Performance-enhancing substances, also known as performance-enhancing drugs (PEDs), are substances that are used to improve any form of activity performance in humans. A well-known example of
cheating in sports Cheating in sports may refer to:
* Cheating
* Cheating in baseball
* Cheating in bridge
* Cheating in chess
* Cheating in esports
* 1994 Formula One cheating controversy
* Cheating at the Paralympic Games
* Doping at the Olympic Games
* Doping at t ...
involves
doping in sport, where banned physical performance-enhancing drugs are used by athletes and
bodybuilders
Bodybuilding is the use of progressive resistance exercise to control and develop one's muscles (muscle building) by muscle hypertrophy for aesthetic purposes. It is distinct from similar activities such as powerlifting because it focuses ...
. Athletic performance-enhancing substances are sometimes referred to as ergogenic aids.
Cognitive performance-enhancing drugs, commonly called
nootropics,
are sometimes used by students to improve academic performance. Performance-enhancing substances are also used by military personnel to enhance combat performance.
The use of performance-enhancing drugs spans the categories of legitimate use and
substance abuse.
Definition
The classifications of substances as performance-enhancing substances are not entirely clear-cut and objective. As in other types of
categorization, certain
prototype performance enhancers are universally classified as such (like
anabolic steroids), whereas other substances (like
vitamins
A vitamin is an organic molecule (or a set of molecules closely related chemically, i.e. vitamers) that is an essential micronutrient that an organism needs in small quantities for the proper functioning of its metabolism. Essential nutrien ...
and
protein
Proteins are large biomolecules and macromolecules that comprise one or more long chains of amino acid residues. Proteins perform a vast array of functions within organisms, including catalysing metabolic reactions, DNA replication, res ...
supplements) are virtually never classified as performance enhancers despite their effects on performance. As is usual with categorization, there are borderline cases;
caffeine
Caffeine is a central nervous system (CNS) stimulant of the methylxanthine class. It is mainly used recreationally as a cognitive enhancer, increasing alertness and attentional performance. Caffeine acts by blocking binding of adenosine to ...
, for example, is considered a performance enhancer by some but not others.
Types
The phrase has been used to refer to several distinct classes of drugs:
Anabolic steroids
Anabolic steroids are synthetically derived from testosterone and modified to have greater anabolic effects.
They work by increasing the concentration of nitrogen in the muscle which inhibits catabolic
glucocorticoid
Glucocorticoids (or, less commonly, glucocorticosteroids) are a class of corticosteroids, which are a class of steroid hormones. Glucocorticoids are corticosteroids that bind to the glucocorticoid receptor that is present in almost every verteb ...
binding to muscle. This ultimately prohibits the breakdown of muscle and preserves muscle mass. Examples of anabolic steroids include:
oxandrolone
Oxandrolone, sold under the brand names Oxandrin and Anavar, among others, is an androgen and anabolic steroid (AAS) medication which is used to help promote weight gain in various situations, to help offset protein catabolism caused by long-ter ...
,
stanozolol
Stanozolol ( abbrev. Stz), sold under many brand names, is an androgen and anabolic steroid (AAS) medication derived from dihydrotestosterone (DHT). It is used to treat hereditary angioedema. It was developed by American pharmaceutical company W ...
and
nandrolone
Nandrolone, also known as 19-nortestosterone, is an androgen and anabolic steroid (AAS) which is used in the form of esters such as nandrolone decanoate (brand name Deca-Durabolin) and nandrolone phenylpropionate (brand name Durabolin). Nandrolon ...
.
Anabolic steroids can be taken through a
transdermal
Transdermal is a route of administration wherein active ingredients are delivered across the skin for systemic distribution. Examples include transdermal patches used for medicine delivery.
The drug is administered in the form of a patch or ointme ...
method, orally, or through injection. Injectable forms of the steroid are the most potent and long-lasting.
In general, potential side effects include:
muscle hypertrophy
Muscle hypertrophy or muscle building involves a hypertrophy or increase in size of skeletal muscle through a growth in size of its component cells. Two factors contribute to hypertrophy: sarcoplasmic hypertrophy, which focuses more on increas ...
