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Nourse G, Fraser S, Moore D. Masculine enhancement as health or pathology: gender and optimisation discourses in health promotion materials on performance and image-enhancing drugs (PIEDs). HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2024:1-17. [PMID: 38286142 DOI: 10.1080/14461242.2023.2297046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 12/03/2023] [Indexed: 01/31/2024]
Abstract
The consumption of performance and image-enhancing drugs (PIEDs) is commonly pathologised in public health discourse as stemming from an unhealthy relationship to masculinity, and is often framed as intrinsically 'risky' and fundamentally at odds with 'good health'. This article examines Australian health promotion materials on PIEDs to analyse their role in shaping notions of good health, normal gender and appropriate self-improvement. To do so, it draws on the work of Butler, Law and Latour to consider how these materials co-constitute men and their health, often in problematic ways. First, we examine the ways in which PIEDs are constituted via a politics of the 'natural', then consider how the health promotion materials on PIEDs participate in the regulation of appropriate, healthy masculinity, and conclude by examining how adolescent masculinity is co-constituted with PIEDs. We observe a key tension between health promotion's avowed interest in improvement and optimisation and its treatment of PIED consumers as aberrant, vulnerable and insecure subjects whose drive to enhance and optimise is characterised by pathology and addiction. We conclude by arguing that health promotion materials on PIEDs fail to acknowledge the exceedingly normative character of enhancement practices in contemporary society.
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Affiliation(s)
- Gemma Nourse
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - Suzanne Fraser
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - David Moore
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
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Dowsett GW, Duncan D, Waling A, Angelides S, Nourse G. Men, bodywork, health and the potentiality of performance and image-enhancing drugs. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2023; 32:341-356. [PMID: 36577038 DOI: 10.1080/14461242.2022.2148959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 11/10/2022] [Indexed: 06/17/2023]
Abstract
In a qualitative study on masculinity, embodiment and sexuality, we interviewed men who were recreational gym-goers about their bodywork practices in Melbourne, Australia. We also asked whether the men had used performance and image-enhancing drugs (PIEDs) as an adjunct to their bodywork practices. While none had used PIEDs, all were considering, or had considered, using them. We found that participants held varying opinions on PIED use and those who used them. The literature on PIEDs noted men's concerns with body appearance and health and focused largely on individual problematic use, but non-users were not mentioned. A second issue in the literature focused on social influences on PIED use, but again with no mention of non-users. Discussion on risk reduction as a public health response did not mention non-users either. This paper, therefore, reports on non-users' thoughts on, regular exposure to, and considerations of PIEDs and other men who use them. We propose that PIEDs might more usefully be understood as an everyday, if contradictory, consideration within most men's bodywork and health practices. We argue that PIEDs constitute a discursive practice exposing a potentiality that engages non-users also and this requires new health promotion approaches.
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Affiliation(s)
- Gary W Dowsett
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - Duane Duncan
- School of Humanities, Arts, and Social Sciences, University of New England, Armidale, Australia
| | - Andrea Waling
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - Steven Angelides
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
- Department of Modern History, Politics and International Relations, Macquarie University, Sydney, Australia
| | - Gemma Nourse
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
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Harvey O, van Teijlingen E, Parrish M. Mixed-methods research on androgen abuse - a review. Curr Opin Endocrinol Diabetes Obes 2022; 29:586-593. [PMID: 35943190 DOI: 10.1097/med.0000000000000767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW This paper reviews the mixed-methods studies from the last 2 years (2021-2022) into androgen use to highlight the most relevant developments within the field. RECENT FINDINGS The literature review found seven papers from 2021 to 2022. These seven cover a range of important considerations, including interventions to reduce androgen use, educational tools to increase professionals' knowledge, explorations on the comorbidity of use with other substances, motivations for use, potential risks factors for androgens' initiation, or risks of using androgens. Key findings include a greater understanding of motivations for use, particularly in females and older males; identification of potential risks for starting use/using androgens; benefits of including practical strength exercises in preventive intervention programmes and the efficacy of e-learning tools to increase professionals' knowledge of androgens use, as well as an increase in their confidence to support androgen users. SUMMARY The key implications for clinical practice are that we still need to support healthcare professionals to overcome the barriers for increasing their skills and knowledge around androgen use. A recognition that people who have become dependent on androgen use are potentially at risk of considerable harm, with further research needed into sub-groups of androgen users. VIDEO ABSTRACT , http://links.lww.com/COE/A35.
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Thirumalai A, Anawalt BD. Androgenic Steroids Use and Abuse. Urol Clin North Am 2022; 49:645-663. [DOI: 10.1016/j.ucl.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Scarth M, Jørstad ML, Reierstad A, Klonteig S, Torgersen S, Hullstein IR, Bjørnebekk A. Psychopathology among anabolic-androgenic steroid using and non-using female athletes in Norway. J Psychiatr Res 2022; 155:295-301. [PMID: 36170757 DOI: 10.1016/j.jpsychires.2022.09.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/24/2022] [Accepted: 09/16/2022] [Indexed: 11/19/2022]
Abstract
Anabolic-androgenic steroids (AAS) are primarily used to improve physical appearance and increase lean muscle mass. Due to their masculinizing properties, the majority of people using AAS are men; however, AAS use among females may increase with changing body ideals trending towards a more muscular appearance. AAS use among males have been associated with risk-taking behavior, and increased prevalence of personality disorders and psychopathology. As a result of low perceived prevalence and stigma among females who use AAS, the relationship between AAS use and psychopathology in this population is not well-known. AAS using women (n = 16) and weight-lifting controls (WLC) (n = 16) completed questionnaires regarding AAS use, health and training information. Psychopathology was evaluated using the Millon Clinical Multiaxial Inventory-III (MCMI-III). Group differences on demographic variables and scores on MCMI-III scales were evaluated with Mann-Whitney U tests. The clinical cut-off was then applied to all MCMI-III scales and groups were compared using Fisher's exact test. AAS consumers demonstrated significantly greater psychopathology than WLC on several scales. Externalizing personality disorder scales were elevated among those who use AAS relative to controls, such as borderline (p < 0.001), antisocial (p = 0.007) and sadistic (p = 0.002), and in addition depressive (p = 0.012), negativistic (p = 0.001) and masochistic (p = 0.029) personality disorders scales. Furthermore, all clinical syndromes were elevated among AAS consumers. AAS consumers thus demonstrated multi-pathology, and 56% (n = 9) of the group met the clinical criteria for six or more disorders. Females who use AAS experience in general increased levels of psychopathology compared to WLC. Clinicians should be aware of these traits and the challenges they present in providing care to this population.
