Anabolic-androgenic Steroid Use in Saudi Arabia and its Impact on Sexual and Reproductive Health: A Systematic Review
Bibliographic record
Abstract
Objectives: Despite severe side effects, anabolic steroids are widely used to enhance appearance and performance, raising global health concerns as unsupervised use persists. We aimed to assess Anabolic-androgenic Steroid (AAS) prevalence and risk factors in Saudi Arabia. Methods: Systematic Medline/PubMed and Google Scholar searches were performed to identify articles of interest related to AAS use in Saudi Arabia from the database's inception until August 2024. Following the PRISMA checklist, the following were included in the search: “Anabolic Steroids and Misuse” and “Anabolic Steroids and Saudi Arabia”. Inclusion and exclusion criteria were used to screen literature and extract data. The Ottawa scale was used for quality evaluation and assessment of nonrandomized studies. We identified 15 articles that reported AAS misuse variables between 2016 and 2024. All studies had a cross-sectional design. We synthesized our results by identifying similarities, highlighting differences between studies and making recommendations based on our findings. Results: Our systematic review revealed that 5303 individuals in Saudi Arabia were reported to have misused AAS based on 15 review articles that have been evaluated in this systematic review. The AAS was predominantly sourced from the internet, friends and gym trainers and the Central Province in Saudi Arabia exhibited the highest instances of AAS misuse. Gym members had a higher prevalence of AAS use. The mean age across the studies ranged from 18 to 49 years. The majority of AAS misusers were males. Most users were either single or not in committed relationships. The prevalence of AAS misuse in Saudi Arabia ranged from 4.7%-32%. The preferred route of AAS administration was oral intake. The most commonly misused AAS types reported in our review were testosterone and deca-durabolin, frequently noted in several studies. Metandienone and oxandrolone have been popular oral AAS choices in multiple studies. The most frequent reports of adverse effects among AAS misusers were liver and kidney damage and psychiatric problems such as depression, breast hypertrophy and hypertension. Sexual dysfunction was reported in 10.6% and 13% of the patients, respectively. Infertility was reported to be 24.5% among users. Conclusion: Our review shows high AAS misuse among Saudi gym members, highlighting the need for public health education and preventive measures, especially for teens.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.020 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.005 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".