,
acne
Acne, also known as ''acne vulgaris'', is a long-term skin condition that occurs when dead skin cells and oil from the skin clog hair follicles. Typical features of the condition include blackheads or whiteheads, pimples, oily skin, and ...
,
increased blood pressure
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high bl ...
,
elevated cholesterol,
thrombosis
Thrombosis (from Ancient Greek "clotting") is the formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system. When a blood vessel (a vein or an artery) is injured, the body uses platelets (t ...
, decreased
high-density lipoprotein
High-density lipoprotein (HDL) is one of the five major groups of lipoproteins. Lipoproteins are complex particles composed of multiple proteins which transport all fat molecules (lipids) around the body within the water outside cells. They are t ...
s, altered
libido
Libido (; colloquial: sex drive) is a person's overall sexual drive or desire for sexual activity. Libido is influenced by biological, psychological, and social factors. Biologically, the sex hormones and associated neurotransmitters that act u ...
,
hepatic carcinoma,
cholestasis
Cholestasis is a condition where bile cannot flow from the liver to the duodenum. The two basic distinctions are an obstructive type of cholestasis where there is a mechanical blockage in the duct system that can occur from a gallstone or malig ...
,
peliosis hepatitis,
septic arthritis
Acute septic arthritis, infectious arthritis, suppurative arthritis, osteomyelitis, or joint infection is the invasion of a joint by an infectious agent resulting in joint inflammation. Generally speaking, symptoms typically include redness, h ...
,
Wilm's tumor
Wilms' tumor or Wilms tumor, also known as nephroblastoma, is a cancer of the kidneys that typically occurs in children, rarely in adults.; and occurs most commonly as a renal tumor in child patients. It is named after Max Wilms, the German sur ...
,
psychosis
Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior ...
,
aggression,
addiction
Addiction is a neuropsychological disorder characterized by a persistent and intense urge to engage in certain behaviors, one of which is the usage of a drug, despite substantial harm and other negative consequences. Repetitive drug use o ...
, and
depression. Potential side effects specifically in males include:
male pattern baldness
Pattern hair loss (also known as androgenetic alopecia (AGA)) is a hair loss condition that primarily affects the top and front of the scalp. In male-pattern hair loss (MPHL), the hair loss typically presents itself as either a receding front ha ...
,
oligospermia
Terms oligospermia, oligozoospermia, and low sperm count refer to semen with a low concentration of sperm and is a common finding in male infertility. Often semen with a decreased sperm concentration may also show significant abnormalities in spe ...
,
prostate hypertrophy
Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss o ...
,
testicular atrophy
Testicular atrophy is a medical condition in which one or both testicles (or "testes") diminish in size and may be accompanied by reduced testicular function. Testicular atrophy is not related to the temporary shrinkage of the surrounding scrotum, ...
, and
prostate cancer.
Potential side specifically in females include:
hirsutism
Hirsutism is excessive body hair on parts of the body where hair is normally absent or minimal. The word is from early 17th century: from Latin ''hirsutus'' meaning "hairy". It usually refers to a "male" pattern of hair growth in a female that ...
,
uterine atrophy,
amenorrhea
Amenorrhea is the absence of a menstrual period in a woman of reproductive age. Physiological states of amenorrhoea are seen, most commonly, during pregnancy and lactation (breastfeeding). Outside the reproductive years, there is absence of menses ...
,
breast atrophy
Breast atrophy is the normal or spontaneous atrophy or shrinkage of the breasts.
Breast atrophy commonly occurs in women during menopause when estrogen levels decrease. It can also be caused by hypoestrogenism and/or hyperandrogenism in women i ...
, and thickening of vocal cords (voice deepening).
Urine samples
A urine test is any medical test performed on a urine specimen. The analysis of urine is a valuable diagnostic tool because its composition reflects the functioning of many body systems, particularly the kidneys and urinary system, and specimens a ...
are tested to determine the ratio of
testosterone glucuronide to epitestosterone glucuronide, which should be 3:1. Any ratio of 4:1 or greater is considered a positive test. The 1988
Anti-Drug Abuse Act and 1990
Anabolic Steroid Act both deemed anabolic steroids as an illegal substance when not used for disease treatment.
