The frequency of formation of a motivated refusal to take androgenic anabolic steroids by men with recreational activity

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BACKGROUND: The widespread use of AAS for non-medical purposes is more than often becoming the cause of secondary hypogonadism. The study of the formation of the negative attitude towards the use of AAS among the gym visitors is quite relevant.

AIMS: To identify the frequency of the formation of a motivated refusal to continue taking androgenic anabolic steroids among men who voluntarily declared their use.

MATERIALS AND METHODS: The study included 44 men, all users of AAS. There has been estimated the effectiveness of the clinical examination: how ready they were to disclose information about the use of AAS (drugs, doses, regimens, duration) or how much they were aware of the mechanisms of action of AAS and their effects on the body. The participants were also asked to evaluate their psychological and emotional state (on the scale “Index of life satisfaction”, Hamilton’s depression, aggressiveness). The experience of our informational lectures on the topic “Risks of using AAS” prior to the selection of volunteers for research, anonymous surveys and interviews with potential participants in the clinical trial, the clinical work itself with the selected volunteers, the characteristic features of a medical history and tests that we identified were compared with clinical recommendations for hypogonadism diagnostic (domestic and foreign).

RESULTS: More than 105 gym visitors responded positively to a motivated offer (free medical consultation and laboratory tests) to participate in a clinical study. Based on the results of the individual interview, 54 men (51.4%) who indicated the use of AAS signed an informed consent. 44 volunteers (41.9%) completed all stages of the study. Among them, 32 participants (72.7%) were aware of the mechanisms of action and side effects of AAS. 21 volunteers (47.7%) filled in the scales. The index of life satisfaction was determined as high, equal to 34 [29; 38] points; the index of aggressiveness was higher than the generally accepted standard and composed 27 [25; 29] points, the level of depression corresponded to a mild depressive disorder, equal to 9 [3; 12] points. Over the use of AAS 22.7% (n = 10) of the examined noted an increase in aggressiveness, which they themselves associated with the use of steroids. The clinical symptoms of hypogonadism (decreased libido, erectile dysfunction) after the cancellation of AAS were indicated by 25% (n = 11) of the volunteers and that was one of the reasons they continued to use anabolics. 31.8% (n = 14) of the participants were ready to completely stop using the steroids.

CONCLUSIONS: Individual informational interviews aimed at providing knowledge about the negative effects of steroids on the body motivated the desire to stop using them amongst 31.8% of AAS users. The obtained data points out to a developed AAS addiction which requires the involvement of psychiatrists to get rid of it.

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About the authors

Mykola P. Lykhonosov

Pavlov First Saint Petersburg State Medical University; Saint-Petersburg State University

Author for correspondence.
ORCID iD: 0000-0001-6460-5226
SPIN-code: 2102-5358

Russian Federation, 6/8, Lva Tolstogo street, St. Petersburg, 197089; 7/9, Universitetskaya embankment, Saint-Petersburg, 199034


Alina Yu. Babenko

Pavlov First Saint Petersburg State Medical University; Almazov National Medical Research Centre

ORCID iD: 0000-0002-0559-697X
SPIN-code: 9388-1077

Russian Federation, 6/8, Lva Tolstogo street, St. Petersburg, 197089; 2, Akkuratova str., Saint- Petersburg, 197341


