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Anabolic androgenic steroids (AAS), also simply referred to as ‘anabolic steroids’, are drugs derived from testosterone, a hormone that is produced in the testes of males and, to a much lesser extent, in the ovaries of females. Testosterone is partially responsible for the developmental changes that occur during puberty and adolescence and is also involved in controlling the build-up and breakdown of the main biochemical components of all tissues, including muscle.

There are two types of anabolic steroids:

• Exogenous steroids are synthetically created versions of the testosterone hormone. These substances are not naturally produced by the body.
• Endogenous steroids are naturally occurring substances in the human body that are involved with the metabolic pathways of testosterone.

Because testosterone affects muscle growth, raising its levels in the blood can help athletes increase muscle size and strength, along with some other benefits such as improved endurance. Anabolic steroids can be taken in tablet form or injected directly in to the muscle.

Athletes who use anabolic steroids claim that as well as increasing muscle mass, they reduce body fat and recovery time after injury. However, the androgenic (masculinising) side-effects—such as increased body hair and a deepening of the voice—are not always desirable, particularly in women. To counteract these side-effects, scientists developed steroids that retain their anabolic effects but have a lower androgenic effect.

Significant health risks have been associated with the abuse of anabolic steroids. Some of the effects are minor or only last while the drug is being taken; others are more serious and long-term. For example, anabolic steroids can cause high blood pressure, acne, abnormalities in liver function, alterations in the menstrual cycle in women, decline in sperm production, impotence and gynaecomastia (growth of breasts) in men, kidney failure and heart disease. They can also make both men and women more irritable, potentially leading to mood swings.

Testing for anabolic steroids has come a long way since the 1970s, when basic radioimmunoassay techniques were used. Today, anabolic steroids and their metabolites can generally be detected in urine, using mass spectrometry. However, since testosterone occurs naturally and amounts in the body fluctuate daily and can vary from person to person, setting a threshold above which an athlete is deemed to be ‘using’ anabolic steroids remains a subject of debate.

Today, anti-doping labs use a range of complex techniques and technology to distinguish between testosterone produced naturally by the body (endogenous) and that which is a result of synthetic compounds (exogenous).

Continuing advancements in the detection of steroids (and stimulants) are currently being developed. In 2014, that a research team in the US was working on a detection system that was being touted as a 1000-fold improvement on the commonly used mass spectrometry-based technique. The new technique, named Paired Ion Electrospray Ionisation (PIESI), makes traces of steroids or amphetamines more visible to current detection equipment by introducing a chemical agent that effectively binds itself to the traces, right down to the parts per trillion. This process is not yet used by the World Anti-Doping Agency as a sanctioned test.

To develop reliable tests, researchers have to know what they are looking for. This is difficult because the development of new ‘designer’ steroids is an ongoing process. The introduction of the Athlete Biological Passport, which can identify the markers of drug use even if the drug itself is not detected, may go some way to helping curb the use of steroids in athletes.