The Effects of Anabolic Androgenic Steroids on Performance and its Adverse Side Effects in AthletesAnabolic-androgenic steroids AAS are used as ergogenic aids by athletes and non-athletes to enhance performance by augmenting muscular development and strength. AAS administration is often associated with various adverse effects that are generally dose related. High and steroid good and bad effects of AAS used for athletic enhancement can lead to serious and irreversible organ damage. Among the most common adverse effects of AAS are some degree of reduced fertility and gynecomastia in males and masculinization in women and children. Other adverse effects include hypertension and atherosclerosis, blood clotting, jaundice, hepatic neoplasms anabolic steroids scientific journal carcinoma, tendon damage, anabolic steroids scientific journal and behavioral disorders.
Adverse effects of anabolic steroids in athletes: A constant threat - ScienceDirect
Anabolic androgenic steroids AAS were initially created for therapeutic purposes, and synthetic derivatives of the male hormone testosterone. Due its great anabolic effects, these drugs are being used on a large scale, for the improvement of sports performance. Sources were reviewed scientific the following search engines: The results showed that in presence of a suitable AAS and diet can contribute to increases in body weight, particularly lean body mass and muscle strength gains achieved by high intensity exercise, these effects can be further potentiated, the use of supraphysiological doses, but in the aspect of aerobic power, there are not scientific evidence to support their improvement.
Regarding side effects, the use of AAS, is related to several complications in the liver, cardiovascular system, reproductive system and psychological characteristics, always assigned by the non-therapeutic and abuse of AAS. Thus we conclude that the use of AAS, are directly linked to gains muscle mass, strength, as well several side effects, always assigned to abusive and indiscriminate doses, it is noteworthy that the scientific literature, still has a certain lack of studies, mainly randomized, controlled, with supraphysiological doses in human, so many effects are still unknown.
Steroids, Sports, Muscle Mass. History of Steroids in Sports 4. Methods and Use of Steroids 5. Introduction The growing cult of the body has characterized the contemporary consumer society thus making the growing importance attached to physical appearance, reflecting itself in the mass media, exposing said models of bodies . In recent years the body has become the target of several techniques to achieve a standard of beauty imposed by the media.
However it is necessary to assess to what extent we risking our health to achieve this standard of beauty, thus contributing to an increasing number of young people who get involved at an earlier age with use of anabolic steroids with muscle development intention quickly .
Steroids have become over the years, a method used to increase strength and muscle mass, increasing user performance and its use has always been used on a large scale in sports, thus improving the performance of users athletes, despite their use is improper . The consumption of these drugs is widely consumed in bodybuilding athletes for years, but the widespread use of these drugs is currently reflecting be in non-athletes and especially in young bodybuilders with purely aesthetic goals .
In Brazil, studies show that the consumption of drugs on these population are scarce. Androgenic anabolic steroids are natural or synthetic compounds similar to the male hormone testosterone, performing changes in their molecular structure in order to delay its absorption into the circulation, minimizing its androgenic actions and maximizing the anabolic .
The vast majority of this drug was developed in the 50s, with the intention of causing only androgen masculinizing effect without anabolic effects, being used only with medical prescription .
Doping is defined as the use of endogenous or exogenous substances in abnormal amounts intended to increase the performance of athletes in competition. Anabolic steroids belong to the class of anabolic agents along with stimulants, narcotics, diuretics, peptide hormones and analogues, composed prohibited substances according to the International Olympic Committee - IOC  .
Anabolic steroids are widely used by athletes, bodybuilders and physically active in general without being professionals. Studies show that the use of these drugs is due to the increase in muscle mass and strength. But the same studies show deficiencies due some studies did not control important aspects such as protein intake, a food plan for the subjects, variations of stimulus in the exercises, some studies include competitive athletes, as it does not specify the control of the cited variables   .
The use of steroids associated with sports practice has always been surrounded by doubts about their benefits and actual harm to health, so the benefits are always observed when using associated with resistance training, aerobic and its harmful effects has been associated with cardiovascular dysfunction, dysfunction hormonal, temperament and other effects that have not been specifically identified . Studies showing the effects on the use of indiscriminate steroids should be increasingly disclosed the population to their actual knowledge.
Like other substances that affect health such as alcohol and tobacco, the use of steroids has become a concern due to its widespread use by individuals younger and younger, which makes this situation in a public health problem. The objective of this study is to conduct a literature review, increasing the texts on the subject, and may thus contribute positively to the discussion and analysis of the material referent to the use of anabolic-androgenic steroids and their use in excess by practitioners of various sports as in the scientific community as to the population.