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Affiliation(s)
- Morgan Scarth
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway.
| | - Marie Lindvik Jørstad
- Anabolic Androgenic Steroid Research Group, National Advisory Unit on SUD Treatment, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | | | - Sandra Klonteig
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | | | - Ingunn R Hullstein
- Norwegian Doping Control Laboratory, Oslo University Hospital, Oslo, Norway
| | - Astrid Bjørnebekk
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Risks of Serious Injury with Testosterone Treatment. Am J Med 2021; 134:84-94.e6. [PMID: 32926849 DOI: 10.1016/j.amjmed.2020.07.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/31/2020] [Accepted: 07/31/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Injury causes significant morbidity and mortality that is sometimes attributed to testosterone and violence. We hypothesized that prescribed testosterone might be associated with the subsequent risk of serious injury. METHODS We conducted a self-matched individual-patient exposure-crossover analysis comparing injury risks before and after initiation of testosterone. We selected adults treated with testosterone in Ontario, Canada, from October 1, 2012, to October 1, 2017 (enrollment) and continued until October 1, 2018 (follow-up). The primary outcome was defined as an acute traumatic event that required emergency medical care. RESULTS A total of 64,386 patients were treated with testosterone of whom 89% were men with a median age of 52 years. We identified 34,439 serious injuries during the baseline interval before starting testosterone (584 per month) and 7349 serious injuries during the subsequent interval after starting testosterone (565 per month). Rates of injuries were substantially above the population norm in both intervals with no significant increased risk after starting testosterone (relative risk = 1.00; 95% confidence interval: 0.96-1.04, P = 0.850). The unchanged risk extended to diverse patients, was observed for different formulations and applied to all injury mechanisms. In contrast, testosterone treatment was associated with a 48% increased risk of a thromboembolic event (relative risk = 1.48; 95% confidence interval: 1.25-1.74, P < 0.001). CONCLUSIONS Testosterone treatment was associated with a substantial baseline risk of serious injury that did not increase further after starting therapy. Physicians prescribing testosterone could consider basic safety reminders to mitigate injury risks.
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Cattelan Souza L, de Brito MLO, Jesse CR, Boeira SP, de Gomes MG, Goes ATR, Fabbro LD, Machado FR, Prigol M, Nogueira CW. Involvement of kynurenine pathway in depressive-like behaviour induced by nandrolone decanoate in mice. Steroids 2020; 164:108727. [PMID: 32891681 DOI: 10.1016/j.steroids.2020.108727] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 08/24/2020] [Accepted: 08/30/2020] [Indexed: 11/17/2022]
Abstract
Nandrolone decanoate (ND) belongs to the class II of anabolic-androgenic steroids (AAS), which is composed of 19-nor-testosterone-derivatives. AAS represent a group of synthetic testosterone that is used in clinical treatment. However, these drugs are widely abused among individuals as a means of promoting muscle growth or enhancing athletic performance. AAS in general and ND in particular have been associated with several behavioral disturbances, such as anxiety, aggressiveness and depression. A factor that contributes to the development of depression is the brain activation of indoleamine 2,3-dioxygenase (IDO), the rate-limiting enzyme of kynurenine pathway (KP). In the present study, we examined the involvement of KP in depressive phenotype induced by a ND treatment (10 mg/kg/day/s.c., for 28 days) that mimics human abuse system (e.g. supraphysiological doses) in C57B/6J mice. Our results showed that ND caused depressive like-behavior in the tail suspension test and anhedonic-like state measured in the sucrose preference test. ND administration decreased the levels of brain-derived neurotrophic factor and neurotrophin-3 and reduced Na+,K+-ATPase activity in the hippocampus, striatum and prefrontal cortex. We also found that ND elicited KP activation, as reflected by the increase of IDO activity and kynurenine levels in these brain regions. Moreover, ND decreased serotonin levels and increased 5-hydroxyindoleacetic acid levels in the brain. Treatment with IDO inhibitor 1-methyl-dl-trypthophan (1 mg/kg/i.p.) reversed the behavioral and neurochemical alterations induced by ND. These results indicate for the first time that KP plays a key role in depressive-like behavior and neurotoxicity induced by supraphysiologicaldoses of ND in mice.
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Affiliation(s)
- Leandro Cattelan Souza
- Laboratory of Pharmacological and Toxicological Evaluations Applied to Bioactive Molecules, Federal University of Pampa, CEP 97650-000, Itaqui, RS, Brazil; Laboratory of Synthesis, Reactivity, Pharmacological and Toxicological Evaluation of Organochalcogen Compounds, Department of Biochemistry and Molecular Biology, Center of Natural and Exact Sciences, Federal University of Santa Maria, Santa Maria, RS 97105-900, Brazil.
