Yesalis, C. E., & Bahrke, M. S. (1995). Anabolic-androgenic steroids: Current issues. Sports Medicine, 19, 326-340.

This excellent review article covers a variety of topics associated with anabolic-androgenic steroid (AAS) use. Of particular relevance is the issue of ergogenic effects because it is believed widely that any AAS will enhance performance in any sport; this is the stance of the World Anti-Doping Agency (WADA) because a positive test result leads to public condemnation, vilification, and at least a two-year ban from sporting participation.

The extent to which ergogenic effects occur from AAS use and the factors underlying their use are numerous and complex. Research variables that need to be considered when performing research include: dosage, testing methods, training methods, drugs, study participants, diet, study design, mechanism of action, length of study, placebo effect, data interpretation, and legal and ethical issues.

Animal studies involving a variety of species have failed to demonstrate consistent effects that surpass lean body mass or performances derived from exercise alone (p. 329). Early analyses attributed performance improvements associated with AAS use mainly to anabolic forms of training (strength training and body building). The parameters of training to derive those effects have not been clearly defined.

Not every individual will react positively to AAS and anabolic training because there is a threshold response of body composition to AAS, as well as variations in response according to type of steroid [Friedl, K., Dettori, J., Hannan, C., et al. (1991). Comparison of the effects of high dose testosterone and 19-nortestosterone to a replacement dose of testosterone on strength and body composition in normal men. Journal of Steroid Biochemistry and Molecular Biology, 40, 607-612]. A majority of studies have shown ergogenic effects in trained subjects that surpassed effects from training alone. However, when subjects were inexperienced or not pretrained with weights, no ergogenic effects were demonstrated. These differences suggest that AAS use effects mainly come from a placebo effect [the treatment affects a subject's expectation for and determination to achieve a result].

There is inadequate scientific information about the effects of high doses or prolonged administration on physique or physiological capacities, reactions to the termination of AAS use, and any effects on females. [Opinions on this latter factor have been influenced by documented programs of AAS use by East German and USSR athletes, particularly women. General opinion is that females derive much greater performance enhancement from AAS use than do men. However, that interpretation still has not been objectively verified by studies employing acceptable scientific methodology.]

Implication. The use of anabolic-androgenic steroids in sports is reported widely as being universally ergogenic. However, scientific findings do not support such a sweeping generalization and suggest the following about AAS ergogenic effects.

• AAS appear to work under certain circumstances with anabolic activities such as weight training and body building. [Research has shown they do not "work" with endurance activities.]
• Effects only occur with experienced trained athletes and not untrained athletes [giving rise to the hypothesis that the effects are due to a placebo effect and not a true effect].
• Individuals respond to various AAS differently, dispelling the popular over-simplified folk-myth that all AAS have similar ergogenic effects in all people in all sports.
• Individuals have thresholds of AAS response. Unless an individual is administered a dose that surpasses the response threshold, there can be no effect. [This calls into question the contention that an athlete who tests positive for a nanoscopic level of an AAS has derived performance-enhancement from the substance.]
• Many of the popularly espoused properties of AAS effects and use in sport are based in myth, misconception, and perpetuated for personal or institutional gains (e.g., WADA, USADA, ASDA).

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