Stimulants
Stimulants improve focus and alertness. Low (therapeutic) doses of
dopaminergic stimulants (e.g.,
reuptake inhibitor
Reuptake is the reabsorption of a neurotransmitter by a neurotransmitter transporter located along the plasma membrane of an axon terminal (i.e., the pre-synaptic neuron at a synapse) or glial cell after it has performed its function of transmi ...
s and
releasing agent
A monoamine releasing agent (MRA), or simply monoamine releaser, is a drug that induces the synapse, release of a monoamine neurotransmitter from the synapse, presynaptic neuron into the synapse, leading to an increase in the extracellular conc ...
s) also promote mental and athletic performance, as cognitive enhancers and ergogenic aids respectively, by improving muscle strength and endurance while decreasing
reaction time
Mental chronometry is the scientific study of processing speed or reaction time on cognitive tasks to infer the content, duration, and temporal sequencing of mental operations. Reaction time (RT; sometimes referred to as "response time") is meas ...
and fatigue;.
Stimulants are commonly used in lengthy exercises that require short bursts (e.g., tennis, team sports, etc.). Stimulants work by increasing
catecholamine
A catecholamine (; abbreviated CA) is a monoamine neurotransmitter, an organic compound that has a catechol (benzene with two hydroxyl side groups next to each other) and a side-chain amine.
Catechol can be either a free molecule or a su ...
levels and agonistic activity at the
adrenergic receptors. Examples of stimulants include:
caffeine
Caffeine is a central nervous system (CNS) stimulant of the methylxanthine class. It is mainly used recreationally as a cognitive enhancer, increasing alertness and attentional performance. Caffeine acts by blocking binding of adenosine to ...
,
ephedrine
Ephedrine is a central nervous system (CNS) stimulant that is often used to prevent low blood pressure during anesthesia. It has also been used for asthma, narcolepsy, and obesity but is not the preferred treatment. It is of unclear benefit in ...
,
methylphenidate
Methylphenidate, sold under the brand names Ritalin and Concerta among others, is the most widely prescribed central nervous system (CNS) stimulant medication used to treat attention deficit hyperactivity disorder (ADHD) and, to a lesser exten ...
and
amphetamine.
Potential side effects include:
hypertension,
insomnia
Insomnia, also known as sleeplessness, is a sleep disorder in which people have trouble sleeping. They may have difficulty falling asleep, or staying asleep as long as desired. Insomnia is typically followed by daytime sleepiness, low energy, ...
,
headaches,
weight loss
Weight loss, in the context of medicine, health, or physical fitness, refers to a reduction of the total body mass, by a mean loss of fluid, body fat ( adipose tissue), or lean mass (namely bone mineral deposits, muscle, tendon, and other co ...
,
arrhythmia,
tremors,
anxiety
Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...
,
addiction
Addiction is a neuropsychological disorder characterized by a persistent and intense urge to engage in certain behaviors, one of which is the usage of a drug, despite substantial harm and other negative consequences. Repetitive drug use o ...
, and
strokes. Some stimulants are allowed in competitive sports and are widely accessible (e.g., caffeine). Others are banned as per the
World Anti-Doping Agency
The World Anti-Doping Agency (WADA; french: Agence mondiale antidopage, AMA) is a foundation initiated by the International Olympic Committee based in Canada to promote, coordinate, and monitor the fight against drugs in sports. The agency's key ...
(WADA) (e.g.,
cocaine
Cocaine (from , from , ultimately from Quechua: ''kúka'') is a central nervous system (CNS) stimulant mainly used recreationally for its euphoric effects. It is primarily obtained from the leaves of two Coca species native to South Ameri ...
,
amphetamines
Substituted amphetamines are a class of compounds based upon the amphetamine structure; it includes all derivative compounds which are formed by replacing, or substituting, one or more hydrogen atoms in the amphetamine core structure with sub ...
