Medical Various AAS and related compounds Since the discovery and synthesis of testosterone in the 1930s, AAS have been used by physicians for many purposes, with varying degrees of success. These can broadly be grouped into anabolic, androgenic, and other uses. Anabolic * Bone marrow stimulation: For decades, AAS were the mainstay of therapy for hypoplastic anemias due to leukemia, kidney failure or aplastic anemia. * Growth stimulation: AAS can be used by pediatric endocrinologists to treat children with growth failure. However, the availability of synthetic growth hormone, which has fewer side effects, makes this a secondary treatment. * Stimulation of appetite and preservation and increase of muscle mass: AAS have been given to people with chronic wasting conditions such as cancer and AIDS. * Stimulation of lean body mass and prevention of bone loss in elderly men, as some studies indicate. However, a 2006 placebo-controlled trial of low-dose testosterone supplementation in elderly men with low levels of testosterone found no benefit on body composition, physical performance, insulin sensitivity, or quality of life. * Prevention or treatment of osteoporosis in postmenopausal women. Nandrolone decanoate is approved for this use. Although they have been indicated for this indication, AAS saw very little use for this purpose due to their virilizing side effects. * Aiding weight gain following surgery or physical trauma, during chronic infection, or in the context of unexplained weight loss. * Counteracting the catabolic effect of long-term corticosteroid therapy. * Oxandrolone improves both short-term and long-term outcomes in people recovering from severe burns and is well-established as a safe treatment for this indication. * Treatment of idiopathic short stature, hereditary angioedema, alcoholic hepatitis, and hypogonadism. * Methyltestosterone is used in the treatment of delayed puberty, hypogonadism, cryptorchidism, and erectile dysfunction in males, and in low doses to treat menopausal symptoms (specifically for osteoporosis, hot flashes, and to increase libido and energy), postpartum breast pain and engorgement, and breast cancer in women. Androgenic * Androgen replacement therapy for men with low levels of testosterone; also effective in improving libido for elderly males. * Induction of male puberty: Androgens are given to many boys distressed about extreme delay of puberty. Testosterone is now nearly the only androgen used for this purpose and has been shown to increase height, weight, and fat-free mass in boys with delayed puberty. * Masculinizing hormone therapy for transgender men, other transmasculine people, and intersex people, by producing masculine secondary sexual characteristics such as a voice deepening, increased bone and muscle mass, masculine fat distribution, facial and body hair, and clitoral enlargement, as well as mental changes such as alleviation of gender dysphoria and increased sex drive. Other * Treatment of breast cancer in women, although they are now very rarely used for this purpose due to their marked virilizing side effects. * In low doses as a component of hormone therapy for postmenopausal and transgender women, for instance to increase energy, well-being, libido, and quality of life, as well as to reduce hot flashes. Testosterone is usually used for this purpose, although methyltestosterone is also used. * Male hormonal contraception; currently experimental, but potential for use as effective, safe, reliable, and reversible male contraceptives. Enhancing performance Numerous vials of injectable AAS Most steroid users are not athletes. In the United States, between 1 million and 3 million people (1% of the population) are thought to have used AAS. Studies in the United States have shown that AAS users tend to be mostly middle-class heterosexual men with a median age of about 25 who are noncompetitive bodybuilders and non-athletes and use the drugs for cosmetic purposes. "Among 12- to 17-year-old boys, use of steroids and similar drugs jumped 25 percent from 1999 to 2000, with 20 percent saying they use them for looks rather than sports, a study by insurer Blue Cross Blue Shield found."(Eisenhauer) Another study found that non-medical use of AAS among college students was at or less than 1%. According to a recent survey, 78.4% of steroid users were noncompetitive bodybuilders and non-athletes, while about 13% reported unsafe injection practices such as reusing needles, sharing needles, and sharing multidose vials, though a 2007 study found that sharing of needles was extremely uncommon among individuals using AAS for non-medical purposes, less than 1%. Another 2007 study found that 74% of non-medical AAS users had post-secondary degrees and more had completed college and fewer had failed to complete high school than is expected from the general populace. The same study found that individuals using AAS for non-medical purposes had a higher employment rate and a higher household income than the general population. AAS users tend to research the drugs they are taking more than other controlled-substance users; however, the major sources consulted by steroid users