title: Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement.
abstract: Despite the high prevalence of performance-enhancing drug (PED) use, media attention has focused almost entirely on PED use by elite athletes to illicitly gain a competitive advantage in sports, and not on the health risks of PEDs. There is a widespread misperception that PED use is safe or that adverse effects are manageable. In reality, the vast majority of PED users are not athletes but rather nonathlete weightlifters, and the adverse health effects of PED use are greatly underappreciated. This scientific statement synthesizes available information on the medical consequences of PED use, identifies gaps in knowledge, and aims to focus the attention of the medical community and policymakers on PED use as an important public health problem. PED users frequently consume highly supraphysiologic doses of PEDs, combine them with other PEDs and/or other classical drugs of abuse, and display additional associated risk factors. PED use has been linked to an increased risk of death and a wide variety of cardiovascular, psychiatric, metabolic, endocrine, neurologic, infectious, hepatic, renal, and musculoskeletal disorders. Because randomized trials cannot ethically duplicate the large doses of PEDs and the many factors associated with PED use, we need observational studies to collect valid outcome data on the health risks associated with PEDs. In addition, we need studies regarding the prevalence of PED use, the mechanisms by which PEDs exert their adverse health effects, and the interactive effects of PEDs with sports injuries and other high-risk behaviors. We also need randomized trials to assess therapeutic interventions for treating the adverse effects of PEDs, such as the anabolic-androgen steroid withdrawal syndrome. Finally, we need to raise public awareness of the serious health consequences of PEDs.
authors.affiliation: McLean Hospital (H.G.P.), Harvard Medical School, Belmont, Massachusetts 02478; University of Southern California (R.I.W.), Los Angeles, California 90089; University of Virginia (A.R.), Charlottesville, Virginia 22904; Department of Pharmaceutical Biosciences, (F.N.), Upsala University, SE-751 24, Upsala, Sweden; United States Anti-Doping Agency (L.B.), Colorado Springs, Colorado 80919; and Brigham and Women's Hospital (S.B.), Harvard Medical School, Boston, Massachusetts 02115.
authors.forename: Harrison G
authors.initials: HG
authors.lastname: Pope
authors.forename: Ruth I
authors.initials: RI
authors.lastname: Wood
authors.forename: Alan
authors.initials: A
authors.lastname: Rogol
authors.forename: Fred
authors.initials: F
authors.lastname: Nyberg
authors.forename: Larry
authors.initials: L
authors.lastname: Bowers
authors.forename: Shalender
authors.initials: S
authors.lastname: Bhasin
mesh_terms: D045930:Anabolic Agents / Q000009:adverse effects*; D000728:Androgens / Q000009:adverse effects*; D004921:Erythropoietin / Q000009:adverse effects*; D019382:Human Growth Hormone / Q000009:adverse effects*; D006801:Humans; D007328:Insulin / Q000009:adverse effects*; D058573:Performance-Enhancing Substances / Q000009:adverse effects*; D012955:Societies, Medical / Q000592:standards*
chemical_list: D045930:Anabolic Agents; D000728:Androgens; D007328:Insulin; D058573:Performance-Enhancing Substances; D004921:Erythropoietin; D019382:Human Growth Hormone