ABSTRACT
Androgens, also referred to as anabolic-androgenic steroids (AAS), are a cluster of hormones comprising natural androgens, such as testosterone, as well as synthetic steroidal derivatives. Performance and image enhancing drugs (PIEDs) are categorised based on their reason for use: AAS, the focus of this chapter and the most widely used PIED, promote growth of the skeletal muscle, development of male sexual characteristics in both males and females, reduce body fat and can improve overall well-being. Muscle dysmorphia is not only a gateway to commencing AAS use but also feeds dependence as individuals are petrified of losing their muscular physique. The use of AAS can cause many adverse effects ranging from the mild to life-threatening. AAS contribute to the development of cardiovascular disease by increasing low-density lipoprotein (LDL) and decreasing high-density lipoprotein (HDL), an effect seen soon after starting AAS.
