Use and abuse of anabolic-androgenic steroids and androgen precursors

Published on 02/03/2015 by admin

Filed under Endocrinology, Diabetes and Metabolism

Last modified 02/03/2015

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Use and abuse of anabolic-androgenic steroids and androgen precursors

1. What are anabolic-androgenic steroids (AASs)?

2. Where are AASs made?

3. Summarize the biologic effects of AASs.

Endogenous AASs have diverse effects with three distinct physiologic surges. The most prominent are effects on male sexual differentiation starting during the fetal period at weeks 6 through 8 of gestation, when AASs promote the development of male genitalia. The second surge occurs during the neonatal period, when AASs are involved in the growth of the phallus to normal size, in testicular descent, and in spermatogonial development. The final surge assists with secondary sexual characteristics during puberty, including growth and development of the prostate, seminal vesicles, penis, and scrotum. Pubertal changes in hair growth and sebaceous glands result in the male pattern of hair growth on the chin, pubic area, chest, and axillary regions, as well as acne provocation via increased sebum production. Vocal cords begin to thicken along with enlargement of the larynx, with resulting voice deepening. Data indicating decreased urinary nitrogen levels support AAS effects on protein anabolism that lead to an increase in lean body mass, specifically in the upper girdle, and alterations of fat distribution. Further structural changes occur with increases in bone mineral density and long bone growth, as well as closure of the epiphyses. Neurologic changes include increased libido and spontaneous erections. Other effects include assistance with wound healing, stimulation of liver release of clotting factors and erythropoietin with a secondary increase in hematocrit, and suppression of high-density lipoprotein (HDL) synthesis (Box 50-1).

4. How does testosterone mediate effects via estradiol?

5. How do AAS levels change with age?

6. How do AASs exert their effects?

7. How are androgens metabolized, and why is it necessary to modify testosterone for administration?

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