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    Anabolic steroids stimulate growth in many types of tissues, especially bone and muscle. Anabolic effects also include increased production of red blood cells. Androgens and anabolic steroids are used as replacement therapy to treat delayed puberty in adolescent boys, hypogonadism and impotence in men, and to treat breast cancer in women. Clinicians should investigate the use of anabolic-androgenic steroids in middle-aged males and young men who present with coronary artery disease (cad) and left ventricular dysfunction. [12] moreover, healthcare providers should obtain a careful history and drugs-use habits in patients presenting with hypogonadism before prescribing testosterone. Figure 1 illustrates the pathophysiology of anabolic-androgenic steroid (aas)–induced hypogonadism (asih) and the mechanism of action of selected treatment strategies. A 30-year-old male presented to the emergency department with dyspnea, fatigue, orthopnea, and paroxysmal nocturnal dyspnea for the past three months. The patient admitted to anabolic steroid use for the past 11 years. Transthoracic echocardiography was significant for severely dilated left ventricle, diffuse hypokinesis, ejection fraction < 15%, and grade ii diastolic dysfunction. This review summarizes 10 years experience with male abusers of anabolic androgenic steroids (aas). The typical user of aas is male, aged between 20 and 40 and lifting weights. Illegal aas are cheap and easily obtained via internet or local suppliers. Aas are mostly used in cycles with a duration between 6 and 18 weeks. Dimeo an, wood ri. Self-administration of estrogen and dihydrotestosterone in male hamsters. Horm behav 49(4):519–526, 2006. Anabolic steroid abuse and dependence. Curr psychiatry rep 4(5):377–387, 2002. Arvary d, pope hg jr. Anabolic-androgenic steroids as a gateway to opioid dependence. N engl j med 342:1532, 2000. [] a 1989 study demonstrated the period of hypogonadism after androgenic-anabolic steroid cessation in male hemodialysis patients. Anabolic androgenic steroid abuse can lead to serious cardiovascular and psychiatric adverse reactions. If abuse is suspected, check testosterone levels to ensure they are in therapeutic range. Counsel patients concerning the serious adverse reactions associated with abuse of testosterone and anabolic androgenic steroids. Conclusions: prior anabolic androgenic steroid use is common in young men who seek treatment for symptomatic hypogonadism and anabolic steroid induced hypogonadism is the most common etiology of profound hypogonadism. These findings suggest that it is necessary to refocus the approach to evaluation and treatment paradigms in young hypogonadal men. Steroids are used in medicine to treat certain conditions, such as inflammation and hypogonadism. Anabolic steroids are more commonly associated with their use in sport to enhance muscle mass. Most steroid users are not athletes. In the united states, between 1 million and 3 million people (1% of the population) are thought to have used aas. Studies in the united states have shown that aas users tend to be mostly middle-class heterosexual men with a median age of about 25 who are noncompetitive bodybuilders and non-athletes and use the drugs for cosmetic purposes. Anabolic-androgenic steroids (aas) are steroidal androgens which include natural androgens such as male sex hormone testosterone or could be synthetic to mimic the action of the endogenous male hormone Anabolic agents are prohibited at all times, both in- and out-of-competition in collegiate and professional sports and appear on both the World Anti-Doping Agency (WADA) and U, anabolic-androgenic steroids hypogonadism in males.
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