Anabolic-androgenic steroids (AAS) are synthetically produced variants of the naturally occurring male sex hormone testosterone. “Anabolic” refers to muscle-building, and “androgenic” refers to increased male sexual characteristics. “Steroids” refers to the class of drugs. These drugs can be legally prescribed to treat conditions resulting from steroid hormone deficiency, such as delayed puberty, as well as diseases that result in loss of lean muscle mass, such as cancer and AIDS.
- How Are Anabolic-Androgenic Steroids Abused?
- How Do AAS Affect the Brain?
- AAS and Mental Health
- Addictive Potential
- What Other Adverse Effects Do AAS Have on Health?
- What Treatment Options Exist?
- How Widespread Is AAS Abuse?
How Are AAS Abused?
Some people, both athletes and nonathletes, abuse AAS in an attempt to enhance performance and/or improve physical appearance. AAS are taken orally or injected, typically in cycles rather than continuously. “Cycling” refers to a pattern of use in which steroids are taken for periods of weeks or months, after which use is stopped for a period of time and then restarted. In addition, users often combine several different types of steroids in an attempt to maximize their effectiveness, a practice referred to as “stacking.”
How Do AAS Affect the Brain?
The immediate effects of AAS in the brain are mediated by their binding to androgen (male sex hormone) and estrogen (female sex hormone) receptors on the surface of a cell. This AAS–receptor complex can then shuttle into the cell nucleus to influence patterns of gene expression. Because of this, the acute effects of AAS in the brain are substantially different from those of other drugs of abuse. The most important difference is that AAS are not euphorigenic, meaning they do not trigger rapid increases in the neurotransmitter dopamine, which is responsible for the “high” that often drives substance abuse behaviors. However, long-term use of AAS can eventually have an impact on some of the same brain pathways and chemicals—such as dopamine, serotonin, and opioid systems—that are affected by other drugs of abuse. Considering the combined effect of their complex direct and indirect actions, it is not surprising that AAS can affect mood and behavior in significant ways.
Next: AAS and Mental Health
Pope HG Jr, Kouri EM, Hudson JI. Effects of supraphysiologic doses of testosterone on mood and aggression in normal men: A randomized controlled trial. Arch Gen Psychiatry 57(2):133–140, 2000.
Pope HG Jr, Katz DL. Affective and psychotic symptoms associated with anabolic steroid use. Am J Psychiatry 145(4):487–490, 1988.
Arnedo MT, Salvador A, Martinez-Sanchis S, Gonzalez-Bono E. Rewarding properties of testosterone in intact male mice: A pilot study. Pharmacol Biochem Behav 65:327–332, 2000.
DiMeo AN, Wood RI. Self-administration of estrogen and dihydrotestosterone in male hamsters. Horm Behav 49(4):519–526, 2006.
Brower KJ. 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.
Find out what women really need.