Shelton and Rajfer (2012) noted that androgen deficiency in aging men is common, and the potential sequelae are numerous. In addition to low libido, erectile dysfunction, decreased bone density, depressed mood, and decline in cognition, studies suggest strong correlations between low testosterone, obesity, and the metabolic syndrome. Because causation and its directionality remain uncertain, the functional and cardiovascular risks associated with androgen deficiency have led to intense investigation of testosterone replacement therapy in older men. Although promising, evidence for definitive benefit or detriment is not conclusive, and treatment of LOH is complicated.
Anabolic steroids do have legitimate medical uses. They were first synthesized in the 1930s to treat underdeveloped testes and resulting testosterone deficiency. In the 1950s, they were used to treat anemia and muscle-wasting disorders and to bulk up patients whose muscles had atrophied from extended bed rest. In the 1960s, anabolic steroids were used to treat some forms of dwarfism. Today anabolic steroids are being studied for their ability to alleviate the extreme body wasting associated with acquired immunodeficiency syndrome (AIDS). Their most common use, however, remains among athletes seeking a quick competitive edge.
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