In part one of this two-post series on performance-enhancing drugs, I discussed some facts on PED use and their known effects. That post and this one present information from a scientific statement recently published by The Endocrine Society.

Also read:
Performance-enhancing drugs: What we know

We need much more insight into some of the long-term health consequences of PEDs. We need more data on the prevalence of their use, how they affect sports performance and sports injuries, their association with high-risk behaviors, and more. As The Endocrine Society points out, there are many possible factors contributing to our lack of knowledge and awareness in these areas.bodybuilder training with dumbbells

The media focuses on the use of PEDs by professional and other elite athletes. However, recreational users, such as weightlifters and bodybuilders, make up the majority of PED users. Plus, fans and the media concentrate on the competitive advantage of these drugs and not their health consequences.

Well-designed studies on these drugs are not feasible or ethical. We can’t perform randomized controlled trials where researchers place certain subjects into the test groups and force them to use performance-enhancing drugs, especially in the huge doses many weightlifters and bodybuilders use. Plus it would be difficult to control for research biases. For example, PED users often abuse other PEDs or drugs of abuse, and users are less likely to report complications. These factors could influence the data from studies on these drugs. Therefore, most scientific knowledge on PEDs comes from animal studies or isolated medical reports.

Most current and past users of PEDs are still under the age of 50. Since many medical illnesses that would be impacted by PED use, like cardiovascular issues, usually don’t develop until later in life, we might not have seen the real long-term medical consequences of these drugs yet.

Performance-enhancing drugs rarely cause medical emergencies that would require users to be treated in hospital emergency departments, where data on these events would be collected.

Current data on the incidence of PED use likely underestimates the true incidence, since most users obtain and use them Weightlifter - smallsecretly. Most PED use starts after the teenage years, so surveys of high school students probably underestimate the use in all of society. Also, users of these drugs often don’t admit it to their doctors.

Again, I think we need more data on the long-term effects of PEDs, like anabolic-androgenic steroids and human growth hormone. Many of the nonathlete weightlifters and recreational bodybuilders who use PEDs believe that side effects are minimal or can be minimized. Plus knowledge on the true use of these drugs might help us recognize the extent of the problem and devise strategies to better raise awareness.

How common do you think the use of performance-enhancing drugs actually is? What can we do to decrease their use and increase awareness of the risks? Share your thoughts below!

Pope HG Jr, Wood R, Rogol A, Nyberg F, Bowers L, Bhasin S. Adverse Health Consequences of Performance-Enhancing Drugs: An Endocrine Society Scientific Statement. Endocr Rev. 2014