Anabolic-androgenic steroids (AAS) are immensely popular with athletes and individuals interested in building muscle mass because they are reliable and effective.1 Much like any other drug, licit or illicit, patients or users can easily administer the drug(s) and readily predict the body’s response with the slightest degree of experience. Sadly, because AAS are so simple, most users fail to even attempt to understand how the drugs work and why different AAS provide different results. Further, safety is rarely considered until a problem occurs.

            Pharmacology is the study of the factors involved with how a drug enters and works in the body, the various ways the cells and systems regulate the processes affected and how the body clears the drug. Despite the fact that AAS are based upon an endogenous hormone (testosterone) and have been utilized as a pharmaceutical product for over 50 years, the complete pharmacology of AAS remains undetermined, even though a significant number of men suffer from symptoms of androgen deficiency, with associated health consequences including cardiovascular disease and earlier mortality.2-4 Fortunately, there is a substantial body of published research in the field, nicely reviewed by Dr. Andrew Kicman of the Department of Forensic Science and Drug Monitoring at King’s College London (England) in the British Journal of Pharmacology.5 While the collective knowledge in the field of AAS is incomplete (as it is with every other drug, such being the nature of science), it is sufficient to develop a working understanding of AAS and suggest potential research to improve safety and efficacy.

            Kicman’s review is organized in excellent fashion and comprehensively referenced. Those truly interested in learning about AAS, which should include anyone using or prescribing such drugs (licitly or illicitly), would be well-served to read the review. The British Journal of Pharmacology has provided free access to the article at their website: http://www.nature.com/bjp/journal/v154/n3/pdf/bjp2008165a.pdf.