,
ephedrine
Ephedrine is a central nervous system (CNS) stimulant that is often used to prevent low blood pressure during anesthesia. It has also been used for asthma, narcolepsy, and obesity but is not the preferred treatment. It is of unclear benefit in ...
, etc.).
Ergogenic aids
Ergogenic aids, or athletic performance-enhancing substances, include a number of drugs with various effects on physical performance. Drugs such as amphetamine and
methylphenidate
Methylphenidate, sold under the brand names Ritalin and Concerta among others, is the most widely prescribed central nervous system (CNS) stimulant medication used to treat attention deficit hyperactivity disorder (ADHD) and, to a lesser exten ...
increase power output at constant levels of perceived exertion and delay the onset of fatigue,
among other athletic-performance-enhancing effects;
bupropion also increases power output at constant levels of perceived exertion, but only during short term use.
Examples
* Human
biomolecules – creatine and
β-hydroxy β-methylbutyrate are naturally occurring compounds in humans that have well-established ergogenic effects and effects on body composition when supplemented.
*
Creatine
Creatine ( or ) is an organic compound with the nominal formula (H2N)(HN)CN(CH3)CH2CO2H. It exists in various modifications (tautomers) in solution. Creatine is found in vertebrates where it facilitates recycling of adenosine triphosphate ( ...
: one of the most popular nutritional supplements, it contributes to 400 million dollars in sales globally every year.
It is a nonessential amino acid that helps to improve an athlete’s performance during short-term, high intensity exercises such as weightlifting. Supplementation of creatine increases skeletal muscle creatine levels, this boosts performance by increasing the rate at which
adenosine triphosphate
Adenosine triphosphate (ATP) is an organic compound that provides energy to drive many processes in living cells, such as muscle contraction, nerve impulse propagation, condensate dissolution, and chemical synthesis. Found in all known forms o ...
can be replenished from
adenosine diphosphate, thereby increasing maximal power output.
Potential side effects include gastrointestinal cramps, weight gain, fatigue, and diarrhea. Creatine is currently not recognized as a prohibited substance and can be purchased as a legal dietary supplement.
*
Human Growth Hormone (hGH): endogenous hormone that can help decrease fat mass while increasing lean body mass.
hGH is one of the most commonly used substances among professional athletes because it has a small window for detection.
It works by promoting the release of
IGF-1, insulin-like growth factor, the release of which has anabolic effects on the body. Potential side effects include:
cardiomyopathy,
diabetes
Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ...
,
renal failure
Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney failure is classified as eit ...
, and
hepatitis
Hepatitis is inflammation of the liver tissue. Some people or animals with hepatitis have no symptoms, whereas others develop yellow discoloration of the skin and whites of the eyes ( jaundice), poor appetite, vomiting, tiredness, abdominal ...
. If not prescribed by a professional, it is a banned substance in competition per
WADA.
Despite its small window for detection, two primary methods of testing have been developed for hGH, one being an isoform test which detects changes in growth hormone structure in the blood,
and the markers test, which detects changes in serum protein ratios.
Adaptogens
Adaptogens are plants that support health through nonspecific effects, neutralize various environmental and physical stressors while being relatively safe and free of side effects.
As of 2008, the position of the
European Medicines Agency was that "The principle of an adaptogenic action needs further clarification and studies in the pre-clinical and clinical area. As such, the term is not accepted in pharmacological and clinical terminology that is commonly used in the EU."
Nootropics
Nootropics, or "cognition enhancers", benefit overall cognition by improving memory (e.g., increasing
working memory
Working memory is a cognitive system with a limited capacity that can hold information temporarily. It is important for reasoning and the guidance of decision-making and behavior. Working memory is often used synonymously with short-term memory, ...
capacity or updating) or other aspects of
cognitive control
In cognitive science and neuropsychology, executive functions (collectively referred to as executive function and cognitive control) are a set of cognitive processes that are necessary for the cognitive control of behavior: selecting and suc ...
(e.g.,
inhibitory control
Inhibitory control, also known as response inhibition, is a cognitive process – and, more specifically, an executive function – that permits an individual to inhibit their impulses and natural, habitual, or dominant behavioral re ...
