Adverse Effects of Anabolic-Androgenic Steroids: A Literature Review
Open accessAbstract
Anabolic-androgenic steroids (AASs) are a large group of molecules including endogenously produced androgens, such as testosterone, as well as synthetically manufactured derivatives. AAS use is widespread due to their ability to improve muscle growth for aesthetic purposes and athletes’ performance, minimizing androgenic effects. AAS use is very popular and 1–3% of US inhabitants have been estimated to be AAS users. However, AASs have side effects, involving all organs, tissues and body functions, especially long-term toxicity involving the cardiovascular system and the reproductive system, thereby, their abuse is considered a public health issue. The aim of the proposed review is to highlight the most recent evidence regarding the mechanisms of action of AASs and their unwanted effects on organs and lifestyle, as well as suggesting that AAS misuse and abuse lead to adverse effects in all body tissues and organs. Oxidative stress, apoptosis, and protein synthesis alteration are common mechanisms involved in AAS-related damage in the whole body. The cardiovascular system and the reproductive system are the most frequently involved apparatuses. Epidemiology as well as the molecular and pathological mechanisms involved in the neuropsychiatric side-effects of AAS abuse are still unclear, further research is needed in this field. In addition, diagnostically reliable tests for AAS abuse should be standardized. In this regard, to prevent the use of AASs, public health measures in all settings are crucial. These measures consist of improved knowledge among healthcare workers, proper doping screening tests, educational interventions, and updated legislation.
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Potential side effects of testosterone and anabolic, androgenic steroids usage can be cardiovascular disease, liver damage, testicular atrophy, gynecomastia, and kidney damage.
“For example, potential side effects of testosterone and anabolic, androgenic steroids usage can be cardiovascular disease, liver damage, testicular atrophy, breast development in men (gynecomastia), and kidney damage [43, 205].”
From Effects of Skeletal Muscle Hypertrophy on Fat Mass and Glucose Homeostasis in Humans and Animals: A Narrative Review with Systematic Literature Search (2025) · cites this paper as [43]
The review describes cardiovascular harm (§4.3), hepatotoxicity (§4.4), kidney damage (§4.5), and gynecomastia in the context of AAS abuse (§4.7); page numbers are unavailable in our copy. Section 4.7 discusses impaired sperm production and hypogonadism, but does not identify testicular atrophy as a side effect. (LLM, conf=0.88)
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References 140 · Cited by 200
- Authors
- Albano, G. D., Amico, F., Cocimano, G., Liberto, A., Maglietta, F., Esposito, M., Rosi, G. L., Di Nunno, N., Salerno, M., & Montana, A.
- Affiliations
- University of Catania (IT)
- University of Foggia (IT)
- Magna Graecia University (IT)
- Department of History, Society and Studies on Humanity, University of Salento, 73100 Lecce, Italy
- Corresponding author
- Montana, Angelo
- ORCID
- Venue
- Healthcare
- Publisher
- MDPI AG
- Published
- 2021-01-19
- Volume
- 9
- Issue
- 1
- Pages
- 97
- ISSN
- 2227-9032 (ISSN-L)
- PMC
- PMC7832337
- OpenAlex
- W3122456433
- Cited by
- 200
- References
- 140
- Citations by year
- 2026: 31 · 2025: 44 · 2024: 43 · 2023: 36 · 2022: 29 · 2021: 17
- FWCI
- 4.80
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Healthcare (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Università Politecnica delle Marche (Università Politecnica delle Marche) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion, other-oa)
- AIRUS (submittedVersion)
- Funders
- Università di Catania
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Social Sciences › Sociology and Political Science › Doping in Sports
- Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Pharmacological Effects and Assays
- Keywords
- anabolic steroids, adverse effects, testosterone, doping, cardiotoxicity, reproductive toxicity, oxidative stress, apoptosis, protein synthesis, neuropsychiatric adverse effects, public health prevention, performance-enhancing drugs
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