Recognizing IPED Use in Clinical Practice
Abstract
Abstract. The non-medical use of image- and performance-enhancing drugs (IPEDs) is widespread in the fitness and bodybuilding scene. The reasons for IPED use are often hedonistic in nature and they are used in so-called “cycles” over several weeks. The most common side effects are: testicular atrophy, acne, hypersexuality, hypertension, gynecomastia, lipid metabolism disorders, mood swings, hair loss, and policythemia. Common consequences following IPED use are: decreased libido, oligo- or azoospermia, and erectile dysfunction. To reduce undesirable side effects and consequences, IPED users often take medications for self-treatment; occasionally IPED users also mention such medications and ask for them in the general medical practice.
Zusammenfassung. Die nicht-medizinische Anwendung von form- und leistungsfördernden Medikamenten (Image- and Performance-Enhancing Drugs, IPED) ist in der Fitness- und Bodybuilding-Szene weit verbreitet. Die Gründe für den IPED-Gebrauch sind oft hedonistischer Natur, und die Anwendung erfolgt oft in mehrwöchigen sogenannten «Kuren». Die häufigsten Nebenwirkungen während einer IPED-Anwendung sind: Hodenschrumpfung, Akne, Hypersexualität, Bluthochdruck, Gynäkomastie, Lipidstoffwechselstörungen, Stimmungsschwankungen, Haarverlust und Polyglobulie. Häufige Folgen nach einer IPED-Anwendung sind: Reduktion der Libido, Oligo- oder Azoospermie und erektile Dysfunktion. Um unerwünschte Nebenwirkungen und Folgen von IPED zu reduzieren, werden oft Medikamente zur Selbstbehandlung eingenommen und gelegentlich auch in der allgemeinärztlichen Praxis angesprochen und nachgefragt.
Résumé. L’utilisation non médicale de médicaments améliorant la forme et les performances (Image- and Performance-Enhancing Drugs, IPEDs) est très répandue dans le milieu du fitness et du bodybuilding. Les raisons de l’utilisation d’IPEDs sont souvent de nature hédoniste et l’utilisation se fait souvent en «cycles» de plusieurs semaines. Les effets secondaires les plus fréquents sont: rétrécissement des testicules, acné, hypersexualité, hypertension, gynécomastie, troubles du métabolisme lipidique, sautes d’humeur, perte de cheveux et polyglobulie. Les conséquences après une application IPED sont: réduction de la libido, oligospermie ou azoospermie et dysfonctionnement érectile. Afin de réduire les effets secondaires et les conséquences indésirables de l’application, les utilisateurs d’IPEDs prennent souvent des médicaments en auto-traitement qu’ils abordent et demandent parfois dans leur cabinet de médecine générale.
Bibliography
. The global epidemiology of anabolic-androgenic steroid use: a meta-analysis and meta-regression analysis. Ann Epidemiol. 2014;24(5):383–398.
. Characteristics and Attitudes of Men Using Anabolic Androgenic Steroids (AAS): A Survey of 2385 Men. Am J Mens Health. 2020;14(6): 1557988320966536.
. Public health impact of androgens. Curr Opin Endocrinol Diabetes Obes. 2018;25(3): 218–223.
. Anabolic androgenic steroid abuse in young males. Endocr Connect. 2020;9(4):R102–R111.
. The injecting use of image and performance-enhancing drugs (IPED) in the general population: a systematic review. Health Soc Care Community. 2017; 25(5):1459–531.
, A diagnostic interview module for anabolic-androgenic steroid dependence: Preliminary evidence of reliability and validity. Exp Clin Psychopharmacol. 2010;18(3):203–213.
. Issues for DSM-V: Clarifying the Diagnostic Criteria For Anabolic-Androgenic Steroid Dependence. Am J Psychiatry. 2009;166(6): 642–645.
. A league of their own: demographics, motivations and patterns of use of 1,955 male adult non-medical anabolic steroid users in the United States. J Int Soc Sports Nutr. 2007;4(1):1–14.
. Anabolic steroid users’ attitudes towards physicians. Addict Abingdon Engl. 2004;99(9):1189–1194.
. The stigma of anabolic steroid use. J Drug Issues. 2016;46(4):446–456.
. Healthcare professionals’ stigmatization of men with anabolic androgenic steroid use and eating disorders. Body Image. 2015;15(C):49–53.
. General practitioners and doping in sport: attitudes and experience. Br J Sports Med. 2003;37(4): 335–338.
. Prevalence, Attitude, Knowledge, and Practice of Anabolic Androgenic Steroid (AAS) Use Among Gym Participants. Mater Socio Medica. 2018;30(1):49.
. Long-term psychiatric and medical consequences of anabolic-androgenic steroid abuse: a looming public health concern? Drug Alcohol Depend. 2008; 98(1–2):1–12.
. Anabolic steroid-induced hypogonadism: diagnosis and treatment. Fertil Steril. 2014;101(5):1271–1279.
, Prolonged Hypogonadism in Males Following Withdrawal from Anabolic-Androgenic Steroids: an Underrecognized Problem. Addict Abingdon Engl. 2015;110(5):823–831.
. Outpatient clinic for users of anabolic androgenic steroids: an overview. Neth J Med. 2018;76(4):167.