,
attentional control
Attentional control, colloquially referred to as concentration, refers to an individual's capacity to choose what they pay attention to and what they ignore. It is also known as endogenous attention or executive attention. In lay terms, attention ...
,
attention span, etc.).
CNS agents
Painkillers
Allows performance beyond the usual pain threshold. Some painkillers raise
blood pressure, increasing oxygen supply to
muscle cells. Painkillers used by athletes range from common
over-the-counter
Over-the-counter (OTC) drugs are medicines sold directly to a consumer without a requirement for a prescription from a healthcare professional, as opposed to prescription drugs, which may be supplied only to consumers possessing a valid prescr ...
medicines such as
NSAID
Non-steroidal anti-inflammatory drugs (NSAID) are members of a therapeutic drug class which reduces pain, decreases inflammation, decreases fever, and prevents blood clots. Side effects depend on the specific drug, its dose and duration of ...
s (such as
ibuprofen) to powerful prescription
narcotics.
Sedatives and anxiolytics
Used in sports like
archery which require steady hands and accurate aim, and also to overcome excessive nervousness or discomfort.
Diazepam
Diazepam, first marketed as Valium, is a medicine of the benzodiazepine family that acts as an anxiolytic. It is commonly used to treat a range of conditions, including anxiety, seizures, alcohol withdrawal syndrome, muscle spasms, insomnia, ...
and
propranolol
Propranolol, sold under the brand name Inderal among others, is a medication of the beta blocker class. It is used to treat high blood pressure, a number of types of irregular heart rate, thyrotoxicosis, capillary hemangiomas, performance an ...
are common examples;
ethanol
Ethanol (abbr. EtOH; also called ethyl alcohol, grain alcohol, drinking alcohol, or simply alcohol) is an organic compound. It is an alcohol with the chemical formula . Its formula can be also written as or (an ethyl group linked to a ...
and
cannabis
''Cannabis'' () is a genus of flowering plants in the family Cannabaceae. The number of species within the genus is disputed. Three species may be recognized: '' Cannabis sativa'', '' C. indica'', and '' C. ruderalis''. Alternative ...
are also used occasionally.
Blood boosters
Blood doping agents increase the oxygen-carrying capacity of blood beyond the individual's natural capacity. They are used in endurance sports like long-distance running, cycling, and Nordic skiing.
Recombinant human erythropoietin (rhEPO) is one of the most widely known drugs in this class.
Erythropoietin
Erythropoietin, or EPO, is a hormone that helps increase the production of
red blood cell
Red blood cells (RBCs), also referred to as red cells, red blood corpuscles (in humans or other animals not having nucleus in red blood cells), haematids, erythroid cells or erythrocytes (from Greek ''erythros'' for "red" and ''kytos'' for "holl ...
s which increases the delivery of oxygen to muscles.
It is commonly used among endurance athletes such as cyclists.
It functions by protecting red blood cells against destruction whilst simultaneously stimulating
bone marrow cells to produce more red blood cells. Potential side effects include:
dehydration
In physiology, dehydration is a lack of total body water, with an accompanying disruption of metabolic processes. It occurs when free water loss exceeds free water intake, usually due to exercise, disease, or high environmental temperature. Mil ...
and an increase in blood viscosity which could result in a
pulmonary embolism
Pulmonary embolism (PE) is a blockage of an artery in the lungs by a substance that has moved from elsewhere in the body through the bloodstream ( embolism). Symptoms of a PE may include shortness of breath, chest pain particularly upon breathin ...
or
stroke. Per the World Anti-Doping Agency, it is a banned substance.
Urine samples can be tested via
electrophoresis, and blood samples via indirect markers.
Gene doping
Gene doping agents are a relatively recently described class of athletic performance-enhancing substances.
These drug therapies, which involve
viral vector-mediated
gene transfer
Horizontal gene transfer (HGT) or lateral gene transfer (LGT) is the movement of genetic material between unicellular and/or multicellular organisms other than by the ("vertical") transmission of DNA from parent to offspring (reproduction). HG ...
