Androgenic--anabolic steroids and body dysmorphia in young men.Anabolic androgenic steroids AAS are artificial substances, acting through androgen receptors and natural bodybuilding steroid use primarily developed for the treatment of hypogonadism, tumors, hypercalcemia, hypercalcuria and other chronic diseases. The discovery, in the early s that these substances may have other benefits related to improvement in physique and athletic anabolik androjenik steroidler, has encouraged anabolik androjenik steroidler use of these substances by amateur and professional athletes and members of the general public. The range of AAS used can be classified as either endogenous or exogenous. When used for ergogenic or recreational purposes the dosage is more often higher than the recommended dosage, and at supraphysiological levels, AAS can cause a number of serious side effects including liver dysfunction, myocardial infarction and potentially stroke, due to anabolik androjenik steroidler ability to increase platelet and platelet aggregation. Furthermore, these high dosages may or can affect other physiological systems including the immune system.
Cutaneous manifestations of anabolic-androgenic steroid use in athletes. - PubMed - NCBI
Currently, few users of anabolic-androgenic steroids AAS seek substance abuse treatment. But this picture may soon change substantially, because illicit AAS use did not become widespread until the s, and consequently the older members of this AAS-using population - those who initiated AAS as youths in the s - are only now reaching middle age.
Members of this group, especially those who have developed AAS dependence, may therefore be entering the age of risk for cardiac and psychoneuroendocrine complications sufficient to motivate them for substance abuse treatment. We suggest that this treatment should address at least three etiologic mechanisms by which AAS dependence might develop. First, individuals with body image disorders such as "muscle dysmorphia" may become dependent on AAS for their anabolic effects; these body image disorders may respond to psychological therapies or pharmacological treatments.
Second, AAS suppress the male hypothalamic-pituitary-gonadal axis via their androgenic effects, potentially causing hypogonadism during AAS withdrawal. Men experiencing prolonged dysphoric effects or frank major depression from hypogonadism may desire to resume AAS, thus contributing to AAS dependence. AAS-induced hypogonadism may require treatment with human chorionic gonadotropin or clomiphene to reactivate neuroendocrine function, and may necessitate antidepressant treatments in cases of depression inadequately responsive to endocrine therapies alone.
Third, human and animal evidence indicates that AAS also possess hedonic effects, which likely promote dependence via mechanisms shared with classical addictive drugs, especially opioids. Indeed, the opioid antagonist naltrexone blocks AAS dependence in animals.
By inference, pharmacological and psychosocial treatments for human opioid dependence might also benefit AAS-dependent individuals. National Center for Biotechnology Information , U.
Didn't get the message? Add to My Bibliography. Generate a file for use with external citation management software. Epub Feb Abstract Currently, few users of anabolic-androgenic steroids AAS seek substance abuse treatment.
Images from this publication. See all images 1 Free text. A proposed theoretical model showing three hypothesized mechanisms by which anabolic-androgenic steroid AAS dependence may develop. Note that hypothesized predisposing factors are not assumed to be exclusively premorbid traits; as discussed in the text, evidence suggests that the association between these factors and AAS dependence may well be bidirectional in each case, in that AAS use may further exacerbate a premorbid trait.
However, evidence suggests that AAS exposure may exacerbate impulsive and risk-taking symptoms by further increasing sensitivity to reward and decreasing sensitivity for punishment. These hypothesized bidirectional mechanisms are not shown in the figure for reasons of clarity.