Acute and chronic adverse reaction of anabolic–androgenic steroids

SummaryAnabolic–androgenic steroids (anabolic androgens, AAS) are widely abused to enhance performance in sport. The use of AAS chronically or at high dose is associated liver toxicity, sexual dysfunction, and cardiovascular disease. There is, however, no epidemiological evidence for a link between cardiovascular disease and AAS use. Mild but more frequently seen adverse reactions, such as acne and testicular atrophy, disappear when the use is discontinued. Some of the cardiovascular adverse effects of AAS, such as hypertension, dyslipidaemia, and coagulation abnormalities, remit after the cessation of anabolic androgen use, whereas reactions such as atherosclerosis and cardiomyopathy appear to be irreversible. AAS are associated with aggressive behaviour in men, but the underlying personality traits of AAS abusers and concomitant alcohol use, may confound this relationship.