, are not known to currently be in use .
Prohormones
Also known as anabolic steroid precursors, they promote
lean body mass
Lean body mass (LBM), sometimes conflated with ''fat-free mass'', is a component of body composition. Fat free mass (FFM) is calculated by subtracting body fat weight from total body weight: total body weight is lean plus fat. In equations:
:LBM&n ...
.
Once in the body, these precursors are converted to
testosterone
Testosterone is the primary sex hormone and anabolic steroid in males. In humans, testosterone plays a key role in the development of male reproductive tissues such as testes and prostate, as well as promoting secondary sexual characteristi ...
and because they increase endogenous testosterone.
The desired effects of steroid precursors however, are often not seen as they do not bind well to
androgen receptors
The androgen receptor (AR), also known as NR3C4 (nuclear receptor subfamily 3, group C, member 4), is a type of nuclear receptor that is activated by binding any of the androgenic hormones, including testosterone and dihydrotestosterone in the ...
.
Examples of prohormones include
norandrostendione,
androstenediol
Androstenediol, or 5-androstenediol (abbreviated as A5 or Δ5-diol), also known as androst-5-ene-3β,17β-diol, is an endogenous weak androgen and estrogen steroid hormone and intermediate in the biosynthesis of testosterone from dehydroepia ...
, and
dehydroepiandrosterone (DHEA).
These steroids have little desired effect compared to anabolic steroids, but have the same side effects.
Androstenedione in 2005 became classified as a controlled substance by WADA, however DHEA can still be obtained legally as an over-the-counter nutritional supplement.
History
While the use of PEDs has expanded in recent times, the practice of using substances to improve performance has been around since the
Ancient Olympic Games. In the Olympic Games of 668 BC,
Charmis had consumed a diet consisting of dried figs which was a significant factor in winning the 200-yard stade race. Ancient Greek athletes at the time also incorporated stimulants such as wine and brandy into their training routines. Stimulants derived from plants (e.g.,
Cola Nitida
''Cola nitida'' is a species of plant belonging to the family Malvaceae.
It is a tree native to the rainforests of tropical West Africa. Common names include kola nut, cola, kola and bitter kola. The seeds contain caffeine and are chewed as a s ...
,
Bufotein, etc.) were used by the
Roman Gladiators
A gladiator ( la, gladiator, "swordsman", from , "sword") was an armed combatant who entertained audiences in the Roman Republic and Roman Empire in violent confrontations with other gladiators, wild animals, and condemned criminals. Some gla ...
to overcome injuries and fatigue.
In the late 19th century as
modern medicine
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pract ...
and
pharmacology were developing, PEDs saw an increase in use.
Supplements were now exclusively being used to enhance muscular work capacity.
The main stimulants being used included
alcoholic drink
An alcoholic beverage (also called an alcoholic drink, adult beverage, or a drink) is a drink that contains ethanol, a type of alcohol that acts as a drug and is produced by fermentation of grains, fruits, or other sources of sugar. The c ...
s,
caffeine
Caffeine is a central nervous system (CNS) stimulant of the methylxanthine class. It is mainly used recreationally as a cognitive enhancer, increasing alertness and attentional performance. Caffeine acts by blocking binding of adenosine to ...
, and mixtures created by the athletic trainers (e.g.,
strychnine tablets made of
cocaine
Cocaine (from , from , ultimately from Quechua: ''kúka'') is a central nervous system (CNS) stimulant mainly used recreationally for its euphoric effects. It is primarily obtained from the leaves of two Coca species native to South Ameri ...
and
brandy).
Testosterone
Testosterone is the primary sex hormone and anabolic steroid in males. In humans, testosterone plays a key role in the development of male reproductive tissues such as testes and prostate, as well as promoting secondary sexual characteristi ...
was also a commonly taken stimulant, however, it was more difficult to obtain.
In 1889, a three-week program began where an athlete injected themselves with blood from the testicular veins,
semen
Semen, also known as seminal fluid, is an organic bodily fluid created to contain spermatozoa. It is secreted by the gonads (sexual glands) and other sexual organs of male or hermaphroditic animals and can fertilize the female ovum. Sem ...
, and fluids from the testicles of a dog or guinea pig.
By 1895, it had been assessed that testicular extracts did in fact improve athletic performance by increasing muscular strength.
In the 20th century, testosterone was isolated and characterized by scientists.
In 1941, the first record of synthesized testosterone use occurred when a horse was given testosterone which successfully improved its race performance. Sports trainers soon after began advocating for testosterone use.
Images of
bodybuilders
Bodybuilding is the use of progressive resistance exercise to control and develop one's muscles (muscle building) by muscle hypertrophy for aesthetic purposes. It is distinct from similar activities such as powerlifting because it focuses ...
with massive muscles began circulating which further perpetuated a desire among athletes to use testosterone.
In the 1980s, the main PEDs were
cortisone
Cortisone is a pregnene (21-carbon) steroid hormone. It is a naturally-occurring corticosteroid metabolite that is also used as a pharmaceutical prodrug; it is not synthesized in the adrenal glands. Cortisol is converted by the action of the enz ...
and
anabolic steroids. In 1988, the United States Congress establishes the
Anti-Drug Abuse Act to criminalize the distribution and possession of non-medical anabolic steroids.
In 1999, WADA was formed to address the escalating use of substances in sports, particularly after the 1998 doping scandal in cycling.
Risk factors
Adolescents are the most vulnerable group when it comes to taking performance-enhancing substances.
This is in part due to the significance placed on physical appearance by this age group as well as feelings of invincibility combined with a lack of knowledge surrounding long-term consequences.
Studies have shown that the most common gendered risk factors include being an adolescent female dissatisfied with their body weight or an adolescent male who perceives larger body sizes as the ideal.
Having a negative body image or a history of depression can also be a significant risk factor.
These are further exacerbated by parental pressures surrounding appearance, media influence, and peer pressure.
Studies show that adolescent males who engage with fitness magazines are twice as likely to use performance-enhancing substances.
Adolescents who partake in competitive sports are at a particularly high risk, with those involved in football, basketball, wrestling, baseball, and gymnastics at the top.
Usage in sport
In sports, the term ''performance-enhancing drugs'' is popularly used in reference to
anabolic steroids or their precursors (hence the colloquial term "steroids"); anti-doping organizations apply the term broadly. Agencies such as the
WADA and
USADA
The United States Anti-Doping Agency (USADA, ) is a non-profit, non-governmental 501(c)(3) organization and the national anti- doping organization (NADO) for the United States. To protect clean competition and the integrity of sport and prevent ...
try to prevent athletes from using these drugs by performing drug tests. When medical exemptions are granted they are called
therapeutic use exemptions.
See also
*
Ergogenic use of anabolic steroids
Since their discovery, anabolic steroids (AAS) have been widely used as performance-enhancing drugs to improve performance in sports, to improve one's physical appearance, as self-medication to recover from injury, and as an anti-aging aid. Use of ...
*
List of doping cases in sport
The following is an incomplete list of sportspeople who have been involved in doping offences. It contains those who have been found to have, or have admitted to having, taken illegal performance-enhancing drugs, prohibited recreational drugs or ...
*
List of drugs used by militaries
Militaries worldwide have used or are using various psychoactive drugs to improve performance of soldiers by suppressing hunger, increasing the ability to sustain effort without food, increasing and lengthening wakefulness and concentration, suppr ...
*
Natural bodybuilding
Natural bodybuilding is a bodybuilding movement with various competitions that take place for bodybuilders who abstain from performance-enhancing drugs. This categorically excludes the use of substances like anabolic steroids, insulin, diuretics an ...
*
Steroid use in American football
The use of anabolic steroids and performance-enhancing drugs in American football is officially prohibited by virtually every sanctioning body.
The National Football League (NFL) began to test players for steroid use during the 1987 season, and ...
References
External links
*
{{DEFAULTSORT:Performance-Enhancing Drugs
Drugs in sport
Amphetamine
*