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Anabolic androgenic steroids (AASs) are appearance and performance-enhancing drugs (APEDs) used in competitive athletics, in recreational sports, and by body-builders. The global lifetime prevalence of AASs abuse is % for males and % for women. Many AASs, often obtained from the internet and dubious sources, have not undergone proper testing and are consumed at extremely high doses and in irrational combinations, also along with other drugs. Controlled clinical trials investigating undesired side effects are lacking because ethical restrictions prevent exposing volunteers to potentially toxic regimens, obscuring a causal relationship between AASs abuse and possible sequelae. Because of the negative feedback in the regulation of the hypothalamic-pituitary-gonadal axis, in men AASs cause reversible suppression of spermatogenesis, testicular atrophy, infertility, and erectile dysfunction (anabolic steroid-induced hypogonadism). Should spermatogenesis not recover after AASs abuse, a pre-existing fertility disorder may have resurfaced. AASs frequently cause gynecomastia and acne. In women, AASs may disrupt ovarian function. Chronic strenuous physical activity leads to menstrual irregularities and, in severe cases, to the female athlete triad (low energy intake, menstrual disorders and low bone mass), making it difficult to disentangle the effects of sports and AASs. Acne, hirsutism and (irreversible) deepening of the voice are further consequences of AASs misuse. There is no evidence that AASs cause breast carcinoma. Detecting AASs misuse through the control network of the World Anti-Doping Agency (WADA) not only aims to guarantee fair conditions for athletes, but also to protect them from medical sequelae of AASs abuse.

In sommige gevallen kan je hiv-behandelaar zogenaamde lipidenverlagende geneesmiddelen voorschrijven. Deze middelen worden gebruikt om hart- en vaatziekten mee te behandelen en bestaan uit statines (die het cholesterolgehalte verlagen) en fibraten (die zowel het triglyceriden- als het cholesterolgehalte verlagen). Sommige statines kunnen reageren op proteaseremmers en zowel statines als fibraten kunnen elk hun eigen bijwerkingen veroorzaken. Je hiv-behandelaar zal dan ook regelmatig tests uitvoeren om te controleren of er bij jou sprake is van deze bijwerkingen.

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