AASs are prescribed by physicians to treat a variety of medical conditions (Bagatell & Bremner, 1996). The most accepted use is for treating boys and men unable to produce normal levels of their own testosterone, a condition known as testosterone deficiency or hypogonadism. AASs are also used to treat a rare skin condition called hereditary angioedema, certain forms of anemia (deficiency of red blood cells), advanced breast cancer, and endometriosis (a painful condition in females in which tissue usually found only in the uterus develops in other body parts). AASs are also combined with female hormones to treat distressing symptoms that can accompany menopause. Experimentally, AASs have been used to treat a condition in which bone loss occurs (osteoporosis), to treat impotency and low sexual desire, and as a male birth control pill. In addition, AASs have been used in the treatment of Acquired Immune Deficiency Syndrome (AIDS) to stimulate appetite, weight gain, strength, and improvements in mood. Most of these medical uses are uncommon, either because the conditions are rare (such as angioedema) or because other treatments are preferred (such as erythropoeitin for anemia). Nevertheless, AASs are important medicines to have available.
Nonmedically, AASs are used to enhance athletic performance, physical appearance, and fighting ability. Since society endows people who look physically fit and attractive with many benefits and recognition, some individuals see AASs as a means to those benefits. Three groups of AAS users have been described:
Most illegal anabolic steroids are sold at gyms, competitions, and through mail order operations; some of those commonly encountered are pictured. (Drug Enforcement Administration)
1. The athlete group aims to win at any cost. The athlete also believes, sometimes correctly, that the competition is using AASs. The anticipated rewards to the athlete are the glory of victory, social recognition and popularity, and financial incentives (college scholarships, major league contracts).
2. The aesthete group aims to create a beautiful body, as if to make the body into a work of art. Aesthetes may be competitive bodybuilders, or aspiring models, actors, or dancers. They put their bodies on display to obtain admiration and financial rewards.
3. This group of AAS users seeks to enhance their ability to fight or intimidate. They include body guards, security guards, prison guards, police, soldiers, bouncers, and gang members. These people depend on fighting for their very survival.
Whether AASs actually work to improve performance and appearance has been debated. Invariably, users believe AASs do work, but some scientific studies have failed to show an effect.
However, there are serious limitations to how these studies were done and what they could show. In general, most researchers agree that AASs can work in some individuals to enhance muscle size and strength when combined with a proper exercise program and diet (Bagatell & Brenner, 1996; Bhasin et al., 1996). By contrast, AASs probably do not improve performance of aerobic or endurance activities (Yesalis, 2000).
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