| | - Maicon Lenon Otenio de Brito
- Laboratory of Pharmacological and Toxicological Evaluations Applied to Bioactive Molecules, Federal University of Pampa, CEP 97650-000, Itaqui, RS, Brazil
| | - Cristiano Ricardo Jesse
- Laboratory of Pharmacological and Toxicological Evaluations Applied to Bioactive Molecules, Federal University of Pampa, CEP 97650-000, Itaqui, RS, Brazil
| | - Silvana Peterini Boeira
- Laboratory of Pharmacological and Toxicological Evaluations Applied to Bioactive Molecules, Federal University of Pampa, CEP 97650-000, Itaqui, RS, Brazil
| | - Marcelo Gomes de Gomes
- Laboratory of Pharmacological and Toxicological Evaluations Applied to Bioactive Molecules, Federal University of Pampa, CEP 97650-000, Itaqui, RS, Brazil
| | - André Tiago Rossito Goes
- Laboratory of Pharmacological and Toxicological Evaluations Applied to Bioactive Molecules, Federal University of Pampa, CEP 97650-000, Itaqui, RS, Brazil
| | - Lucian Del Fabbro
- Laboratory of Pharmacological and Toxicological Evaluations Applied to Bioactive Molecules, Federal University of Pampa, CEP 97650-000, Itaqui, RS, Brazil
| | - Franciele Romero Machado
- Laboratory of Pharmacological and Toxicological Evaluations Applied to Bioactive Molecules, Federal University of Pampa, CEP 97650-000, Itaqui, RS, Brazil
| | - Marina Prigol
- Laboratory of Pharmacological and Toxicological Evaluations Applied to Bioactive Molecules, Federal University of Pampa, CEP 97650-000, Itaqui, RS, Brazil
| | - Cristina Wayne Nogueira
- Laboratory of Synthesis, Reactivity, Pharmacological and Toxicological Evaluation of Organochalcogen Compounds, Department of Biochemistry and Molecular Biology, Center of Natural and Exact Sciences, Federal University of Santa Maria, Santa Maria, RS 97105-900, Brazil
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Byne W, Karasic DH, Coleman E, Eyler AE, Kidd JD, Meyer-Bahlburg HFL, Pleak RR, Pula J. Gender Dysphoria in Adults: An Overview and Primer for Psychiatrists. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2020; 18:336-350. [PMID: 33343244 DOI: 10.1176/appi.focus.18304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
(Copyright © William Byne et al. 2018; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.).
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de Wit AE, De Boer MK, Bosker FJ, van der Does AJW, Gooren LJG, Nolen WA, Penninx BWJH, Schoevers RA, Giltay EJ. Associations of plasma androgens with suicidality among men and women: A 9-year longitudinal cohort study. J Affect Disord 2020; 269:78-84. [PMID: 32217346 DOI: 10.1016/j.jad.2020.03.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/30/2019] [Accepted: 03/16/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Testosterone has been implicated in suicidality in cross-sectional studies. Stress that coincides with a suicide attempt may alter androgen levels, so prospective studies are needed to exclude reverse causation. We aimed to examine the associations of plasma androgens with concurrent and future suicidality, and if present, whether these associations were mediated by a behavioral trait like reactive aggression. METHODS Baseline plasma levels of total testosterone, 5α-dihydrotestosterone, and androstenedione were determined with liquid chromatography-tandem mass spectrometry, and dehydroepiandrosterone-sulphate with a radioimmunoassay. Suicidality was assessed using the Suicidal Ideation Scale at baseline and after 2-, 4-, 6-, and 9-year follow-up. Men and women were analyzed separately, and potential confounders were considered. RESULTS Participants (N = 2861; 66.3% women) had a mean age of 42.0 years (range 18-65) and almost half (46.9%) fulfilled criteria for a major depressive or anxiety disorder. At baseline 13.2% of men and 11.2% of women reported current suicidal ideation. In participants who were non-suicidal at baseline, slightly more men than women reported suicidal ideation during follow-up (14.7% vs. 12.5%), whereas the reverse pattern was observed for suicide attempts (3.6% vs. 4.2%). None of the associations between androgens and current and future suicidality were significant. LIMITATIONS Androgens were determined once, which may have been insufficient to predict suicidality over longer periods. DISCUSSION The lack of associations between plasma levels of androgens determined by 'gold-standard' laboratory methods with suicidality do not support previous cross-sectional and smaller studies in adult men and women with values within the physiological range.
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Affiliation(s)
- A E de Wit
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, PO Box 30.001, Groningen, RB 9700, the Netherlands.
| | - M K De Boer
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, PO Box 30.001, Groningen, RB 9700, the Netherlands
| | - F J Bosker
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, PO Box 30.001, Groningen, RB 9700, the Netherlands
| | - A J W van der Does
- Department of Clinical Psychology, Institute of Psychology, Leiden University, the Netherlands
| | - L J G Gooren
- Department of Endocrinology, UMC Amsterdam, the Netherlands
| | - W A Nolen
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, PO Box 30.001, Groningen, RB 9700, the Netherlands
| | - B W J H Penninx
- Department of psychiatry, Amsterdam UMC, VU University, the Netherlands
| | - R A Schoevers
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, PO Box 30.001, Groningen, RB 9700, the Netherlands
| | - E J Giltay
- Department of Psychiatry, Leiden University Medical Center, the Netherlands
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Fraser S, Fomiatti R, Moore D, Seear K, Aitken C. Is another relationship possible? Connoisseurship and the doctor–patient relationship for men who consume performance and image-enhancing drugs. Soc Sci Med 2020; 246:112720. [DOI: 10.1016/j.socscimed.2019.112720] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 10/28/2019] [Accepted: 12/03/2019] [Indexed: 01/06/2023]
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Mata EFD, Nascimento AMD, Lima EMD, Kalil IC, Endringer DC, Lenz D, Bissoli NS, Brasil GA, Andrade TUD. Finasteride promotes worsening of the cardiac deleterious effects of nandrolone decanoate and protects against genotoxic and cytotoxic damage. BRAZ J PHARM SCI 2020. [DOI: 10.1590/s2175-97902019000318289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Lima EMD, Cassaro KDODS, Silva CLD, Silva MDA, Poltronieri MP, Nascimento AMD, Andrade TUD, Bissoli NS, Brasil GA. Eight weeks of treatment with nandrolone decanoate in female rats promotes disruption in the redox homeostasis and impaired renal function. Life Sci 2019; 242:117227. [PMID: 31881226 DOI: 10.1016/j.lfs.2019.117227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 12/11/2019] [Accepted: 12/23/2019] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Misuse of AAS is emergent among both genders, however, few studies were performed evaluating AAS effects on female body and none evaluate the impact of nandrolone decanoate (ND) in renal function. AIM Determine the effects of chronic treatment with ND on kidney function of female rats and evaluate the influence of oxidative stress on it. MATERIAL AND METHODS Female rats were separated into two groups (n = 8 each), the treated group (DECA), which received ND at a dose of 20 mg/kg/week (i.m), and the control group (C), which was treated with the vehicle (peanut oil, i.m.). All treatments were performed during eight weeks. After this period, 24 h urine, blood and organs (heart, gastrocnemius muscle, liver and kidney) were collected. Organ hypertrophy was calculated, and kidney collagen content was evaluated. AOPP, TBARS, SOD and catalase activity were determined in the kidney. Moreover, proteinuria and creatinine clearance were also investigated. KEY-FINDINGS Hypertrophy was observed in the liver, gastrocnemius muscle, heart and kidney. Kidney hypertrophy was followed by a reduced organ function and an increase in collagen deposition. Oxidative stress upsurge occurred in both proteins and lipids, followed by a reduction in SOD activity. SIGNIFICANCE Administration of DN in rats was followed by renal damage and kidney fibrosis due to increased oxidative stress on that organ.
