin system. Hum Exp Toxicol. 2015. doi:10.1177/0960327115571766.

  82. Sondergaard EB, Thune JJ, Gustafsson F. Characteristics and outcome of patients referred for management of advanced heart failure due to anabolic-androgenic steroid abuse. Scand Cardiovasc J. 2014;21:1–11.

    Google Scholar 

  83. Franke WW. Dualism in cardiac pathogenesis: illicit use of anabolic-androgenic steroids in a shot-put athlete homozygous for a missense desmoglein-2 (Dsg2) mutation. Cell Tissue Res. 2012;348:335–70.

    Article  PubMed Central  Google Scholar 

  84. Friedrich FW, Carrier L. Genetics of hypertrophic and dilated cardiomyopathy. Curr Pharm Biotechnol. 2012;13:2467–76.

    Article  PubMed  CAS  Google Scholar 

  85. Maisch B, Richter A, Sandmöller A, Porting I, Pankuweit S. Inflammatory dilated cardiomyopathy (DCMI). Herz. 2005;30:535–44.

    Article  PubMed  Google Scholar 

  86. Nieschlag E. Is the use of methyltestosterone obsolete? Dtsch Med Wochenschr. 1981;106:1123–5.

    Article  PubMed  CAS  Google Scholar 

  87. El Sherrif Y, Potts JR, Howard MR, Barnardo A, Cairns S, Knisely AS, et al. Hepatotoxicity from anabolic androgenic steroids marketed as dietary supplements: contribution from ATP8B1/ABCB11 mutations? Liver Int. 2013;33:1266–70.

    Article  PubMed  Google Scholar 

  88. Basaria S. Androgen abuse in athletes: detection and consequences. J Clin Endocrinol Metab. 2010;95:1533–43.

    Article  PubMed  CAS  Google Scholar 

  89. Robles-Diaz M, Gonzalez-Jimenez A, Medina-Caliz I, Stephens C, García-Cortes M, García-Muñoz B, et al. Distinct phenotype of hepatotoxicity associated with illicit use of anabolic androgenic steroids. Aliment Pharmacol Ther. 2015;41:116–25.

    Article  PubMed  CAS  Google Scholar 

  90. Nakao A, Sakagami K, Nakata Y, Komazawa K, Amimoto T, Nakashima K, et al. Multiple hepatic adenomas caused by long-term administration of androgenic steroids for aplastic anemia in association with familial adenomatous polyposis. J Gastoenterol. 2000;35:557–62.

    Article  CAS  Google Scholar 

  91. Shah NL, Zacharias I, Khettry U, Afdhal N, Gordon FD. Methasteron-associated cholestatic liver injury: clinicopathologic findings in 5 cases. Clin Gastroenterol Hepatol. 2008;6:255–8.

    Article  PubMed  CAS  Google Scholar 

  92. Socas L, Zumbado M, Pérez-Luzardo O, Ramos A, Pérez C, Hernández JR, et al. Hepatocellular adenomas associated with anabolic androgenic steroid abuse in bodybuilders: a report of two cases and a review of the literature. Br J Sports Med. 2005;39, e27.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  93. Giannitrapani L, Soresi M, La Spada E, Cervello M, D’Alessandro N, Montalto G. Sex hormones and risk of liver tumor. Ann N Y Acad Sci. 2006;1089:228–36.

    Article  PubMed  CAS  Google Scholar 

  94. Hardt A, Stippel D, Odenthal M, Hölscher AH, Dienes HP, Drebber U. Development of hepatocellular carcinoma associated with anabolic androgenic steroid abuse in a young bodybuilder: a case report. Case Rep Pathol. 2012;195607. doi:10.1155/2012/195607.

  95. Solbach P, Potthoff A, Raatschen HJ, Soudah B, Lehmann U, Schneider A, et al. Testosterone-receptor positive hepatocellular carcinoma in a 29-year old bodybuilder with a history of anabolic androgenic steroid abuse: a case report. BMC Gastroenterol. 2015;15:60. doi:10.1186/s12876-015-0288-0.

    Article  PubMed  PubMed Central  Google Scholar 

  96. Johnson CA. Use of androgens in patients with renal failure. Semin Dial. 2000;13:36–9.

    Article  PubMed  CAS  Google Scholar 

  97. Luciano RL, Castano E, Moeckel G, Perazella MA. Bile acid nephropathy in a bodybuilder abusing an anabolic androgenic steroid. Am J Kidney Dis. 2014;64:473–6.

    Article  PubMed  Google Scholar 

  98. Rosenfeld GA, Chang A, Poulin M, Kwan P, Yoshida E. Cholestatic jaundice, acute kidney injury and acute pancreatitis secondary to the recreational use of methandrostenolone: a case report. J Med Case Rep. 2011;5:138.

    Article  PubMed  PubMed Central  Google Scholar 

  99. Unai S, Miessau J, Karbowski P, Baram M, Cavarocchi NC, Hirose H. Caution for anabolic androgenic steroid use: a case report of multiple organ dysfunction syndrome. Respir Care. 2013;58:e159–63.

    Article  PubMed  Google Scholar 

  100. Deshmukh N, Petroczi A, Barker J, Szekely AD, Hussain I, Naughton DP. Potentially harmful advantage to athletes: a putative connection between UGT2B17 gene deletion polymorphism and renal disorders with prolonged use of anabolic androgenic steroids. Subst Abuse Treat Prev Policy. 2010;5:1–7.

