Androgenic anabolic steroids: awareness of indiscriminate use, use in therapy and risk-benefit ratio

Abstract

Anabolic-androgenic steroids (AAE) are molecules derived from the hormone testosterone. AAE have important positive effects in the treatment of different diseases. However, the harmful effects arising from the indiscriminate use of AAE is currently aggravated by the appeal of the aesthetic perfection that these substances are supposed to bring, making the general population to neglect its risks that can lead to serious health problems, including death. In this context, this review brings an analysis of studies available in different databases, which address when and under what conditions the safe use of AAE is advised in medical practice, weighing the associated risk-benefit ratio. Since used in therapeutic doses and monitored by health professionals, besides being useful for treating puberty disturbances, AAE can also be beneficial during the treatment of various pathologies, including muscular dystrophy, sarcopenia, bone marrow failure, myelofibrosis, chronic kidney disease, as well as recovering functionality in patients who need for mechanical ventilation or those ones with prolonged stay in intensive care units and in postoperative periods. On the other hand, there is a need for public health policies to promote greater awareness by health professionals and the population in general (mainly bodybuilders), instituting practices that allow an understanding of the context in which this therapeutic class is appropriate, since serious health risks associated with the indiscriminate use of these endocrine disruptors is related to considerable rates of morbidity and mortality.