As athletics has become a prosperous international business and source of entertainment, use of anabolic steroids to potentially aid athletic performance has increased. When did this practice start? How do anabolic steroids exert their effects? What are the usual patterns of steroid use by athletes? Are the hazards of steroid use overstated? This well-documented article clearly explains a complex and often controversial subject. Use of anabolic steroids is widespread in the athletic community, especially among power athletes, who have used them for about 30 years. Despite educational and preventive measures, steroid use has increased. Controversy continues regarding the enhancement of athletic performance and the incidence of major side effects. Some investigators have suggested that the hazards of anabolic steroids may be overstated in the diseased population and are minimal or absent in healthy subjects. Yet, many questions are unanswered. Current data do not link life-threatening side effects with intermittent use of anabolic steroids. However, many concerns remain. Dangerous situations include use of anabolic steroids by adolescents, preadolescents, and persons with liver or heart disease and use of oral compounds in high doses for long periods. A coordinated team appraoch (with representatives from sports, medicine, advertising, and the pharmaceutical industry) is needed to determine the real risks of anabolic steroids to athletes who are considering their use.
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