Position Statement

Anabolic Steroids to Enhance Athletic Performance

This Position Statement was developed as an educational tool based on the opinion of the authors. It is not a product of a systematic review. Readers are encouraged to consider the information presented and reach their own conclusions.

The American Academy of Orthopaedic Surgeons (AAOS) recognizes that although anabolic steroids may enhance athletic performance by increasing both the size and strength of athletes, their use can cause serious harmful physiological and psychological effects.

The AAOS believes that anabolic steroids and their precursors should not be used to enhance performance or appearance, and should be banned from use in all sports programs. We recommend that sports-governing bodies continue implementing aggressive drug testing programs to deter and to detect drug use. Relevant sports medicine bodies should continue to implement aggressive drug testing programs to detect their use and impose harsh penalties for those athletes who use them and those individuals or institutions that facilitate their use.

The Code of Medical Ethics and Professionalism for Orthopaedic Surgeons specifically addresses this issue. It provides in Paragraph VII.B: "It is unethical to prescribe controlled substances when they are not medically indicated. It is also unethical to prescribe substances for the sole purpose of enhancing athletic performance."

Use of anabolic steroids has been associated with the following adverse effects: increased risk of benign and malignant tumors of the liver, testes and prostate; increased risk of serious cardiovascular disease; impaired reproductive functioning in males and females, which may be irreversible; tendon weakening and potential ruptures; irreversible closure of bone growth centers in adolescents; menstrual irregularity; and psychological dependence which may lead to withdrawal symptoms and depression upon the cessation of use. Major personality changes may occur, manifested by increasing aggressiveness and intensity that may lead to intense anti-social or psychotic behavior.

The use of performance-enhancing substances by athletes represents a most serious violation of ethical standards of organized sports activities at all levels, and should not be tolerated. The Drug Enforcement Administration (DEA) classifies anabolic steroids as controlled substances and places restrictions on their distribution and use. The AAOS strongly supports law enforcement agencies in their efforts to enforce existing legislation to control the distribution and use of anabolic steroids.

© December 1991. Revised June 2005 American Academy of Orthopaedic Surgeons.
This material may not be modified without the express written permission of the American Academy of Orthopaedic Surgeons^®.

Position Statement 1102

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