The health effects of non‐prescribed anabolic–androgenic steroid use: Findings from The Performance and image‐enhancing drugs UseRS' Health (PUSH) audit

Author:

Dunn Matthew12ORCID,Dawe Joshua3,Eu Beng45,Lee Kevin6,Piatkowski Timothy7ORCID,Stoové Mark3

Affiliation:

1. School of Health and Social Development Deakin University Geelong Australia

2. Institute for Health Transformation Deakin University Geelong Australia

3. Burnet Institute Melbourne Australia

4. Prahran Market Clinic Melbourne Australia

5. Melbourne Medical School, University of Melbourne Melbourne Australia

6. Monash University Melbourne Australia

7. School of Applied Psychology Griffith University Gold Coast Australia

Abstract

AbstractIntroductionTo ascertain the adverse health outcomes experienced by those using prescribed testosterone and non‐prescribed anabolic–androgenic steroids presenting to general practitioner (GP) clinics.MethodsRetrospective clinical audit from nine GP clinics in major metropolitan areas across three Australian states. Data included demographic and individual characteristics (age, sexuality, body mass index, smoking status and HIV status); performance and image‐enhancing drug use (type, reasons for use, patient‐reported adverse effects); and blood biochemistry measurements (lipid profiles, liver function tests and red blood cell tests). Adverse health outcomes included evidence of polycythaemia, hypertension, liver abnormalities and hypercholesterolemia.ResultsThree hundred men were identified as either using prescribed testosterone (66%; n = 197) or non‐prescribed anabolic–androgenic steroids (AAS) (34%; n = 103). Individuals in the prescribed group were more likely to be older (p < 0.001), gay or bisexual (p < 0.001) and living with diagnosed HIV (p < 0.001) compared to individuals in the non‐prescribed group. Abnormal liver function, polycythemia and gynecomastia were the top three adverse events experienced. When adjusting for age, sexuality, HIV status and smoking status, those who used non‐prescribed AAS were more likely to experience any adverse event (aPR = 1.28; 95% CI 1.01–1.60; p = 0.038), hypertension (aPR = 1.86; 95% CI 1.19–2.91; p = 0.006) and liver abnormalities (aPR = 1.51; 95% CI 1.04–2.20; p = 0.030) compared to those using prescribed testosterone.Discussion and ConclusionFor GPs who have clients who may be using, or who they suspect of using, AAS, these findings highlight the importance of not only exploring a patient's history of the adverse effects they have experienced, but that measuring for these other conditions may provide a more accurate clinical picture.

Publisher

Wiley

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