Endocrine Abstracts

Objective: The use of anabolic, androgenic steroids (AAS) to increase muscle mass and strength has become widespread among younger men engaged in recreational strength training. Although, repercussions exist for elite athletes with a ban of two to four years, the long-term effects on muscle mass following cessation are currently unknown. The present study aims to investigate previous users’ ability to retain lean mass and strength after long-term AAS cessation.

Design and methods: A cross-sectional study of men involved in strength training, including current and previous users of AAS, and recreational athletes with no prior use of AAS (controls). Lean body mass was assessed by dual-energy X-ray absorptiometry (DXA). Strength was assessed by one repetition max (1RM) bench press and leg press performed under controlled laboratory settings. Standardized questionnaires were used to assess AAS use, and blood was drawn, measuring serum total and free testosterone using liquid chromatography mass spectrometry.

Results: We included 40 participants (14 current, 11 previous, and 15 controls with no AAS use). The mean (SD) age was 31.3 (6.8) years, with no differences between groups (0.920). The median (IQR) length of AAS use was 149.5 (104-208) vs. 48 (24-186) weeks for current and previous users (P=0.049). Median (IQR) time since cessation was 5.0 (1-14) years among previous users. As expected, free testosterone levels were increased in current AAS users (P=0.017), while no difference was observed among previous users (P=0.332) and controls (median (IQR): 1.7 (0.5-3.1) vs. 0.4 (0.4-0.5) vs 0.6 (0.5-0.7) nmol/l). Interestingly, lean mass of the upper extremities was higher in both current (P=0.010) and previous users (P=0.021) compared with controls (12.4 vs. 12.3 vs. 10.8 kg). In contrast, no difference in lean mass was observed for the lower extremities (P=0.200). Strength performance in 1RM leg press was significantly higher in current users (P=0.015), while a benefit was suggested in previous users (P=0.068) as compared with controls (367 vs. 279 vs. 235 kg). Accordingly, current, and previous users showed a tendency towards outperforming controls in 1RM bench press with (133 vs. 136 vs. 111 kg)(P<0.010).

Conclusion: Previous users showed compartmentally increased lean body mass and a tendency towards greater strength even 5 years after discontinuation of AAS when compared with controls, mirroring findings among current users. The suggested ability to retain an increase in lean mass following AAS use may translate to retaining an advantage in competitive settings.