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Affiliation(s)
- Ewelyne Miranda de Lima
- Department of Pharmaceutical Sciences, University of Vila Velha - UVV, Vila Velha, Espírito Santo, Brazil
| | | | - Cristiane Lyrio da Silva
- Department of Pharmaceutical Sciences, University of Vila Velha - UVV, Vila Velha, Espírito Santo, Brazil
| | - Mirian de Almeida Silva
- Department of Pharmaceutical Sciences, University of Vila Velha - UVV, Vila Velha, Espírito Santo, Brazil
| | | | | | - Tadeu Uggere de Andrade
- Department of Pharmaceutical Sciences, University of Vila Velha - UVV, Vila Velha, Espírito Santo, Brazil
| | - Nazaré Souza Bissoli
- Health Sciences Center, Department of Physiology and Pharmacology, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Girlandia Alexandre Brasil
- Department of Pharmaceutical Sciences, University of Vila Velha - UVV, Vila Velha, Espírito Santo, Brazil.
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Moyer AM, Matey ET, Miller VM. Individualized medicine: Sex, hormones, genetics, and adverse drug reactions. Pharmacol Res Perspect 2019; 7:e00541. [PMID: 31844524 PMCID: PMC6897337 DOI: 10.1002/prp2.541] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 10/08/2019] [Indexed: 12/16/2022] Open
Abstract
Clinically relevant adverse drug reactions differ between men and women. The underlying physiological and pharmacological processes contributing to these differences are infrequently studied or reported. As gene expression, cellular regulatory pathways, and integrated physiological functions differ between females and males, aggregating data from combined groups of men and women obscures the ability to detect these differences. This paper summarizes how genetic sex, that is, the presence of sex chromosomes XY for male or XX for female, and the influence of sex hormones affect transporters, receptors, and enzymes involved in drug metabolism. Changing levels of sex steroids throughout life, including increases at puberty, changes with pregnancy, and decreases with age, may directly and indirectly affect drug absorption, distribution, metabolism, and elimination. The direct and indirect effects of sex steroids in the form of exogenous hormones such as those used in hormonal contraceptives, menopausal hormone treatments, transgender therapy, and over-the-counter performance enhancing drugs may interfere with metabolism of other pharmaceuticals, and these interactions may vary by dose, formulation, and mode of delivery (oral, injection, or transdermal) of the steroid hormones. Few drugs have sex-specific labeling or dosing recommendations. Furthermore, there is limited literature evaluating how the circulating levels of sex steroids impact drug efficacy or adverse reactions. Such research is needed in order to improve the understanding of the impact of sex hormones on pharmacological therapies, particularly as medicine moves toward individualizing treatments.
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Affiliation(s)
- Ann M. Moyer
- Laboratory Medicine and PathologyMayo ClinicRochesterMNUSA
| | - Eric T. Matey
- Medical Therapy Management and Center for Individualized MedicineMayo ClinicRochesterMNUSA
| | - Virginia M. Miller
- Departments of Surgery, and Physiology and Biomedical EngineeringWomen's Health Research CenterMayo ClinicRochesterMNUSA
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Harvey O, Keen S, Parrish M, van Teijlingen E. Support for people who use Anabolic Androgenic Steroids: A Systematic Scoping Review into what they want and what they access. BMC Public Health 2019; 19:1024. [PMID: 31366349 PMCID: PMC6670144 DOI: 10.1186/s12889-019-7288-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 07/09/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Since there is a paucity of research on support for people using Anabolic Androgenic Steroids (AAS), we aimed to identify and synthesise the available evidence in this field. Gaining an understanding of the support both accessed and wanted by recreational AAS users will be of use to professionals who provide services to intravenous substance users and also to those working in the fields of public health and social care, with the aim to increase engagement of those using AAS. METHODS A systematic scoping review of the literature to explore and identify the nature and scope of information and support both accessed and wanted by non-prescribed AAS users. Any support services or information designed to help people who use AAS were considered. RESULTS We identified 23 papers and one report for review, which indicated that AAS users access a range of sources of information on: how to inject, substance effectiveness, dosages and side effects, suggesting this is the type of information users want. AAS users sought support from a range of sources including medical professionals, needle and syringe programmes, friends, dealers, and via the internet, suggesting that, different sources were used dependent on the information or support sought. DISCUSSION AAS users tended to prefer peer advice and support over that of professionals, and access information online via specialist forums, reflecting the stigma that is experienced by AAS users. These tendencies can act as barriers to accessing services provided by professionals. CONCLUSIONS Support needs to be specific and targeted towards AAS users. Sensitivity to their perceptions of their drug-use and the associated stigma of being classified in the same sub-set as other illicit drug users is relevant to facilitating successful engagement.
