Androgenic-Anabolic Steroid-Induced Body Changes in Strength Athletes

Androgenic-Anabolic Steroid-Induced Body Changes in Strength Athletes

BACKGROUND: Some strength athletes use androgenic-anabolic steroids (AAS) to improve body dimensions, though the drugs' long- and short-term effects have not been definitively established.

OBJECTIVE: This study sought to investigate the short- and long-term effects of AAS self-administration on body dimensions and total and regional body composition.

DESIGN: This prospective, unblinded study involved 35 experienced male strength athletes: 19 AAS users (drugs were self-administered) and 16 nonuser controls engaged in their usual training regimens. At baseline, 8 weeks, and 6 weeks after AAS withdrawal (for AAS users) circumferences were measured at 10 sites, and skinfolds measured at 8 sites. To assess differences in AAS regimens, 9 subjects took AAS for 8 weeks (short-AAS) and 10 athletes took AAS for 12 to 16 weeks (long-AAS). Body composition and anthropometry were assessed at baseline, at the end of AAS use, and 6 weeks later. Lean body mass (LBM) was calculated from body weight and percentage fat. Total and regional body composition was measured by dual-energy x-ray absorptiometry.

RESULTS: AAS use increased users' body weight by 4.4 kg and LBM by 4.5 kg, and produced increases in several circumferences. Percentage of fat decreased (17.0% to 16.0%), but fat mass remained unchanged. Changes persisted 6 weeks after drug withdrawal but were not less than those taken at 8 weeks. Bone-free lean mass of all regional body parts increased in subjects taking AAS, but fat mass was unaffected. Short- and long-term AAS users did not differ in any parameter measured at 8 weeks or after drug withdrawal.

CONCLUSION: In AAS users, 8 weeks of self-administered AAS increased body weight, lean body mass, and limb circumferences, but decreased percentage fat compared with controls. Changes remained 6 weeks after drug withdrawal, though for some measurements only partially. AAS stimulated the bone-free lean mass of all body parts, but it did not affect fat mass. Short-term and long-term AAS administration produced comparable effects.

The use of androgenic-anabolic steroids (AAS) in athletes seems to be widespread. As reported by laboratories accredited by the International Olympic Committee (1), these drugs have been the most frequently detected substances in urine samples of athletes. AAS use by elite athletes is of great concern for national and international sports federations because the drugs give users an unfair advantage and produce potentially deleterious health effects (2,3). AAS use is not limited to elite athletes, however, and may be more extensive among recreational and amateur strength athletes, even though the media devote less attention to use in these groups.

Strength athletes often progress to self-administration of AAS to increase muscle mass and strength. Weight lifters and power lifters strive primarily for strength, whereas bodybuilders train for optimal muscle mass and body dimensions (3). Consequently, in all strength athletes increased muscle mass is desirable. Only a few studies have investigated the effects of AAS on muscle mass and body dimensions. Unfortunately, data are equivocal, and many questions remain to be answered.

Our study sought answers to three questions: (1) Which body measurements and composition are altered in strength athletes when they use several AAS simultaneously? (2) Does self-administration of AAS exert distinct effects on the separate components of regional body composition? and (3) What impact does the duration of AAS use have on anthropometry and body composition?

Methods

Subjects and their AAS use. Strength athletes were recruited with advertisements at local gyms. Inclusion criteria were: male, at least 3 years of strength training experience, and age between 20 and 45 years. Candidates excluded were those who smoked or had hypertension, diabetes mellitus, liver disease or abnormal liver enzyme levels, hereditary hypercholesterolemia, elevated serum cholesterol levels (>6.5 mmol/L), or infertility. Before participating, all subjects completed a questionnaire containing questions about medical history, health status, training experience and status, nutrition, nutritional supplement use, and AAS use.

After the initial screening, each strength athlete underwent a full medical examination by a physician for evaluation of health status and to screen for possible missed exclusion criteria. During the examination, we provided extensive oral and written information about the study to each subject. All subjects signed an informed consent form approved by the Ethical Committee of Maastricht University (Maastricht, The Netherlands).

Thirty-five strength athletes participated in this study. Most athletes (28) performed strength training mainly for esthetic purposes and characterized their training regimen as bodybuilding training; only 7 of these subjects participated in bodybuilding contests. Seven participants were competitors: 3 engaged in strength training as a part of their boxing training in addition to using AAS for esthetic reasons, and 4 athletes were principally involved in resistance training for powerlifting competition.

Among the subjects, 19 had decided to begin using AAS to supplement their regular strength training regimen (AAS group). The remaining 16 volunteers who had not used nor were willing to take AAS served as controls (CO group). The physical and training characteristics of both groups are presented in table 1.

TABLE 1. Baseline Physical and Training Status of Strength Athletes

Characteristic AAS (n = 19) Controls (n = 16)

Age (yr) 31.3 + 7.0 32.8 + 5.3

Height (cm) 176 + 9 177 + 7

Weight (kg) 84.0 + 9.9 88.5 + 11.2

Body fat (%) 17.0 + 5.7 19.4 + 3.6

Training history (yr) 10.0 + 7.3 8.8 + 3.6

Training regimen (hr/wk) 8.8 + 2.5 8.2 + 2.3

Values are expressed as the mean + standard deviation; AAS = androgenic-anabolic steroid

Assessing AAS status. Before entering the study, AAS group members were expected not to have used AAS for at least