It also aims to make a review on the history, benefits and side effects of using anabolic steroids. Methods This paper presents a systematic review of survey information and clarification on the subject in specialized articles and journals between and These documents were consulted in virtual libraries as: Between January and June , found articles related to the keywords mentioned.
These items were selected according to the criteria of exclusion and inclusion, in which were excluded papers that related the use of anabolic-androgenic steroids for treatment, disease control and unrelated to sports practices.
At the end, we selected 92 articles with a history of anabolic steroids with the sport, methods and use, sporting performances as strength gains, hypertrophy, aerobic capacity and side effects, always connected to sports practice.
History of Steroids in Sports Throughout history, the search for better physical performance is very old. There are reports that the Greeks developed hallucinogenic mushrooms, gladiators of Rome used natural stimulators, Indians in South America used coca leaves to stimulate, and there are reports in China that used a plant called "machung" to encourage athletes of the time for their battles .
Since then the use of synthetic testosterone was been spread around the world, its use at the time showed the ease of muscle growth . The first synthesis of reports of this drug are and is used during the second world war, with intent to cause aggression to combatants, also being used in therapeutic treatment in burn and post-surgical patients in the 50s was widely used in causing diseases muscle atrophy and anemia . The use of this drug associated with the sport began in also with reports of abuses by Russian athletes this substance, then for weight lifting athletes in so widespread its use in sports media and especially in the bodybuilding world with purpose increasing muscle mass and strength  .
However, its use has shown many adverse effects on the liver, cardiovascular system, reproductive both male and female and psychological behavior  .
The use of the substance gained fame in , when the athlete Fred Ortiz showed a muscle and superior to its competitors in a championship bodybuilding . In Olympic appearance, due to the spread of steroids in , it was announced that the use of any substance that enhances physical performance of athletes would be declared as doping, which entered into force in , but only in the Olympics athletes were really tested .
Due to the intensification of anti-doping tests, the tests were being made throughout the Olympic period before and after the games in the Olympics in Beijing, where 10, athletes, 4, were tested .
With this increased control on the antidoping tests, athletes that were tested positive for the use of steroids, such as Ben Johnson, which in Seoul had been olympic champion for the m and tested positive for stanozolol . After the Johnson episode, various athletes were caught with positive tests, as it was the case of those with nandrolone in the Sydney Olympics, being one of those a gold medalist, Lindford Chirstie .
The athletes with the highest incidence of steroids are in their majority practitioners of activities of strength and speed, being followed by athletes of resistance and collective sports, all of them with the objective of gaining muscle mass, protein synthesis, muscle recuperation and strength .
Amongst the sports which presents the greatest numbers of positive tests for doping, cycling is the first place, with cases. Baseball comes in second place with and football in third with , finally, athleticism comes with positive tests, however, it is the sport with the highest number of tested athletes .
Methods and Use of Steroids The steroid hormones have lipidic origin, being formed from cholesterol and synthesized by organs like gonads, ovaries, adrenal glands, testicles and being classified into three types . First off, there are the androgens, male hormones produced by the testicles, which are fundamental for the male characteristics such: Following, we have estrogen, female hormones, produced by ovaries and that are responsible for the female characteristics .
Lastly, there is the cortisone hormone, produced by both genders, with the anti-inflammatory effect. They are natural hormones associated to the adrenal cortex, have the function of controlling bodily processes, such as cardiovascular, kidney, skeletal muscle and metabolic functions .
Testosterone is responsible for the development of androgenic characteristics as previously said. Its production happens in the Leydig cells, located inside the testicles and in very low numbers inside the ovaries and adrenals. However, on women, this hormone is converted into female hormone in the fat tissues by enzymatic complex aromatase .
The anabolic steroid hormones are derived from the androgen hormones, due to its anabolic properties, being visible in users of these substances, mainly on women. They might be produced in several forms such as sprays, suppositories and skin attachments, however, the most known are the oral and injection forms, even though all the other forms withhold the same anabolic capacities .
Testosterone acts by a direct process. At the moment in which its reactions begin when its molecules penetrate the cell, they bind for some hours to an androgen receptor and migrate to the cell nucleus, finding another receptor, binding to determined regions of the DNA and producing RNAm . After this process, the receptors depart and return to inactivity. These receptors may explain the development of certain muscle groups, as a study has verified that over torso muscles had more receptors than the lower muscles .
