Anabolic Androgenic Steroids: No Longer on the Fringes of Endocrinology
Abstract
In this review, “Anabolic Androgenic Steroids,” or “AAS” is used as the preferred term to indicate the use of exogenous androgens in supraphysiologic doses for the purpose of muscle growth or image enhancement. This definition does not include the use of physiologic doses of testosterone prescribed for the treatment of male hypogonadism. Although there is disagreement regarding the accuracy of this terminology, AAS continues to be one of the most common designations used in the literature today.
References
Pope HG Jr, Wood RI, Rogol A, Nyberg F, Kanayama G, Harrison AJ, et al. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocr Rev. 2014;35(3):341-375. doi: 10.1210/er.2013-1058
Handelsman DJ. Androgen misuse and abuse. Endocr Rev. 2021;42(4):457-501. doi: 10.1210/endrev/bnab001
Bonnecaze AK, O’Connor T, Aloi JA. Characteristics and attitudes of men using anabolic androgenic steroids (AAS): a survey of 2385 men. Am J Mens Health. 2020;14(6):1557988320966536. doi: 10.1177/1557988320966536
Grant B, Hyams E, Davies R, Minhas S, Jayasena CN. Androgen abuse: risks and adverse effects in men. Ann N Y Acad Sci. 2024;1538(1):56-70. doi: 10.1111/nyas.15187
Smit DL, Verdegaal T, Bond P, de Ronde W. Approach to the young male patient who abuses androgens: harm reduction as a clinical strategy. J Clin Endocrinol Metab. 2025;111(1):e292-e297. doi: 10.1210/clinem/dgaf496
Anawalt BD. Diagnosis and management of anabolic androgenic steroid use. J Clin Endocrinol Metab. 2019;104(7):2490-2500. doi: 10.1210/jc.2018-01882
Ganson KT, Hallward L, Cunningham ML, Murray SB, Nagata JM. Anabolic-androgenic steroid use: patterns of use among a national sample of Canadian adolescents and young adults. Perform Enhanc Health. 2023;11(1):100241. doi: 10.1016/j.peh.2022.100241
Smit DL, de Hon O, Venhuis BJ, den Heijer M, de Ronde W. Baseline characteristics of the HAARLEM study: 100 male amateur athletes using anabolic androgenic steroids. Scand J Med Sci Sports. 2020;30(3):531-539. doi: 10.1111/sms.13592
Solanki P, Eu B, Smith J, Allan C, Lee K. Physical, psychological and biochemical recovery from anabolic steroid-induced hypogonadism: a scoping review. Endocr Connect. 2023;12(12):e230358. doi: 10.1530/EC-23-0358
Bond P, Smit DL, de Ronde W. Anabolic-androgenic steroids: how do they work and what are the risks? Front Endocrinol (Lausanne). 2022;13:1059473. doi: 10.3389/fendo.2022.1059473
Duiven E, van Loon LJC, Spruijt L, Koert W, de Hon OM. Undeclared doping substances are highly prevalent in commercial sports nutrition supplements. J Sports Sci Med. 2021;20(2):328-338. doi: 10.52082/jssm.2021.328
Goldman AL, Pope HG, Bhasin S. The health threat posed by the hidden epidemic of anabolic steroid use and body image disorders among young men. J Clin Endocrinol Metab. 2019;104(4):1069-1074. doi: 10.1210/jc.2018-01706
Anawalt BD. Barbells and Ken: bodybuilders and androgenic steroid abuse. J Clin Endocrinol Metab. 2024;109(6):e1452–e1453. doi: 10.1210/clinem/dgad683
Rahnema CD, Lipshultz LI, Crosnoe LE, Kovac JR, Kim ED. Anabolic steroid-induced hypogonadism: diagnosis and treatment. Fertil Steril. 2014;101(5):1271-1279. doi: 10.1016/j.fertnstert.2014.02.002
Borowiec A, Waluszewska I, Jurkiewicz M, Szczurek Wasilewicz W. Impact of anabolic–androgenic steroid abuse on the cardiovascular system: molecular mechanisms and clinical implications. Int J Mol Sci. 2025;26:11037. doi:10.3390/ijms262211037
Nieschlag E, Vorona E. Mechanisms in endocrinology: medical consequences of doping with anabolic androgenic steroids: effects on reproductive functions. Eur J Endocrinol. 2015;173(2):R47-R58. doi: 10.1530/EJE-15-0080
Ganson KT, Nagata JM. Surveys on androgen abuse: a review of recent research. Curr Opin Endocrinol Diabetes Obes. 2023;30(6):291-299. doi: 10.1097/MED.0000000000000833
Bonnecaze AK, O’Connor T, Burns CA. Harm reduction in male patients actively using anabolic androgenic steroids (AAS) and performance-enhancing drugs (PEDs): a review. J Gen Intern Med. 2021;36(7):2055-2064. doi: 10.1007/s11606-021-06751-3
Grant B, Pradeep A, Minhas S, Dhillo WS, Quinton R, Jayasena CN. Survey of endocrinologists managing recovery from anabolic androgenic steroid induced hypogonadism. Reprod Fertil. 2023;4(1):e220097. doi:10.1530/RAF 22 0097.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Canadian Diabetes & Endocrinology Today

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.