Anabolic androgenic steroids (AAS) are known to be misused both in competitive and in non-competitive sports (Haupt and Rovere 1984; Wilson 1988; Yesalis etal. 1993). Moreover, it seems that AAS are becoming "social drugs", as even young people apply them as an expression of an improved "life-style".

The misuse of AAS in athletics has been observed for more than 40 years. The first rumours dated from 1954 and were attributed to weightlifters who seemed to have used testosterone (Wade 1972). By 1965 synthetic AAS had become widely popular amongbodybuilders andweightlifters,but were also applied in other forms of sports.

By using these steroids athletes hoped to increase muscle strength. Such improvements in muscle strength to increase physical performance in sport are naturally an essential effect of training. As AAS stimulate protein synthesis in muscle cells, athletes expect performance-enhancing effects beyond that brought about by training alone. At the end of the sixties the first anti-doping rules were established by international sport federations (1967 International Cycling Union, UCI, and 1968 International Olympic Committee, IOC), but only stimulants and narcotics were banned (Clasing 1992). At that time the Medical Commission (MC) of the IOC was alreadyaware of widespread misuse of AAS in sports. They were not banned because no reliable method was available to detect them (Beckett and Cowan 1979). Under these circumstances the first methods for AAS detection were developed (Brooks etal. 1975; Ward etal. 1975) and in 1974 the MC of the IOC and the International Amateur Athletic Federation (IAAF) first banned the use of AAS. This prohibition encompassed only synthetic steroids, such as metandienone, stanozolol etc. and the misuse of endogenous steroids, e.g. testosterone, was not restricted. At that time athletes misused only synthetic AAS. The reason was that AAS were used in human medicine to treat catabolic conditions, scientific data obtained from animal studies led to the conclusion that synthetic AAS are more anabolic and less androgenic than testosterone itself (Kochakian 1976).

Whether athletes experience a positive performance-enhancing effect or not when using AAS has been discussed controversially for many years. Nowadays it is known that androgens have muscle growth-promoting effects in boys, in women and in hypogonadal men. It has never been proven that androgens, when administered in therapeutical doses, have positive effects on muscle growth in adult men. The assumption that AAS have less effect on muscle growth in males is based on the fact that the androgen receptor in men is nearly completely saturated (Wilson 1996). However, high doses of androgens have been reported to exert muscle mass enhancing effects (Bhasin et al. 1996). An unethical and secret program of hormonal doping of athletes in the former German Democratic Republic was reported (Franke and Berendonk 1997) and performance-improving effects of AAS were elucidated.

To control the (mis)use of synthetic AAS urine samples of athletes collected after competition events were tested. As AAS are not used directly during competition but rather during training to increase muscle strength, athletes stopped administration of AAS before competition, switching to those AAS (e.g. stanozolol) they believed could not be detected and to endogenous androgens, such as testosterone, which were not banned. Investigations of test samples from the Olympic Summer Games 1980 in Moscow showed that 2.1% of male and 7.1% of female athletes had elevated testosterone levels (Zimmermann 1986) in urine and the highest urinary testosterone levels were detected for women in swimming and track and field events (Donike 1983). These results could only be explained by exogenous application of testosterone. Donike developed a gas chromatographic/mass spectrometric (GC-MS) method for detection of testosterone and epitestosterone excreted in urine and proved that the ratio of testosterone to epitestosterone is significantly increased after application of testosterone (Donike et al. 1983). Based on these results sport federations also banned testosterone in 1984 and applied the T/E ratio measurements (cutoff level of six) to their rules. In addition to the ban of testosterone other endogenous androgens such as dihydrotestosterone and prohormones of testosterone, dihydrotestosterone and nortestosterone were added to the list of prohibited AAS during recent years.

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