Androgen abuse in athletes: detection and consequences.
BACKGROUND
Doping with anabolic androgenic steroids (AAS) both in sports (especially power sports) and among specific subsets of the population is rampant. With increasing availability of designer androgens, significant efforts are needed by antidoping authorities to develop sensitive methods to detect their use.


METHODS
The PubMed and Google Scholar search engines were used to identify publications addressing various forms of doping, methods employed in their detection, and adverse effects associated with their use.


RESULTS
The list of drugs prohibited by the World Anti-Doping Agency (WADA) has grown in the last decade. The newer entries into this list include gonadotropins, estrogen antagonists, aromatase inhibitors, androgen precursors, and selective androgen receptor modulators. The use of mass spectrometry has revolutionized the detection of various compounds; however, challenges remain in identifying newer designer androgens because their chemical signature is unknown. Development of high throughput bioassays may be an answer to this problem. It appears that the use of AAS continues to be associated with premature mortality (especially cardiovascular) in addition to suppressed spermatogenesis, gynecomastia, and virilization.


CONCLUSIONS
The attention that androgen abuse has received lately should be used as an opportunity to educate both athletes and the general population regarding their adverse effects. The development of sensitive detection techniques may help discourage (at least to some extent) the abuse of these compounds. Investigations are needed to identify ways to hasten the recovery of the gonadal axis in AAS users and to determine the mechanism of cardiac damage by these compounds.
Department of Medicine, Division of Endocrinology and Metabolism, Boston University School of Medicine, Boston, Massachusetts 02118, USA. shehzad.basaria@bmc.org
Shehzad
S
Basaria
D000328:Adult; D045930:Anabolic Agents / Q000009:adverse effects*; D000728:Androgens / Q000009:adverse effects*; D004300:Doping in Sports / Q000266:history; D004965:Estrogen Antagonists / Q000494:pharmacology; D007987:Gonadotropin-Releasing Hormone / Q000494:pharmacology; D006062:Gonadotropins / Q000494:pharmacology; D049673:History, 20th Century; D006801:Humans; D008297:Male; D013058:Mass Spectrometry; D053580:Muscle Strength / Q000187:drug effects; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders / Q000150:complications* / Q000175:diagnosis*; D013739:Testosterone / Q000097:blood; D055815:Young Adult
D045930:Anabolic Agents; D000728:Androgens; D004965:Estrogen Antagonists; D006062:Gonadotropins; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone