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Anabolic androgenic steroids (AAS) are synthetic analogs of testosterone that induce an increase in body mass, muscle mass, bone intensity, collagen deposition, primarily through the action of the androgen receptor, particularly when they are used in supraphysiological doses to boost the serum testosterone level up to 1000 ng/dL. This study was conducted to address attitudes and health issue awareness of AAS use amongst male gym users in Sulaymaniyah city using an anonymous questionnaire. Most of the participants (67%) were aged between 18 and 30 years and well-educated (65.7%). However, there was no correlation between education level and participants’ opinions about using or banning AAS. The most commonly used AASs were testosterone (15.2%) and dianabol (12.5%), and injectable forms were frequently used (54.9%). Coaches (18.2%) and friends (12.1%) were the main sources of gym users’ introduction to AAS. Despite being unwilling to disclose, 45.9% of them indirectly admitted or knew someone who had AAS-related adverse effects, including acne, skin rash, eczema (29%), infertility (7.9%), reduced libido (7.9%), testicular atrophy (5.3%). The vast majority (84.8%) of them had information at least about one or more adverse effects of AAS, but still 26.3% of them were active users of AAS. The use of AAS was relatively high among gym users in the region.

Attitude and health issue awareness of anabolic androgenic steroids use among male gym users in some gym centers in Sulaymaniyah city, Iraq