Anabolic-androgenic steroid use among bodybuilders in Erbil city


  • Ramadhan Khidhir Ahmed Family Medicine Residency Program, Kurdistan Board of Medical Specialties, Erbil, Iraq.
  • Karwan Hawez Sulaiman Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq.
  • Muhammed Khalid Hasan Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq.
  • Ali Shakir Dauod Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq.



Anabolic steroids, Gym users, Bodybuilders, Knowledge, Erbil


Background and objective: Anabolic-androgenic steroids are synthetic testosterone derivatives with a longer duration of action than physiological androgens. They are abused by bodybuilders because of their potential to enhance muscle strength. Serious medical and psychological complications may be associated with their non-medical use. This study aimed to determine the prevalence of anabolic androgenic steroids among bodybuilders and their awareness of health-related risks.

Methods: A cross-sectional study was carried out from the 1st of January 2019 to the end of July 2019 in 18 randomly selected gym centers in Erbil city, Iraq using stratified random sampling. A self-administered questionnaire was distributed to 400 bodybuilders to assess the prevalence and knowledge of using Anabolic-androgenic steroids.

Results: The study showed a high prevalence of Anabolic-androgenic steroid consumption (26.3%) among gym users in Erbil city. Anabolic-androgenic steroid use was significantly higher among participants with a longer duration of bodybuilding practice ≥4 years (P = 0.001). Anabolic-androgenic steroid abuse was significantly associated with drinking alcohol, smoking cigarettes, and using growth hormones. Trainers were the commonest source of recommendation.

Conclusion: The prevalence of anabolic androgenic steroids abuse is high among bodybuilders in Erbil city. Public health awareness is essential and may help avoid the propagation of the problem.


Metrics Loading ...


Hartgens F. Effects of androgenic-anabolic. Sport Med. 2014; 34(November):513–54.

Achar S, Rostamian A, Narayan SM. Cardiac and metabolic effects of anabolic-androgenic steroid abuse on lipids, blood pressure, left ventricular dimensions, and rhythm. Am J Cardiol. 2010; 106(6):893–901.

Momaya A, Fawal M, Estes R. Performance– enhancing substances in sports: A review of the literature. Sport Med. 2015; 45(4):517–31.

Sagoe D, Molde H, Andreassen CS, Torsheim T, Pallesen S. The global epidemiology of anabolic-androgenic steroid use: A meta-analysis and meta-regression analysis. Ann Epidemiol. 2014; 24(5):383–98.

Christou MA, Christou PA, Markozannes G, Tsatsoulis A, Mastorakos G, Tigas S. Effects of anabolic androgenic steroids on the reproductive system of athletes and recreational users: A systematic review and meta-analysis. Sport Med. 2017; 47(9):1869–83.

Althobiti S, Alqurashi N, Alotaibi A, Alharthi T, Alswat K. Prevalence, attitude, knowledge, and practice of anabolic androgenic steroid (AAS) use among gym participants. Mater Socio Medica. 2018; 30(1):49.

Bahri A, Mahfouz MS, Marran NM, Dighriri YH, Alessa HS, Khwaji MO, et al. Prevalence and awareness of anabolic androgenic steroid use among male body builders in Jazan, Saudi Arabia. Trop J Pharm Res. 2017; 16(6):1425–30.

Khullar N, Scull N, Deeny M, Hamdan E. Prevalence and predictors of anabolic-androgenic steroid use among gym users in Kuwait: A preliminary study. Int J Mens Health. 2016; 15(2):144–56.

Nakhaee MR, Pakravan F, Nakhaee N. Prevalence of use of anabolic steroids by bodybuilders using three methods in a city of Iran. Addict Heal. 2016; 5(3–4):77–82.

Herlitz LC, Markowitz GS, Farris AB, Schwimmer JA, Stokes MB, Kunis C, et al. Development of focal segmental glomerulosclerosis after anabolic steroid abuse. J Am Soc Nephrol. 2010; 21(1):163–72.

Sharef AY, Rasoul AM. Nandrolone effects on men's semen parameters in Erbil city. Zanco J Med Sci. 2017; 21(2):1688–95.

Razavi Z, Moeini B, Shafiei Y, Bazmamoun H. Prevalence of anabolic steroid use and associated factors among bodybuilders in Hamadan, western province of Iran. J Res Health Sci. 2014; 14(2):163–6.

Al-Falasi O, Al-Dahmani K, Al-Eisaei K, Al-Ameri S, Al-Maskari F, Nagelkerke N, et al. Knowledge, attitude and practice of anabolic steroids use among gym users in Al-Ain district, United Arab Emirates. Open Sport Med J. 2009; 2(1):75–81.

Charan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med. 2013; 35(2):121.

Habeeb MB, Kasim WJ, Khamees LA, Hawi MM, Nea Q. Athletes’ perceptions toward substance use in Baghdad city. AJMH. 2012; 6(6):462–71.

Omer W, Al-Hadithi T. Developing a socioeconomic index for health research in Iraq. East Mediterr Health J. 2017; 23(10):670–7.

De Siqueira Nogueira FR, De Freitas Brito A, De Oliveira CVC, Vieira TI, Beniz Gouveia RL. Anabolic-androgenic steroid use among Brazilian bodybuilders. Subst Use Misuse. 2014; 49(9):1138–45.

Haerinejad MJ, Ostovar A, Farzaneh MR, Keshavarz M. The prevalence and characteristics of performance-enhancing drug use among bodybuilding athletes in the south of Iran, Bushehr. Asian J Sports Med. 2016; 7(3):e35018.

Fijan A, Eftekhari MH, Dashtabi A. The prevalence of anabolic androgenic steroid misuse and its associated factors among bodybuilders in Shiraz, Iran. Int J Nutr Sci. 2018; 3(3):151–6.




How to Cite

Ahmed, R. K., Sulaiman, K. H., Hasan, M. K., & Dauod, A. S. (2021). Anabolic-androgenic steroid use among bodybuilders in Erbil city. Zanco Journal of Medical Sciences (Zanco J Med Sci), 25(3), 657–665.



Original Articles