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Use of steroids for self-enhancement: an epidemiologic/societal perspective.

AIDS Reader 2001 March
Humans are basically competitive. For centuries, athletes have used various substances to enhance performance, increase strength, and prolong endurance. In the early 1940s, research indicating that testosterone improved a sense of well-being, appearance, and sexual performance led to the use of anabolic steroid hormones by a select few athletes. Today, even among high school students, the use of androgenic steroid hormones is prevalent, with 1% to 2% of adolescent girls and 4% to 6% of adolescent boys having used an anabolic steroid at least once. An estimated 1 million people in the United States are current of former users of anabolic-androgenic steroid hormones, with men having a higher prevalence of use than women. Androgenic steroid use has been associated with the use of other illicit drugs, cigarette smoking, and alcohol use. Nevertheless, anabolic-androgenic steroid hormones appear to have legitimate uses in certain patients. In HIV-infected, hypogonadal men, anabolic steroid hormones optimize muscle strength and muscle mass when combined with resistance exercise. Although a large number of people have used these drugs for many years, no studies of the long-term health effects have been done. However, when taken in supraphysiologic doses, these drugs are known to cause a wide range of acute adverse effects. When used in less then supraphysiologic doses in eugonadal or hypogonadal HIV-infected patients, these drugs reverse HIV-related hypogonadism, muscle wasting, and perhaps lipodystrophy. Provided that the oral preparations are not used and patients are closely monitored, anabolic-androgenic steroid hormones offer HIV-infected patients a better quality of life and an improved sense of well-being.

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