Adolescence as a Unique Period of Vulnerability to Anabolic-Androgenic Steroid Exposure: A Narrative Review
DOI:
https://doi.org/10.12775/QS.2026.72.74917Keywords
anabolic-androgenic steroids, adolescence, developmental vulnerability, muscle dysmorphia, endocrine disruption, cardiovascular riskAbstract
Introduction. The non-medical use of anabolic-androgenic steroids (AAS) is an increasingly important public health concern among adolescents, particularly males engaged in resistance training, appearance-oriented sports, and social media-driven muscularity culture. Adolescence represents a period of increased vulnerability because exposure to supraphysiological androgen concentrations occurs during ongoing endocrine, skeletal, reproductive, cardiovascular, and neuropsychiatric development. This narrative review synthesizes current evidence on the health consequences of adolescent AAS exposure, focusing on endocrine disruption, cardiovascular, neuropsychiatric, and musculoskeletal complications, developmental vulnerability, and long-term health risks.
Brief description. Available evidence indicates that AAS exposure may suppress the hypothalamic-pituitary-gonadal axis, impair spermatogenesis, contribute to hypogonadism, and disrupt pubertal maturation. Reported cardiovascular complications include dyslipidaemia, hypertension, myocardial remodelling, cardiomyopathy, and increased cardiovascular risk. Neuropsychiatric effects include aggression, mood disturbances, dependence, withdrawal syndromes, and body image-related psychopathology. Additional concerns include hepatotoxicity, renal injury, gynecomastia, premature epiphyseal closure, and tendon rupture. However, direct evidence in adolescents remains limited, and many long-term risks are extrapolated from adult cohorts and developmental biology.
Conclusions. Adolescents should not be regarded simply as younger adult AAS users. Exposure during adolescence may disrupt critical biological and psychological development, potentially resulting in long-term health consequences. Prevention should emphasize early education, identification of body image-related risk factors, and multidisciplinary interventions targeting both health behaviours and psychosocial vulnerabilities.
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Copyright (c) 2026 Kacper Petelicki, Julia Szulim, Agnieszka Tora, Ewa Biełanowicz, Aleksandra Barszcz, Wojciech Pondo, Jan Koziej, Krzysztof Skoczyński, Maksymilian Sikorski, Michał Szczechowicz, Filip Tokarski, Natalia Malicka
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