Systemic Effects of Anabolic-Androgenic Steroid Abuse: A Case in Primary Care

Anabolic-androgenic steroid (AAS) abuse is a growing public health concern due to its wide-ranging physical and psychological effects. This case report highlights the multisystemic consequences of prolonged AAS use in a 30-year-old male presenting initially with a minor respiratory infection during a consultation in his healthcare center. Despite his primary complaint, upon physical examination, muscle hypertrophy, bilateral gynecomastia, and suspected testicular atrophy were observed, prompting further investigation. Laboratory findings showed high levels of testosterone, suppressed gonadotropins, elevated estradiol, dyslipidemia, and liver enzyme elevation, consistent with chronic AAS abuse. Imaging confirmed gynecomastia, and the patient was diagnosed with hypertension, likely secondary to AAS use. Despite counseling on the potential short- and long-term health risks, the patient chose to continue AAS use. Ongoing follow-up in primary care, however, made it possible for the patient to return to care after one year, when he presented with depressive symptoms and body image dissatisfaction following steroid cessation, demonstrating the critical role of family physicians in early detection, patient education, and motivational support. This case shows the importance of a thorough approach in identifying AAS abuse and managing its systemic effects to mitigate potentially perilous health outcomes.