Viktor A. Makarin

Saint-Petersburg State University

ORCID iD: 0000-0003-1710-8045
SPIN-code: 8885-2085

Russian Federation, 7/9, Universitetskaya embankment, Saint-Petersburg, 199034


Yury  N. Fedotov

Saint-Petersburg State University

ORCID iD: 0000-0003-0445-9428

Russian Federation, 7/9, Universitetskaya embankment, Saint-Petersburg, 199034

MD, PhD, Professor


  1. Levine H, Jørgensen N, Martino-Andrade A, et al. Temporal trends in sperm count: a systematic review and meta-regression analysis. Hum Reprod Update. 2017;23(6):646-659. doi:
  2. Travison TG, Araujo AB, O’Donnell AB, et al. A population-level decline in serum testosterone levels in American men. J Clin Endocrinol Metab. 2007;92(1):196-202. doi:
  3. Jarow JP, Lipshultz LI. Anabolic steroid-induced hypogonadotropic hypogonadism. Am J Sports Med. 1990;18(4):429-431. doi:
  4. Coward RM, Rajanahally S, Kovac JR, et al. Anabolic steroid induced hypogonadism in young men. J Urol. 2013;190(6):2200-2205. doi:
  5. Sagoe D. Methods used in a meta-analysis and meta-regression analysis of the global epidemiology of anabolic-androgenic steroid use. Publishing Company: SAGE Publications, Ltd; 2014. doi:
  6. Lykhonosov MP, Babenko AYu. The medical aspect of using anabolic androgenic steroids in males attending gyms of Saint-Petersburg. Problemy endokrinologii. 2019;65(1):19-30. doi: 10.14341/probl9832
  7. Pope HG, Kanayama G, Ionescu-Pioggia M, Hudson JI. Anabolic steroid users’ attitudes towards physicians. Addiction. 2004;99(9): 1189−1194. doi:
  8. Pope HG, Kanayama G. Treatment of anabolic-androgenic steroid related disorders. Textbook of addiction treatment: International perspectives. Springer Link. 2014. рр. 621-636. doi:
  9. Order № 780n Ministry Of Health Russia «Ob utverzhdenii standarta pervichnoy mediko-sanitarnoi pomoshchi pri gipogonadizme», dated 2012 Nov 9.
  10. Karelin A. Bol’shaia entsiklopediia psikhologicheskikh testov. Moscow: Exmo; 2007. 416 р.
  11. Dermanova IB. Diagnostika emotsional’no-nravstvennogo razvitiia. St. Petersburg: Rech’; 2002. 171 р.
  12. Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56−62. doi:
  13. Bland M. An introduction to medical statistics (Oxford Medical Publications). 3rd ed. Oxford University Press, Oxford; 2000. рр. 335-347.
  14. McBride JA, Carson CC, Coward RM. The availability and acquisition of illicit anabolic androgenic steroids and testosterone preparations on the Internet. Am J Mens Health. 2018;12(5):1352-1357. doi:
  15. Kanayama G, Brower KJ, Wood RI, et al. Anabolic-androgenic steroid dependence: an emerging disorder. Addiction. 2009;104(12): 1966-1978. doi:
  16. Beutel A, Bergamaschi CT, Campos RR. Effects of chronic anabolic steroid treatment on tonic and reflex cardiovascular control in male rats. J Steroid Biochem Mol Biol. 2005;93(1):43-48. doi:
  17. Brower KJ. Anabolic steroid abuse and dependence in clinical practice. Phys Sportsmed. 2009;37(4):131-140. doi:
  18. Dodge T, Hoagland MF. The use of anabolic androgenic steroids and polypharmacy: a review of the literature. Drug Alcohol Depend. 2011;114(2−3):100-109. doi:
  19. Wood RI. Anabolic-androgenic steroid dependence? Insights from animals and humans. Front Neuroendocrinol. 2008;29(4):490-506. doi:
  20. Nyberg F, Hallberg M. Interactions between opioids and anabolic androgenic steroids: implications for the development of addictive behavior. Int Rev Neurobiol. 2012;102:189-206. doi:
  21. Gårevik N, Rane A. Dual use of anabolic-androgenic steroids and narcotics in Sweden. Drug Alcohol Depend. 2010;109(1−3):144-146. doi:
  22. Skarberg K, Nyberg F, Engstrom I. Multisubstance use as a feature of addiction to anabolic-androgenic steroids. Eur Addict Res. 2009;15(2):99-106. doi:
  23. Kanayama G, Brower KJ, Wood RI, et al. Issues for DSM-V: clarifying the diagnostic criteria for anabolic-androgenic steroid dependence. Am J Psychiatry. 2009;166(6):642-645. doi:
  24. Park HJ. Anabolic steroid-induced hypogonadism: a challenge for clinicians. J Exerc Rehabil. 2018;14(1):2-3. doi:
  25. Hildebrandt T, Lai JK, Langenbucher JW, et al. The diagnostic dilemma of pathological appearance and performance enhancing drug use. Drug Alcohol Depend. 2011;114(1):1-11. doi:
  26. Kouri EM, Pope HG, Katz DL, Oliva P. Fat-free mass index in users and nonusers of anabolic-androgenic steroids. Clin J Sport Med. 1995;5(4):223-228. doi:
  27. Nieschlag E, Vorona E. Mechanisms in endocrinology: medical consequences of doping with anabolic androgenic steroids: effects on reproductive functions. Eur J Endocrinol. 2015;173(2):R47−58. doi:
  28. De Souza GL, Hallak J. Anabolic steroids and male infertility: a comprehensive review. BJU Int. 2011;108(11):1860-1865. doi:
  29. Melchert RB, Welder AA. Cardiovascular effects of androgenic-anabolic steroids. Med Sci Sports Exerc. 1995;27(9):1252-1262. doi:
  30. Lane HA, Grace F, Smith JC, et al. Impaired vasoreactivity in bodybuilders using androgenic anabolic steroids. Eur J Clin Invest. 2006;36(7):483-488. doi:
  31. Olivardia R, Pope HG, Hudson JI. Muscle dysmorphia in male weightlifters: a case-control study. Am J Psychiatry. 2000;157(8): 1291-1296. doi:
  32. Cole JC, Smith R, Halford JC, Wagstaff GF. A preliminary investigation into the relationship between anabolic-androgenic steroid use and the symptoms of reverse anorexia in both current and ex-users. Psychopharmacology (Berl). 2003;166(4):424-429. doi:
  33. Pope HG, Kouri EM, Hudson JI. Effects of supraphysiologic doses of testosterone on mood and aggression in normal men. Arch Gen Psychiatry. 2000;57(2):133-140; discussion 155-156. doi:

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Copyright (c) 2020 Lykhonosov M.P., Babenko A.Y., Makarin V.A., Fedotov Y.N.

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