In this manner, we may explain the possible difference in muscle mass distribution between men and women, being the amount of receptors the justification to this difference, as shown in the studies of  . The indirect mechanism of testosterone are also known, however, there is still much speculation as to if its indirect effects are anti-catabolic actions by androgen receptors and the glucocorticoids. Androgens compete with catabolic hormones in this manner, such as cortisol, thus reducing its action, preventing protein degradation caused by this hormone.
Furthermore, androgens also might interfere with glucocorticoids production . A hypothesis that had been verified in various studies about the activation of satellite cells, a very important part on hypertrophy, has demonstrated that the injection of testosterone causes proliferation of the satellite cells in little more than a day, occurring the increase in number of mionuclei .
The liver, as responsible for fighting off outside bodies, is harmed by the abusive use of steroids, which causes diverse pathologies such as hepatic malfunction being much associated to oral use, different from injections, as they do not pass through the process of alkalinization, being considered less harmful. However, these have their disadvantages for showing higher nephrotoxicity, due to its absorption by the blood .
A study has shown this use of steroids associated to abusive dosis, up to times more than the therapeutic recommendations by doctors, thus it is possible to affirme that users might use doses of to mg of testosterone weekly . Analysing the diverse forms of steroid use, the mentioned author demonstrates that the use of various substances does not make its use more efficient, as, for a bodybuilder, his concern is the retention of nitrogen for muscle growth.
As all steroids have this action, there is not plausible motive for the use of many . By means of molecular manipulation, it is possible to alter the biochemical structure of testosterone, which creates other derived substances with androgenic anabolic effects and are divided into three classes .
Being ingested orally, it is harmful, an example is Methyltestosterone. After the use of anabolic steroids, the users maintain a diet and medication regime, which has the objective of suppressing estrogen on the hypothalamic axis, pituitary and testicles.
The objective of this is to restore endogenous testosterone production, always preserving muscle mass and strength. This post-cycle therapy, as it is called, has the function of inhibiting side effects . Body Composition, Muscle Strength and Aerobic Capacity The acute effects of strength training related to the concentration of testosterone are still controversial. Studies demonstrate a fall in testosterone concentration  .
However, there are studies which demonstrate the increase  , as well as studies that did not find any difference in the level of testosterone before and after training  .
Some training methods are stimulating to increase the testosterone levels, such as tension methods, due to the higher potential given  . However, authors defend that any method that uses great intensity produce this increase on concentration, due to the increase of lactate stimulating this production . It was speculated that the increase on training frequency would influence due to higher muscle work.
However, results about this are also controversial, studies show that the increase happens both with one or three series . Nevertheless,  did not find this difference on the conducted study with two, four or six series for each muscle group. Thus it is necessary to analyze with caution the acute studies, as the hormonal spike, when fast, might fall right after, we cannot take into consideration the acute changes in testosterone levels.
Therefore, neither GH and IGF 1, as these are not associated to the increase of protein synthesis, nor gains in strength and muscle mass obtained through training    . Chronically, the changes on testosterone concentration that result from strength training, do not show to be significant for the increase of muscle mass and strength when there is only evidence that the strength training may influence by indirect factors the efficiency of the hormone by changes in receptors and satellite cells .
This fact is demonstrated in strength trained athletes that show higher quantities of satellite cells in comparison to non-trained ones. This shows that a duplication of RNAm after two days of muscle training, the receptors are synthesized by the own nuclei of the muscle fibers, providing a long term hypertrophy .
Which may be considered a consequence of the enlargement of the nuclei, thus increasing the efficiency of testosterone. However, as already expected, studies conducted with higher than physiological doses demonstrated surprising gains. For example, one study that compared four groups in which one group did not train and was divided into testosterone and placebo, two other groups that trained and were divided into placebo and testosterone.
At the end of 10 weeks, the group that trained and used testosterone had a gain of 6 kg of muscle mass as the placebo had a gain of 2 kg. However, the most surprising was that the groups without training the ones with placebo had, as expected, no gain, however, the group that used testosterone gained 3,2 kg of muscle mass, surpassing the group that trained and used placebo . Another two studies were favourable to the users of steroids in relation the the increase of body composition, due to the water retention by steroids, in general, the use of androgenic steroids contributed significantly to the increase of body composition due to the increase of muscle mass .
A study demonstrate a body comparison evaluated by hydrostatic weighing in which one is determined by the significant gain in weight due to muscle mass. During sports, a factor of high importance is the muscle strength that an athlete may execute. Many factors may contribute for an athlete to develop this strength, like training intensity, diet, psychology. Thus it is difficult to measure all of these factors in one study .
In literature, studies are controversial about the gain of muscle strength.