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Affiliation(s)
- Orlanda Harvey
- Bournemouth University, Lansdowne Campus, Royal London House, 109 Christchurch Road, Bournemouth, BH1 3LT UK
| | - Steve Keen
- Bournemouth University, Lansdowne Campus, Royal London House, 109 Christchurch Road, Bournemouth, BH1 3LT UK
| | - Margarete Parrish
- Bournemouth University, Lansdowne Campus, Royal London House, 109 Christchurch Road, Bournemouth, BH1 3LT UK
| | - Edwin van Teijlingen
- Bournemouth University, CMMPH, Bournemouth House, 19 Christchurch Road, Bournemouth, BH1 3LH UK
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Weiss RV, Hohl A, Athayde A, Pardini D, Gomes L, de Oliveira M, Meirelles R, Clapauch R, Spritzer PM. Testosterone therapy for women with low sexual desire: a position statement from the Brazilian Society of Endocrinology and Metabolism. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2019; 63:190-198. [PMID: 31340240 PMCID: PMC10522198 DOI: 10.20945/2359-3997000000152] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 04/22/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To summarize current evidence regarding testosterone treatment for women with low sexual desire. MATERIALS AND METHODS The Female Endocrinology and Andrology Department of the Brazilian Society of Endocrinology and Metabolism invited nine experts to review the physiology of testosterone secretion and the use, misuse, and side effects of exogenous testosterone therapy in women, based on the available literature and guidelines and statements from international societies. RESULTS Low sexual desire is a common complaint in clinical practice, especially in postmenopausal women, and may negatively interfere with quality of life. Testosterone seems to exert a positive effect on sexual desire in women with sexual dysfunction, despite a small magnitude of effect, a lack of long-term safety data, and insufficient evidence to make a broad recommendation for testosterone therapy. Furthermore, there are currently no testosterone formulations approved for women by the relevant regulatory agencies in the United States, Brazil, and most other countries, and testosterone formulations approved for men are not recommended for use by women. CONCLUSION Therefore, testosterone therapy might be considered if other strategies fail, but the risks and benefits must be discussed with the patient before prescription. Arch Endocrinol Metab. 2019;63(3):190-8.
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Affiliation(s)
- Rita V. Weiss
- Pontifícia Universidade Católica do Rio de JaneiroInstituto Estadual de Diabetes e Endocrinologia Luiz CapriglionePontifícia Universidade Católica do Rio de JaneiroEscola Médica de Pós-Graduação em EndocrinologiaRio de JaneiroRJBrasilInstituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, Pontifícia Universidade Católica do Rio de Janeiro, Escola Médica de Pós-Graduação em Endocrinologia (IEDE-PUC/RJ), Rio de Janeiro, RJ, Brasil
| | - Alexandre Hohl
- Universidade Federal de Santa CatarinaDepartamento de Medicina InternaHospital UniversitárioUniversidade Federal de Santa CatarinaFlorianópolisSCBrasilServiço de Endocrinologia e Metabolismo, Departamento de Medicina Interna, Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brasil
| | - Amanda Athayde
- Pontifícia Universidade Católica do Rio de JaneiroInstituto Estadual de Diabetes e Endocrinologia Luiz CapriglionePontifícia Universidade Católica do Rio de JaneiroEscola Médica de Pós-Graduação em EndocrinologiaRio de JaneiroRJBrasilInstituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, Pontifícia Universidade Católica do Rio de Janeiro, Escola Médica de Pós-Graduação em Endocrinologia (IEDE-PUC/RJ), Rio de Janeiro, RJ, Brasil
- Universidade Federal do Rio de JaneiroUniversidade Federal do Rio de JaneiroRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Dolores Pardini
- Universidade Federal de São PauloUniversidade Federal de São PauloSão PauloSPBrasilDisciplina de Endocrinologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil
| | - Larissa Gomes
- Universidade de São PauloFaculdade de MedicinaHospital de ClínicasUniversidade de São PauloSão PauloSPBrasilDisciplina de Endocrinologia, Faculdade de Medicina, Hospital de Clínicas, Universidade de São Paulo (USP), São Paulo, SP, Brasil
| | - Monica de Oliveira
- Instituto de Medicina Integral Professor Fernando FigueiraInstituto de Medicina Integral Professor Fernando FigueiraRecifePEBrasilInstituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brasil
| | - Ricardo Meirelles
- Pontifícia Universidade Católica do Rio de JaneiroInstituto Estadual de Diabetes e Endocrinologia Luiz CapriglionePontifícia Universidade Católica do Rio de JaneiroEscola Médica de Pós-Graduação em EndocrinologiaRio de JaneiroRJBrasilInstituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, Pontifícia Universidade Católica do Rio de Janeiro, Escola Médica de Pós-Graduação em Endocrinologia (IEDE-PUC/RJ), Rio de Janeiro, RJ, Brasil
| | - Ruth Clapauch
- Departamento de Fisiologia Endócrina e FisiologiaLaboratório de Pesquisas Clínicas e Experimentais em Biologia VascularRio de JaneiroRJBrasilDepartamento de Fisiologia Endócrina e Fisiologia e Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular (BIOVASC), Rio de Janeiro, RJ, Brasil
| | - Poli Mara Spritzer
- Universidade Federal do Rio Grande do SulHospital de Clínicas de Porto AlegreDepartamento de FisiologiaUniversidade Federal do Rio Grande do SulPorto AlegreRSBrasilUnidade de Endocrinologia Ginecológica, Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre e Departamento de Fisiologia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil
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Anawalt BD. Diagnosis and Management of Anabolic Androgenic Steroid Use. J Clin Endocrinol Metab 2019; 104:2490-2500. [PMID: 30753550 PMCID: PMC6517163 DOI: 10.1210/jc.2018-01882] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 01/03/2019] [Indexed: 01/14/2023]
Abstract
CONTEXT The lifetime prevalence of anabolic androgenic steroid (AAS) use is estimated at 1% to 5% worldwide. AAS use occurs primarily male elite athletes and men who want a muscular appearance. The evidence for effective, safe management of AAS cessation and withdrawal is weak. DESIGN Key studies were extracted from PubMed (1990-2018) and Google Scholar with reference searches from relevant retrieved articles. RESULTS The proven adverse effects of AASs include suppression of the gonadal axis and infertility, hirsutism and defeminization in women, and erythrocytosis. Alkylated AASs that are taken orally may cause hepatopathy. There is an association between high-dosage AAS use and increased risk of cardiovascular disease. Clues for AAS use include very low serum high-density cholesterol and sex hormone-binding globulin concentrations and unexplained erythrocytosis. For elite athletes, the biological passport (monitoring of blood or urinary androgen and androgen precursor concentrations after determining the athlete's baseline) is useful for detecting AAS use. For nonelite athletes, the best method to confirm AAS use is to inquire in a nonjudgmental manner. Cessation of chronic AAS use is associated with a withdrawal syndrome of anxiety and depression. CONCLUSIONS Men who use AASs <1 year typically recover normal hypothalamic-pituitary-testicular axis function within 1 year after cessation. Men who have infertility due to high-dosage AAS use ≥1 year might benefit from short-term treatment with clomiphene or human chorionic gonadotropin.