    Article  Google Scholar 

  101. Zhu AZ, Cox LS, Ahluwalia JS, Renner CC, Hatsukami DK, Benowitz NL, et al. Genetic and phenotypic variation in UGT2B17, a testosterone-metabolizing enzyme, is associated with BMI in males. Pharmacogenet Genomics. 2015;25:263–9.

    Article  PubMed  CAS  Google Scholar 

  102. Parkinson AB, Evans NA. Anabolic androgenic steroids: a survey of 500 users. Med Sci Sports Exerc. 2006;38:644–51.

    Article  PubMed  CAS  Google Scholar 

  103. Piacentino D, Kotzalidis GD, Del Casale A, Aromatario MR, Pomara C, Girardi P, et al. Anabolic-androgenic steroid use and psychopathology in athletes. A systematic review. Curr Neuropharmacol. 2015;13:101–21.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  104. Pope CG, Pope HG, Menard W, Fay C, Olivardia R, Phillips KA. Clinical features of muscle dysmorphia among males with body dysmorphic disorder. Body Image. 2005;2:395–400.

    Article  PubMed  PubMed Central  Google Scholar 

  105. Björk T, Skåberg K, Engström I. Eating disorders and anabolic androgenic steroids in males – similarities and differences in self-image and psychiatric symptoms. Subst Abuse Treat Prev Policy. 2013;8:1–7.

    Article  Google Scholar 

  106. Blashill AJ, Safren SA. Sexual orientation and anabolic-androgenic steroids in U.S. adolescent boys. Pediatrics. 2014;133:469–75.

    Article  PubMed  PubMed Central  Google Scholar 

  107. Virmani A, Ali SF, Binienda ZK. Neuroprotective strategies in drug abuse-evoked encephalopathy. Ann N Y Acad Sci. 2010;1199:52–68.

    Article  PubMed  CAS  Google Scholar 

  108. Pomara C, Neri M, Bello S, Fiore C, Riezzo I, Turillazzi E. Neurotoxicity by synthetic androgen steroids: oxidative stress, apoptosis, and neuropathology: a review. Curr Neuropharmacol. 2015;13:132–45.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  109. Lindqvist AS, Moberg T, Eriksson BO, Ehrnborg C, Rosén T, Fahlke C. A retrospective 30-year follow-up study of former Swedish-elite male athletes in power sports with a past anabolic androgenic steroids use: a focus on mental health. Br J Sports Med. 2013;47:965–9.

    Article  PubMed  CAS  Google Scholar 

  110. Kanayama G, Brower KJ, Wood RI, Hudson JI, Pope Jr HG. Treatment of anabolic-androgenic steroid dependence: emerging evidence and its implications. Drug Alcohol Depend. 2010;109:6–13.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  111. Skarberg K, Nyberg F, Engstrom I. Multisubstance use as a feature of addiction to anabolic-androgenic steroids. Eur Addict Res. 2009;15:99–106.

    Article  PubMed  Google Scholar 

  112. Lundholm L, Frisell T, Lichtenstein P, Långström N. Anabolic androgenic steroids and violent offending: confounding by polysubstance abuse among 10,365 general population men. Addiction. 2015;110:100–8.

    Article  PubMed  Google Scholar 

  113. Thiblin I, Lindquist O, Rajs J. Cause and manner of death among users of anabolic androgenic steroids. J Forensic Sci. 2000;45:16–23.

    Article  PubMed  CAS  Google Scholar 

  114. Kersey RD, Elliot DL, Goldberg L, Kanayama G, Leone JE, Pavlovich M, et al. National Athletic Trainers’ Association position statement: anabolic-androgenic steroids. J Athl Train. 2012;47:567–88.

    PubMed  PubMed Central  Google Scholar 

  115. Thevis M, Kuuranne T, Geyer H, Schänzer W. Annual banned-substance review: analytical approaches in human sports drug testing. Drug Test Anal. 2015;7:1–20.

    Article  PubMed  CAS  Google Scholar 

  116. Sottas PE, Vernec A. Current implementation and future of the athlete biological passport. Bioanalysis. 2012;4:1645–52.

    Article  PubMed  CAS  Google Scholar 

  117. Pokrywka A, Kaliszewski P, Majorczyk E, Zembroń-Łacny A. Genes in sport and doping. Biol Sport. 2013;30:155–61.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

Download references

Acknowledgments

The authors thank Susan Nieschlag M.A. for language editing and Maria Schalkowski for processing the manuscript.

Conflict of interest

The authors declare no conflicts of interest.

Author information

Authors and Affiliations

  1. Centre of Reproductive Medicine and Andrology, University of Münster, Münster, Germany

    Eberhard Nieschlag

  2. Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia

    Eberhard Nieschlag

  3. Centre of Endocrinology, Diabetology and Rheumatology, Dortmund, Germany

    Elena Vorona

Authors
  1. Eberhard Nieschlag
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elena Vorona
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eberhard Nieschlag.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nieschlag, E., Vorona, E. Doping with anabolic androgenic steroids (AAS): Adverse effects on non-reproductive organs and functions. Rev Endocr Metab Disord 16, 199–211 (2015). https://doi.org/10.1007/s11154-015-9320-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11154-015-9320-5

Keywords

Search

Navigation