The group of anabolic agents (anabolic = tissue-building) is subdivided into:

1. Anabolic Androgenic Steroids (AAS). These include steroid hormones such as the male sex hormone testosterone and substances with similar effects as testosterone (androgenic = masculinising).
2. other anabolic agents, such as the beta-2 agonists clenbuterol and zilpaterol, which have an anabolic effect on the musculature, or the selective androgen receptor modulators (SARMs), whose effects are similar to those of the anabolic androgenic steroids.

The administration of anabolics increases protein synthesis (the production of protein in the body) and thus induces a positive nitrogen balance of the organism (anabolic effect). Anabolics shorten recovery time and reduce body fat percentage. At the same time, however, they also affect the male sexual characteristics. This is referred to as «androgenic effect». Despite intensive efforts in the development of synthetic anabolics to disconnect the undesired androgenic effect from the anabolic effect, satisfactory results have not yet been obtained.

The body's own anabolic agent testosterone is produced by the testicles and, in small quantities, by the ovaries.

It is released into the blood circulation, distributed throughout the body, and binds to androgen receptors. Androgen receptors are produced in most types of tissue. Anabolics introduced from outside the body also bind to these receptors.

By this mechanism, the administration of anabolic steroids causes a positive nitrogen balance with the effects of muscle growth, a reduction in recovery time, increased metabolisation of fat and, ultimately, an increase in performance.

⬆ Nitrogen balance

⬇ Recovery time

⬇ Body fat percentage

Selective androgen receptor modulators (SARMs) have similar effects as anabolic androgenic steroids. Their abuse for doping purposes is prohibited.

The best-known and best-researched SARMs are Ostarine (enobosarm) and Andarine (S-4). These medications are intended for oral administration. They were developed to treat muscle wasting, osteoporosis and benign prostatic hyperplasia (non-cancerous enlargement of the prostate). At present, neither of these medications has been medically approved. Nevertheless, preparations – containing controversial amounts of the active ingredient – are being illegally produced in China and distributed in Europe and America.

In addition to enhancing performance, anabolics have a number of adverse effects, some of which are dangerous. They can provoke physical alterations that cannot be reversed.

The general adverse effects of anabolics include damage to the cardiovascular system and the liver, alterations in lipid metabolism and the retention of water in body tissues.

Anabolics harden the arteries

A dangerous effect of anabolics abuse is hardening of the arteries (arteriosclerosis). The deterioration of blood fat levels disturbs the free flow of blood through the vessels. This increases the danger of arterial occlusion and can result in a stroke or a heart attack.

Anabolics harm the liver

Abuse of anabolics for prolonged periods can lead to liver disease, including liver cancer.

Anabolics cause weight gain

The administration of anabolics reduces the excretion of sodium, which leads to increased water retention in the tissues and an increase in body weight.

Multiplicator effect

To combat the numerous adverse effects, abusers often use additional doping substances such as hormones, hormone antagonists and diuretics which in turn have their own adverse health effects.

Anabolic abuse has many and varied psychological effects. Mood changes can occur that may be either positive, such as increased motivation and euphoria, or negative, such as irritability, emotional instability and a tendency to violence. All these psychological side effects may also cause problems in the private relationships of the person consuming anabolics.

Depression

Anabolic abuse can lead to depression. Depression is a mental disorder characterised by a severely depressed mood and a lack of energy.

Aggressiveness

Irritability and over-aggressiveness can occur and lead to increasingly confrontational and reckless behaviour. Research has shown a significantly positive correlation between the sex hormone testosterone and aggressiveness.

Sex drive

Anabolic androgenic steroids also affect sexual arousal. Sexual desire may strongly increase, but anabolic abuse can also lead to sexual disinterest and male erectile dysfunction.

Addictive potential

Anabolics have a potential for addiction, as demonstrated e.g. by depressive mood changes after discontinuation / consumption of the products.

Because anabolics disturb the balance of the body's self-produced sex hormones, the do not only have general but also sex-specific adverse effects.

Anabolics destroy masculinity

In men, the use of anabolics carries the risk that the testicles may shrink and the production of sperm may diminish. In addition, sexual sensation and erectile function may deteriorate to the point of infertility.

Anabolics alter physical appearance

Anabolics abuse often leads to acne. Moreover, feminisation of the body can occur because excess testosterone is partly converted into the female sex hormone oestrogen. This can lead to breast enlargement (gynaecomastia) in men.

Adolescents additionally run the risk of premature growth arrest.

Anabolics destroy femininity

In women, the use of anabolics can lead to masculinisation. The symptoms of masculinisation, also called virilisation, include a masculine physique, masculine facial features, acne, growth of facial hair, a deeper voice due to enlargement of the voice box, disturbances in the menstrual cycle and enlargement of the clitoris (irreversible). The breasts may shrink because the distribution of fatty tissue is suddenly altered, and the risk of breast cancer increases.

Cysts and pathological growth of uterine tissue are additional adverse effects.

Because anabolics stimulate muscle growth, they are abused mostly in sports where strength, power or muscle mass are decisive for victory. Since they also shorten recovery time, there is a danger that athletes in endurance disciplines may use anabolics to help cope with their large training loads. In contrast to strength athletes, they use anabolics only in low doses because excessive muscle mass would negatively affect their performance.

Recreational athletes most frequently involved

The abuse of anabolics today occurs most frequently in the fitness and body-building scene. In this little regulated domain of sport, very few doping controls are carried out worldwide. Most countries even lack a legal basis to prosecute violations. According to projections and results from scientific studies, it is assumed that five percent of adolescents in the USA consume anabolic steroids. In European industrial countries, the rate is probably similar. The doping supplies confiscated by the Swiss customs authorities during the first half of 2013 mostly involved anabolics, and 90% had been ordered by body builders, fitness athletes, security personnel and adolescents.