Hassan Bin Usman, Farah Rashid, Harris Ayub, Adil Ayub, Nabeel Akram, Samran Walter, Summia Matin, Shanza Bashir.
Knowledge, awareness and practices of harmful effects of anabolic steroids among body builders in Rawalpindi and Islamabad.
Pak Armed Forces Med J Jan ;65(2):282-5.

Objective: To determine the knowledge, awareness and practices of anabolic steroids amongst body builders of Rawalpindi and Islamabad. Study Design: Cross sectional study. Place and Duration of Study: The study was conducted in various gyms and fitness centres in Rawalpindi and Islamabad from November 2013 to May 2014. Material and Methods: A structured close ended questionnaire was filled from the body builders in various gyms/fitness centres after taking informed consent. A total of 310 male body builders between age group of 15-35 years were interviewed by non-probability convenience sampling technique. Standard descriptive and analytical statistics were used to analyze the data. Data analysis was done including variables like age, education, legality, motivation, workout, side effects and withdrawal symptoms of steroids. Chi-square test was used to ascertain the association between categorical variables, 95% confidence intervals (95% CI) and p value less than 0.05 was considered significant. Results: A total of 310 male adolescents were surveyed, 64% reported past or present use of anabolic steroids. Mean (SD) age of the body builders was 24.7 (+ 3) years and most (84%) of them were educated. More than 72% of all the body builders had the knowledge that the steroids are harmful for their health. About the side effects of steroid use, 37% knew about hair loss, acne 21%, aggression/hypertension 14%, and sterility/infertility 15%. Bodybuilders who were aware that steroid use is illegal was 62% but still they were using them (p <0.001). The withdrawal symptoms of steroids were not known to 64% bodybuilders (p < 0.001). Trainers and friends seemed to be the main motivational forces (p <0.008). Bodybuilders taking steroids were satisfied using them (p < 0.000). It was interesting to note that the bodybuilders who were themselves hooked onto steroids were not willing to recommend others to use them (p < 0.000). Mood swings were seen in majority (61%) of bodybuilders. About 17% of the non-users of steroids were planning to start it in future. Steroids in the injectable form were used by 83% of the bodybuilders. Conclusion: Use of steroids in bodybuilders is rising and a large number of body builders are using anabolic steroids without proper knowledge of the adverse effects and withdrawal symptoms of steroids. People being aware that steroids are illegal, continue using them. Trainers, peer pressure are main motivators for steroid use. Most of the body builders who are taking steroids seem pleased with its effect on the body. In addition, our study showed that there were unregulated sources of steroids in Rawalpindi and Islamabad from where the majority of the participants can have easy access. Media and health care professionals can play a vital role in the dissemination of knowledge.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com