Presentation Authors: Jonathan Beilan*, Alexander Tatem, Houston, TX, Daniel Mazur, Denver, CO, Jabez Jabez Gondokusumo, Nannan Thirumavalavan, Nelson Vergel, Larry Lipshultz, Houston, TX
Introduction: Urologists are being called upon to counsel an increasing number of patients who are taking androgenic-anabolic steroids (AAS). Despite the potential negative health ramifications of these drugs, physique competitors have long utilized synthetic testosterone and other anabolic steroids. Although there is great concern regarding the potential side effects of AAS, there has been little research into what drives individuals to start bodybuilding. This study serves to update our previous series in an effort to better understand the motivating factors that prompt individuals to begin both bodybuilding and AAS usage.
Methods: An online survey was sent to men's health and bodybuilding forums in an effort to target individuals who may be interested in or actively participate in bodybuilding. Answers were anonymous and not linked to personal data in any way. Participants responded voluntarily and were not compensated for their time.
Results: This updated series includes 212 men who responded to the online survey. Of all respondents, 17.9% were â‰¤35 years old, 36.3% were between 36-50 years old, and 45.8% were >50 years old. Only 20.3% of men engaged to some degree in bodybuilding/physique competition, however 77.3% of men were interested in bodybuilding. The most popular motivators for men to bodybuild were enhancing muscle or strength (26.3%), improving appearance (21.1%), and increasing self-esteem (10.5%). A comparison between individuals who currently participate in bodybuilding versus those who are interested to enter the sport revealed similar rates of AAS use (75.8% vs 77.1%, respectively, p=0.17). Furthermore, both of these groups of men have similar rates of non-prescription AAS usage (34.2% vs 25.7%, respectively, p=0.31). Top motivators to start using AAS included seeing positive results in friends (16.0%), enhancing muscle or strength (13.2%), and improving appearance (10.4%).
Conclusions: Our updated cohort demonstrates that over 75% of men merely interested in bodybuilding use AAS. Remarkably, men interested in bodybuilding have similar rates of non-prescription AAS use compared to those who are already active competitors. Clinicians should remain nonjudgmental and understand that patients interested in bodybuilding are most likely using AAS, and a significant portion of these men are taking non-prescription drugs. We conclude that it is of the utmost importance to take a careful history and consider these motivating factors when evaluating patients for potential hormonal therapy.
Source of Funding: This work is supported in part by NIH grant K12 DK0083014, the Multidisciplinary K12 Urologic Research (KURe) Career Development Program (NT is a K12 Scholar).