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Affiliation(s)
- Bradley D Anawalt
- Department of Medicine, University of Washington, Seattle, Washington
- Correspondence and Reprint Requests: Bradley D. Anawalt, MD, Department of Medicine, University of Washington Medical Center, Box 356420, 1959 NE Pacific Street, Seattle, Washington 98195. E-mail:
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17
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Vieira TM, Rossi Junior WC, Da Ré Guerra F, Damião B, Marques PP, Esteves A. Effect of testosterone cypionate and stanozolol on the heart of young trained mice: A morphometric study. Steroids 2019; 145:19-22. [PMID: 30772437 DOI: 10.1016/j.steroids.2019.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 02/12/2019] [Indexed: 11/20/2022]
Abstract
Testosterone cypionate and Stanozolol are Anabolic-Androgenic Steroids (AAS) which are synthetic substances that possess functions similar to testosterone. The use of these substances has increased considerably among youngsters and sports practitioners aiming better performance of with aesthetic purposes. The major concern is the effects caused by the inappropriate use of the substances, such as hypertension, myocardial ischemia, and left ventricle hypertrophy. The objective of the present research was to measure the diameter of the left ventricle lumen and the thickness of the left ventricle myocardium in mice submitted to supraphysiological doses of AAS. A total of 30 female Swiss mice were used in the experiments. The animals received supraphysiological doses of the AAS for 30 days, and during the treatment period, they were put to swim in intercalated days. After treatment animals were euthanized and slides were made from the hearts for measurements. Results demonstrated that both AAS changed significantly the heart morphology: Testosterone cypionate led to an increase in the ventricular lumen and stanozolol increased left ventricle myocardium thickness. In conclusion, the use of AAS in supraphysiological doses can change the heart morphology and can lead to serious health consequences.
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Affiliation(s)
- Tânia Martins Vieira
- Institute of Biomedical Sciences, Department of Anatomy, Federal University of Alfenas, Alfenas, Brazil
| | - Wagner Costa Rossi Junior
- Institute of Biomedical Sciences, Department of Anatomy, Federal University of Alfenas, Alfenas, Brazil
| | - Flávia Da Ré Guerra
- Institute of Biomedical Sciences, Department of Anatomy, Federal University of Alfenas, Alfenas, Brazil
| | - Bruno Damião
- Doctorate in the Program of Pharmaceutical Sciences, Federal University of Alfenas, Alfenas, Brazil
| | - Petrus Pires Marques
- Department of Morphology, Medical School, José Vellano University, Unifenas, Alfenas, Brazil
| | - Alessandra Esteves
- Institute of Biomedical Sciences, Department of Anatomy, Federal University of Alfenas, Alfenas, Brazil.
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Lenz B, Röther M, Bouna-Pyrrou P, Mühle C, Tektas OY, Kornhuber J. The androgen model of suicide completion. Prog Neurobiol 2018; 172:84-103. [PMID: 29886148 DOI: 10.1016/j.pneurobio.2018.06.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 09/02/2017] [Accepted: 06/05/2018] [Indexed: 10/14/2022]
Abstract
Suicide is a devastating public health issue that imposes severe psychological, social, and economic burdens not only for the individuals but also for their relatives, friends, clinicians, and the general public. Among the different suicidal behaviors, suicide completion is the worst and the most relevant outcome. The knowledge of biological etiopathological mechanisms involved in suicide completion is limited. Hitherto, no objective markers, either alone or in combination, can reliably predict who will complete a suicide. However, such parameters are strongly needed to establish and optimize prediction and prevention. We introduce here a novel ideation-to-completion framework in suicide research and discuss the problems of studies aiming at identifying and validating clinically useful markers. The male gender is a specific risk factor for suicide, which suggests that androgen effects are implicated in the transition from suicidal ideation to suicide completion. We present multiple lines of direct and indirect evidence showing that both an increased prenatal androgen load (with subsequent permanent neuroadaptations) and increased adult androgen activity are involved in suicide completion. We also review data arguing that modifiable maternal behavioral traits during pregnancy contribute to the offspring's prenatal androgen load and increase the risk for suicide completion later in life. We conclude that in utero androgen exposure and adult androgen levels facilitate suicide completion in an synergistic manner. The androgen model of suicide completion provides the basis for the development of novel predictive and preventive strategies in the future.
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Affiliation(s)
- Bernd Lenz
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany.
| | - Mareike Röther
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Polyxeni Bouna-Pyrrou
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Christiane Mühle
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Ozan Y Tektas
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
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Debate position: cognition and mood are not improved in men administered exogenous testosterone therapy. Curr Opin Urol 2018; 27:525-531. [PMID: 28863017 DOI: 10.1097/mou.0000000000000435] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The purpose of this article is to provide an overview of the increasing evidence suggesting that exogenous testosterone therapy is not associated with improvements in cognition or mood. This article is part of a series, in this issue, in which authors are assigned opinion pieces on controversial topics pertaining to testosterone replacement. RECENT FINDINGS Testosterone is increasingly being prescribed. Particularly in the setting of recent data suggestive of possible cardiovascular risk associated with its use; a clear understanding of the domains of health that improve with exogenous testosterone use is important. Data on endogenous and exogenous testosterone with cognition and mood are mixed, likely partly related to methodological differences of type of testosterone, patient population, and dosing. SUMMARY Overall, available data are not suggestive of a clear benefit of testosterone supplementation in multiple domains of cognition and in mood. Supraphysiologic testosterone has been associated with adverse psychological outcomes, albeit not uniformly in studies.