include friends, non-medical handbooks, internet-based forums, blogs, and fitness magazines, which can provide questionable or inaccurate information. AAS users tend to be unhappy with the portrayal of AAS as deadly in the media and in politics. According to one study, AAS users also distrust their physicians and in the sample 56% had not disclosed their AAS use to their physicians. Another 2007 study had similar findings, showing that, while 66% of individuals using AAS for non-medical purposes were willing to seek medical supervision for their steroid use, 58% lacked trust in their physicians, 92% felt that the medical community's knowledge of non-medical AAS use was lacking, and 99% felt that the public has an exaggerated view of the side-effects of AAS use. A recent study has also shown that long term AAS users were more likely to have symptoms of muscle dysmorphia and also showed stronger endorsement of more conventional male roles. A recent study in the Journal of Health Psychology showed that many users believed that steroids used in moderation were safe. AAS have been used by men and women in many different kinds of professional sports to attain a competitive edge or to assist in recovery from injury. These sports include bodybuilding, weightlifting, shot put and other track and field, cycling, baseball, wrestling, mixed martial arts, boxing, football, and cricket. Such use is prohibited by the rules of the governing bodies of most sports. AAS use occurs among adolescents, especially by those participating in competitive sports. It has been suggested that the prevalence of use among high-school students in the U.S. may be as high as 2.7%. Dosages General dosage ranges of<unk> s Medication Route Dosage range Danazol Oral 100–800 mg/day Drostanolone propionate Injection 100 mg 3 times/week Ethylestrenol Oral 2–8 mg/day Fluoxymesterone Oral 2–40 mg/day Mesterolone Oral 25–150 mg/day Metandienone Oral 2.5–15 mg/day Metenolone acetate Oral 10–150 mg/day Metenolone enanthate Injection 25–100 mg/week Methyltestosterone Oral 1.5–200 mg/day Nandrolone decanoate Injection 12.5–200 mg/week Nandrolone phenylpropionate Injection 6.25–200 mg/week Norethandrolone Oral 20–30 mg/day Oxandrolone Oral 2.5–20 mg/day Oxymetholone Oral 1–5 mg/kg/day or50–150 mg/day Stanozolol Oral 2–6 mg/day Injection 50 mg up to every two weeks Testosterone Oral 400–800 mg/day Injection 25–100 mg up tothree times weekly Testosterone cypionate Injection 50–400 mg up toevery four weeks Testosterone enanthate Injection 50–400 mg up toevery four weeks Testosterone propionate Injection 25–50 mg up tothree times weekly Testosterone undecanoate Oral 80–240 mg/day Injection 750–1000 mg up to every 10 weeks Trenbolone Injection 75 mg every 10 days Sources: Available forms The AAS that have been used most commonly in medicine are testosterone and its many esters (but most typically testosterone undecanoate, testosterone enanthate, testosterone cypionate, and testosterone propionate), nandrolone esters (typically nandrolone decanoate and nandrolone phenylpropionate), stanozolol, and metandienone (methandrostenolone). Others that have also been available and used commonly but to a lesser extent include methyltestosterone, oxandrolone, mesterolone, and oxymetholone, as well as drostanolone propionate (dromostanolone propionate), metenolone (methylandrostenolone) esters (specifically metenolone acetate and metenolone enanthate), and fluoxymesterone. Dihydrotestosterone (DHT), known as androstanolone or stanolone when used medically, and its esters are also notable, although they are not widely used in medicine. Boldenone undecylenate and trenbolone acetate are used in veterinary medicine. Designer steroids are AAS that have not been approved and marketed for medical use but have been distributed through the black market. Examples of notable designer steroids include 1-testosterone (dihydroboldenone), methasterone, trenbolone enanthate, desoxymethyltestosterone, tetrahydrogestrinone, and methylstenbolone. Routes of administration A vial of injectable testosterone cypionate There are four common forms in which AAS are administered: oral pills; injectable steroids; creams/gels for topical application; and skin patches. Oral administration is the most convenient. Testosterone administered by mouth is rapidly absorbed, but it is largely converted to inactive metabolites, and only about one-sixth is available in active form. In order to be sufficiently active when given by mouth, testosterone derivatives are alkylated at the 17α position, e.g. methyltestosterone and fluoxymesterone. This modification reduces the liver's ability to break down these compounds before they reach the systemic circulation. Testosterone can be administered parenterally, but it has more irregular prolonged absorption time and greater activity in muscle in enanthate, undecanoate, or cypionate ester form. These derivatives are hydrolyzed to release free testosterone at the site of injection; absorption rate (and thus injection schedule) varies
Anabolic steroid
Antiglucocorticoid
Antiandrogen
Thyroid blocker
Glucocorticoid
17α-Alkylated anabolic steroid
Antiestrogen
Anticorticosteroid