Anabolic-Androgenic Steroids (2025-2026 Recording)-Anabolic-Androgenic Steroids Recording

Video Transcription

Video Summary

The session focused on anabolic-androgenic steroids (AAS), covering their definition, misuse patterns, diagnosis, complications, and management. Dr. Antwiler explained that AAS are synthetic testosterone derivatives used non-medically for appearance, performance, and body image. Although steroid misuse is declining among adolescents, it remains common in athletes, bodybuilders, military personnel, and some non-athletes. She reviewed normal testosterone physiology, including hypothalamic-pituitary-gonadal axis control, and described how AAS alter this system.<br /><br />Key board-relevant topics included common AAS forms: injectable agents like testosterone esters and nandrolone, and oral 17-alpha alkylated steroids like stanozolol and oxandrolone, which are more hepatotoxic. She highlighted common use patterns such as cycling, stacking, and pyramiding, as well as post-cycle therapies using agents like clomiphene, tamoxifen, hCG, and aromatase inhibitors.<br /><br />The lecture emphasized psychiatric and withdrawal effects, especially irritability, aggression, mood disorders, and the major concern of depression and suicidality after cessation. AAS dependence can be biologically plausible, though DSM-5 criteria can be imperfect for this population. Medical complications reviewed included hypogonadism, infertility, gynecomastia, dyslipidemia, erythrocytosis, cardiomyopathy, atherosclerosis, hepatotoxicity, and injection-related infections.<br /><br />Treatment is largely behavioral and harm-reduction based, since there is no FDA-approved medication for AAS use disorder. Management centers on motivational interviewing, psychoeducation, monitoring withdrawal, and addressing comorbid psychiatric or endocrine issues. The fellows then presented a case of a man using non-prescribed testosterone and described a gradual taper strategy with possible use of clomiphene, hCG, or tamoxifen to support recovery.

Keywords

anabolic-androgenic steroids

AAS misuse

testosterone derivatives

hypothalamic-pituitary-gonadal axis

steroid cycling

steroid stacking

post-cycle therapy

clomiphene

hCG

hepatotoxicity

steroid withdrawal depression