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Byne W, Karasic DH, Coleman E, Eyler AE, Kidd JD, Meyer-Bahlburg HF, Pleak RR, Pula J. Gender Dysphoria in Adults: An Overview and Primer for Psychiatrists. Transgend Health 2018; 3:57-70. [PMID: 29756044 PMCID: PMC5944396 DOI: 10.1089/trgh.2017.0053] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Regardless of their area of specialization, adult psychiatrists are likely to encounter gender-variant patients; however, medical school curricula and psychiatric residency training programs devote little attention to their care. This article aims to assist adult psychiatrists who are not gender specialists in the delivery of respectful, clinically competent, and culturally attuned care to gender-variant patients, including those who identify as transgender or transsexual or meet criteria for the diagnosis of Gender Dysphoria (GD) as defined by The Diagnostic and Statistical Manual of Mental Disorders (5th edition). The article will also be helpful for other mental health professionals. The following areas are addressed: evolution of diagnostic nosology, epidemiology, gender development, and mental health assessment, differential diagnosis, treatment, and referral for gender-affirming somatic treatments of adults with GD.
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Affiliation(s)
- William Byne
- Mental Illness Research Education and Clinical Center, James J Peters VA Medical Center, Bronx, New York
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai and Center for Transgender Medicine and Surgery at Mount Sinai, New York, New York
| | - Dan H. Karasic
- Department of Psychiatry, University of California, San Francisco, San Francisco, California
| | - Eli Coleman
- Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota
| | - A. Evan Eyler
- Departments of Psychiatry and Family Medicine, University of Vermont College of Medicine, Burlington, Vermont
| | - Jeremy D. Kidd
- Department of Psychiatry, Division on Substance Use Disorders, College of Physicians and Surgeons of Columbia University, New York, New York
| | - Heino F.L. Meyer-Bahlburg
- Division of Gender, Sexuality, and Health, New York State Psychiatric Institute/Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York
| | - Richard R. Pleak
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Hofstra North Shore-LIJ School of Medicine, Albert Einstein College of Medicine, Zucker Hillside Hospital, Ambulatory Care Pavilion, Glen Oaks, New York
| | - Jack Pula
- Department of Psychiatry, Division of Gender, Sexuality and Health, College of Physicians and Surgeons of Columbia University, New York, New York
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21
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Berthonneau C, Nun P, Rivière M, Pauvert M, Dénès F, Lebreton J. Hemisynthesis of 2,3,4-13C3-1,4-Androstadien-3,17-dione: A Key Precursor for the Synthesis of 13C3-Androstanes and 13C3-Estranes. J Org Chem 2018; 83:3727-3737. [DOI: 10.1021/acs.joc.7b03216] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Clément Berthonneau
- Université de Nantes, Chimie et Interdisciplinarité: Synthèse, Analyse, Modélisation (CEISAM), UMR CNRS 6230, 2, rue de la Houssinière BP 92208, Nantes Cedex 3 44322, France
- Atlanchim Pharma, 3, Rue Aronnax, Saint Herblain 44800, France
| | - Pierrick Nun
- Université de Nantes, Chimie et Interdisciplinarité: Synthèse, Analyse, Modélisation (CEISAM), UMR CNRS 6230, 2, rue de la Houssinière BP 92208, Nantes Cedex 3 44322, France
| | - Matthieu Rivière
- Université de Nantes, Chimie et Interdisciplinarité: Synthèse, Analyse, Modélisation (CEISAM), UMR CNRS 6230, 2, rue de la Houssinière BP 92208, Nantes Cedex 3 44322, France
| | - Mickael Pauvert
- Atlanchim Pharma, 3, Rue Aronnax, Saint Herblain 44800, France
| | - Fabrice Dénès
- Université de Nantes, Chimie et Interdisciplinarité: Synthèse, Analyse, Modélisation (CEISAM), UMR CNRS 6230, 2, rue de la Houssinière BP 92208, Nantes Cedex 3 44322, France
| | - Jacques Lebreton
- Université de Nantes, Chimie et Interdisciplinarité: Synthèse, Analyse, Modélisation (CEISAM), UMR CNRS 6230, 2, rue de la Houssinière BP 92208, Nantes Cedex 3 44322, France
- Atlanchim Pharma, 3, Rue Aronnax, Saint Herblain 44800, France
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22
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Bertozzi G, Sessa F, Albano GD, Sani G, Maglietta F, Roshan MHK, Volti GL, Bernardini R, Avola R, Pomara C, Salerno M. The Role of Anabolic Androgenic Steroids in Disruption of the Physiological Function in Discrete Areas of the Central Nervous System. Mol Neurobiol 2017; 55:5548-5556. [PMID: 28971285 PMCID: PMC5994209 DOI: 10.1007/s12035-017-0774-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 09/12/2017] [Indexed: 12/12/2022]
Abstract
Anabolic-androgenic steroids (AAS) abuse is often associated with a wide spectrum of adverse effects. These drugs are frequently abused by adolescents and athletes for esthetic purposes, as well as for improvement of their endurance and performances. In this literature review, we evaluated the correlation between AAS and anxiety or aggression. Two pathways are thought to be involved in AAS-induced behavioral disorders. Direct pathway via the amygdalo-fugal pathway, which connects the central nucleus of the amygdala to the brainstem, is involved in cognitive-emotive and homeostatic processes. The latter is modified by chronic AAS use, which subsequently leads to increased anxiety. Indirect pathways via the serotonergic, dopaminergic, and glutamatergic signals which are modified by AAS abuse in latero-anterior hypothalamus and can mediate the aggressive behavior. In conclusion, the molecular mechanisms underlying the behavioral alterations following AAS abuse is unclear and remains ambiguous as additional long-term studies aimed to understand the precise mechanisms are required.
