Male gonad hormones and their artificial derivatives are now banned as doping agents, but there are numerous medical indications for their use. If certain preparations were to become common as contraceptives or general activating geriatric drugs for men, it would be difficult to distinguish between legal prescription and abuse.
John M. Hoberman and Charles E. Yesalis
On 1 June 1889 Charles Édouard Brown-Séquard announced to the French Biological Society in Paris and anavar that they had discovered a fountain of youth and had already tried it on himself. The then 72-year-old neurologist and physiologist (Fig. 2), a temporary professor at Harvard University in Cambridge (Massachusetts) and since 1878 holder of the chair of experimental medicine at the Collège de France, had repeatedly injected himself with a liquid extract of animal testicles – from dogs and guinea pigs. Since then, he claimed, he felt physically stronger and mentally fresher; he told the auditorium that his problems with constipation had been solved and that he could urinate again in a high arch.
Despite the scepticism of some colleagues, he insisted on a direct connection between injection and effect. Even today, many experts believe in a placebo effect (in order to work as described, the medication should have been much more intensive). Nevertheless, Brown-Séquard is considered a founder of endocrinology, the study of the formation and effect of hormones: His assumption that testicular substances could increase or replace their function later proved to be correct in essence.
It is his merit to have recognized that the lack of certain physiological regulators secreted in the body – the term hormone was first coined in 1905 after Greek hormone (drive, stimulate, set in motion) – can be counteracted with extracts of animal organs. He thus continued the fundamental research results of his predecessor at the Paris Chair: Claude Bernard (1813 to 1878) had developed the concept of the inner environment and in 1855 had introduced the idea of inner secretion in connection with investigations into the function of the liver and pancreas in the sugar balance and in digestion.
This was the beginning of partly abstruse, partly increasingly refined attempts at hormone treatments. Research culminated in 1935 in the synthesis of testosterone, the most important hormone produced by the testes. It is produced both in the male and – to a lesser extent – in the female organism. On the one hand, it has an androgenic effect, i.e. it promotes the development of the male reproductive organs and secondary sexual characteristics, typically shapes the psyche and is involved in sperm maturation; on the other hand, it has an anabolic effect by increasing protein biosynthesis from dietary protein – anabolism. Chemically, it is a steroid (see box on page 85).
Since then, various artificial anabolic-androgenic substances have been produced, derived from testosterone or related compounds – an ambivalent success. Because of their two main properties, they offered therapeutic benefits as well as tempting abuse.
Already in the forties it became known among bodybuilders and competitive athletes that such synthetic hormones accelerate the build-up of muscles and enable a more intensive training (picture 1). Especially those derivatives of natural substances were used in large quantities, which have a relatively low androgenic (virilizing) effect, but which have a strong anabolic effect and are only degraded slowly. Doping with anabolic steroids has long been banned and, like the use of other non-physiologically performance-enhancing drugs, has been controlled in international competitions since 1966; but there is still a grey area from which a black market with immensely high sales profits.
The other, lesser-known application is the legitimate one for therapeutic purposes. Anabolic steroids with the weakest possible virilizing effect have been used for longer than doping to increase the synthesis of the body’s own proteins in the case of epizootic diseases, as well as artificial androgens to compensate for a lack of natural hormones or for so-called hormonal castration of patients with breast cancer. At first, testosterone and related substances seemed to become standard remedies for men against age-related symptoms of decay, but this prevented the side effects of certain preparations in particular: behavioural changes, functional impairments of the liver as well as partial impotence and infertility; prostate and testicular cancer can also be aggravated as a result. Women who are given androgens to counteract certain hormone-influenced diseases may also suffer from prostate and testicular cancer.