Associations between types of anabolic androgenic steroids and growth hormone and adverse effects: Insights from a male cohort study

Use of anabolic androgenic steroids (AAS) is associated with a wide range of adverse health effects. Preclinical studies suggest that different AAS compounds, as well as factors including dose and administration routes, may have distinct risks for certain adverse effects. This exploratory study aims to evaluate associations between adverse effects and use of structurally different AAS compounds and human growth hormone (hGH), as well as patterns of AAS use including dose and duration of use. A total of 91 males reporting long-term AAS use completed comprehensive questionnaires detailing their AAS regimen and self-reported adverse effects, comprising psychological, cardiovascular, cognitive, and physical effects. Objective cardiovascular conditions were assessed using echocardiography and blood pressure measurements. Regression models were used to determine the associations between adverse effects and recent use of popular AAS compounds. Recent use of stanozolol was linked to several adverse effects, including psychological, cognitive, and self-reported and objective cardiovascular effects. Recent use of trenbolone was also associated with reported psychological adverse effects. Physical adverse effects and dependence were correlated with higher dosages, earlier initiation age, older age and the use of multiple compounds. Notably, hGH use was associated with fewer AAS dependence symptoms. Though exploratory, our findings highlight the need for caution when using AAS, especially stanozolol and trenbolone, given their potential links to more adverse effects than other popular AAS. Additionally, factors including dose, duration of use, and age of initiation should be considered potential risk factors for undesired effects of AAS.