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Affiliation(s)
- Giuseppe Bertozzi
- Department of Clinical and Experimental Medicine, Section of Forensic Pathology, University of Foggia, Ospedale Colonnello D'Avanzo, Foggia, Italy
| | - Francesco Sessa
- Department of Clinical and Experimental Medicine, Section of Forensic Pathology, University of Foggia, Ospedale Colonnello D'Avanzo, Foggia, Italy
| | - Giuseppe Davide Albano
- Department of Clinical and Experimental Medicine, Section of Forensic Pathology, University of Foggia, Ospedale Colonnello D'Avanzo, Foggia, Italy
| | - Gabriele Sani
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University of Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy
- Centro Lucio Bini, Rome, Italy
| | - Francesca Maglietta
- Department of Clinical and Experimental Medicine, Section of Forensic Pathology, University of Foggia, Ospedale Colonnello D'Avanzo, Foggia, Italy
| | - Mohsin H K Roshan
- Department of Anatomy, School of Medicine, University of Malta, Msida, Malta
| | - Giovanni Li Volti
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Renato Bernardini
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Roberto Avola
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Cristoforo Pomara
- Department of Clinical and Experimental Medicine, Section of Forensic Pathology, University of Foggia, Ospedale Colonnello D'Avanzo, Foggia, Italy.
- Department of Anatomy, School of Medicine, University of Malta, Msida, Malta.
- D'Avanzo Hospital, 71122, Foggia, Italy.
| | - Monica Salerno
- Department of Clinical and Experimental Medicine, Section of Forensic Pathology, University of Foggia, Ospedale Colonnello D'Avanzo, Foggia, Italy
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Zahnow R, McVeigh J, Ferris J, Winstock A. Adverse Effects, Health Service Engagement, and Service Satisfaction Among Anabolic Androgenic Steroid Users. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/0091450917694268] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There are a number of adverse health effects associated with the use of anabolic androgenic steroids (AAS), ranging from mood disturbances to gynecomastia and impaired sexual function. Despite the potentially serious nature of adverse effects, evidence suggests that users are reluctant to seek medical assistance. This study explores factors associated with health service engagement and treatments related to service satisfaction among a sample of AAS users. The analyses are based on a sample of 195 respondents from the Global Drug Survey 2015 who reported using steroids in the previous 12-month period and experiencing concerns about adverse health effects. The results indicate reluctance among AAS users to engage with health services, with only 35.23% reporting that they visited a doctor when experiencing concerns about adverse effects. Concern about sexual function increased the likelihood that users engaged with health services, while concern about changes in sexual organs decreased the odds of service engagement. Among AAS users who engaged with health services, individuals who received a mental health assessment or diabetes test rated the service as more helpful than those who did not; a finding that resonates with literature indicating a desire among AAS users to monitor the health impacts of their drug use and respond to issues as they arise. While more research is needed, the present results underscore a need for nonjudgmental health services aimed at assisting AAS users to monitor adverse effects and minimize harm through early intervention.
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Affiliation(s)
- Renee Zahnow
- Institute for Social Science Research, The University of Queensland, St. Lucia, Queensland, Australia
| | - Jim McVeigh
- Centre for Public Health, Liverpool John Moores University, Liverpool, UK
| | - Jason Ferris
- Institute for Social Science Research, The University of Queensland, St. Lucia, Queensland, Australia
| | - Adam Winstock
- Global Drug Survey, London, UK
- Kings College London, London, UK
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Fadda A, Syed N, Mackeh R, Papadopoulou A, Suzuki S, Jithesh PV, Kino T. Genome-wide Regulatory Roles of the C2H2-type Zinc Finger Protein ZNF764 on the Glucocorticoid Receptor. Sci Rep 2017; 7:41598. [PMID: 28139699 PMCID: PMC5282477 DOI: 10.1038/srep41598] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 12/23/2016] [Indexed: 01/13/2023] Open
Abstract
The C2H2-type zinc finger protein ZNF764 acts as an enhancer for several steroid hormone receptors, and haploinsufficiency of this gene may be responsible for tissue resistance to multiple steroid hormones including glucocorticoids observed in a patient with 16p11.2 microdeletion. We examined genome-wide regulatory actions of ZNF764 on the glucocorticoid receptor (GR) in HeLa cells as a model system. ZNF764- and GR-binding sites demonstrated similar distribution in various genomic features. They positioned predominantly around 50-500 kbs from the transcription start sites of their nearby genes, and were closely localized with each other, overlapping in ~37% of them. ZNF764 demonstrated differential on/off effects on GR-binding and subsequent mRNA expression: some genes were highly dependent on the presence/absence of ZNF764, but others were not. Pathway analysis revealed that these 3 gene groups were involved in distinct cellular activities. ZNF764 physically interacted with GR at ligand-binding domain through its KRAB domain, and both its physical interaction to GR and zinc finger domain appear to be required for ZNF764 to regulate GR transcriptional activity. Thus, ZNF764 is a cofactor directing GR transcriptional activity toward specific biologic pathways by changing GR binding and transcriptional activity on the glucocorticoid-responsive genes.
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Affiliation(s)
- Abeer Fadda
- Division of Translational Medicine, Sidra Medical and Research Center, Doha 26999, Qatar
| | - Najeeb Syed
- Division of Biomedical Informatics, Sidra Medical and Research Center, Doha 26999, Qatar
| | - Rafah Mackeh
- Division of Translational Medicine, Sidra Medical and Research Center, Doha 26999, Qatar
| | - Anna Papadopoulou
- Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA
| | - Shigeru Suzuki
- Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA
- Department of Pediatrics, Asahikawa Medical University, Asahikawa 078-8510, Japan
| | - Puthen V. Jithesh
- Division of Biomedical Informatics, Sidra Medical and Research Center, Doha 26999, Qatar
| | - Tomoshige Kino
- Division of Translational Medicine, Sidra Medical and Research Center, Doha 26999, Qatar
- Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA
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