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The American College of Sports Medicine acknowledges that AAS, in the presence of adequate diet, can contribute to increases in body weight, often as lean mass increases and that the gains in muscular strength achieved through high-intensity exercise and proper diet can be additionally increased by the use of AAS in some individuals.

These effects include harmful changes in cholesterol levels (increased low-density lipoprotein and decreased high-density lipoprotein), acne, high blood pressure, liver damage (mainly with most oral AAS), and dangerous changes in the structure of the left ventricle of the heart.

AAS use in adolescence is also correlated with poorer attitudes related to health. Development of breast tissue in males, a condition called gynecomastia (which is usually caused by high levels of circulating estradiol), may arise because of increased conversion of testosterone to estradiol by the enzyme aromatase.

Another male-specific side-effect that can occur is testicular atrophy, caused by the suppression of natural testosterone levels, which inhibits production of sperm (most of the mass of the testes is developing sperm).

Studies indicate that the anabolic properties of AAS are relatively similar despite the differences in pharmacokinetic principles such as first-pass metabolism.

However, the orally available forms of AAS may cause liver damage in high doses.

AAS use occurs among adolescents, especially by those participating in competitive sports. There are four common forms in which AAS are administered: oral pills; injectable steroids; creams/gels for topical application; and skin patches. Testosterone administered by mouth is rapidly absorbed, but it is largely converted to inactive metabolites, and only about one-sixth is available in active form.

For example, AAS may prematurely stop the lengthening of bones (premature epiphyseal fusion through increased levels of estrogen metabolites), resulting in stunted growth.

Other effects include, but are not limited to, accelerated bone maturation, increased frequency and duration of erections, and premature sexual development.

Conditions pertaining to hormonal imbalances such as gynecomastia and testicular size reduction may also be caused by AAS.[citation needed] Ergogenic uses for AAS in sports, racing, and bodybuilding as performance-enhancing drugs are controversial because of their adverse effects and the potential to gain unfair advantage in physical competitions.

Their use is referred to as doping and banned by most major sporting bodies.




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