Sport Performance (wk 10)

Question 1

What are AAS?

Answer 1

-AAS -> Anabolic-androgenic steroids
-First used in professional athletes
-Increasingly common in recreational gym users (Ip et al., 2012) – predominantly used by non-athlete weightlifters/ bodybuilders
-Prohibited in sport but largely unnoticed in gyms - ADRV’s in sport

Question 2

Drivers of use in AAS
-Prevalence

Answer 2

• Estimated that between 328,00 to 687,000 makes used AAS in the UK (Hope et al., 2023)
• Estimated that between 17,000 to 76,000 use AAS in the UK (Hope et al., 2023)
• Global prevalence of 3.3% (Sagoe et al. 2014) – most commonly used IPED

Question 3

Drivers of use in AAS
-Internal motivations and Muscle dysmorphia

Answer 3

-Internal motivations -> Body dissatisfaction and desire to increase size. Includes: Muscle dysmorphia (Pope at al., 2012), Eating disorders (Cole et al., 2003).
-Muscle dysmorphia -> Pope et al. 2005 -> Belief that the individual is puny and small when in reality they are unusually muscular. May neglect important social/occupational activities – bodily shame/ meticulous diet/ regimented training. Poor quality of life, suicidal attempts, high frequency of substance abuse.

Question 4

Identified harms associated with misuse
(undesired effects, cosmetic, physical, psychological + study)

Answer 4

-Undesired effects -> Myriad of effects – idiosyncratic and dependent on dose. UGLs – increased risk of harms
-Cosmetic -> Acne, increased bodily hair, baldness, abscesses
-Physical -> Muscle/ tendon damage, cholesterol imbalances, elevated RBSCs, lowering of voice, gyno, clitoral enlargement
-Psychological -> Decreased/ increased libido, depression, increased anxiety, mood swings, insomnia, increased body checking
-Bjornebekk group (2016,2021,2022) -> Neurological studies from this group found: thinner cortices, reduced brain volume, increased brain ageing, decreased BDNF.

Question 5

Describe what AAS dependence is

Answer 5

-Dependence -> ‘Continuous use despite adverse medica, psychiatric, social, and occupational effects’ (Kanayama et al., 2009). 30% of AAS users (Pope et al., 2014). Researchers has explored the differing levels of dependence in AAS users (Scarth et al., 2022)

Question 6

AAS dependence
-AAS Use in women + motivations and undesired effects

Answer 6

-AAS Use in women -> Professionalism in female bodybuilding and trends in desire to enhance fitness (Henning and Andreasson, 2019). 1.6% lifetime prevalence in women (Sagoe et al. 2014). Motivations:
* Similar to men = increased muscle mass, strength and aesthetics (Ip et al., 2010)
* Different to men = increase self-protection after abuse (Gruber and Pope, 1999), improving self-evaluation and self-confidence (Dunn et al., 2022)
Often pushed to use by male figure (e.g. coaches and/or partner: Dunn et al., 2022)
Undesired effects:
* Often irreversible – masculinizing effects
* Clitoral enlargement
* Irregular menstrual cycles and/ or fertility

Question 7

Stats and description of the public health issue of AAS use

Answer 7

-342% increase of AAS users in UK from 1995 to 2015 (McVeigh & Begely, 2016)
-From Hope et al. (2023)’s estimations up to 763,000 men and women are currently using
-Presence of BBVs in this population
-Only 37.1% of AAS users seek medical support
-Absence of treatment, prevention or intervention protocols in the UK

Question 8

Public health issue of AAS use
-Prevention vs Harm reduction

Answer 8

-Prevention vs Harm reduction -> Is prevention prudent – 1920’s prohibition. Needle and syringe programs. Educational programs. Understanding motivations to use substances. Managing use.