Anabolic steroids: prohibition for aesthetic purposes divides doctors – 04/13/2023 – Equilíbrio

Since Monday (11), Brazilian doctors are prohibited from prescribing androgenic and anabolic steroids for aesthetic purposes, muscle mass gain or improvement of sports performance. Courses, events and any type of advertising that encourages the use of hormones for these purposes are also banned. The rule came into force after a resolution of the CFM (Federal Council of Medicine) that authorizes the prescription only in cases of proven hormone deficiency.

The decision came after pressure from medical societies which, in a joint letter to the CFM, published on March 27, defended the regulation of this type of treatment based on scientific evidence. The text, signed by six entities, argues that, in the midst of the dissemination of these therapies on the internet, it is important to highlight the risks behind them.

“The consumption of hormones for aesthetic purposes has grown and become popular on social networks. But there are not enough randomized studies that attest to its safety, not even under medical supervision”, says endocrinologist Maria Augusta Kara Zellas, professor at Fempar (Faculdade Evangélica Mackenzie from Paraná).

Cardiac complications are among the risks of use, points out cardiologist Gustavo Lenci Marques, from Hospital Marcelino Champagnat, in Curitiba. Accumulation of fat in blood vessels, heart hypertrophy, high blood pressure, heart attack and thrombosis are some of the possible problems.

The patient is also at risk of liver failure, erectile dysfunction, decreased libido and even mental disorders such as depression. “As the majority of users are young, the long-term damage of such a treatment is especially worrying”, adds Zellas.

Doctor Andressa Heimbecher Soares, PhD in Endocrinology from USP (University of São Paulo), indicates that in cases of hormone replacement there is a balance to be promoted. But when the drug is used in healthy people, the opposite can happen and the risks outweigh the gains.

“Men and women have reference values ​​for the amount of testosterone in the body. But I’ve seen serious cases of people with an index much higher than the average considered healthy due to the use of hormones”, says the endocrinologist.

But the ban is not a consensus among professionals. Doctor Lucas Caseri, a doctoral student at Unifesp’s Evidence-Based Health program (Federal University of São Paulo), sees the CFM resolution as an emergency and ineffective measure. According to the researcher, much of the anabolic steroid market works in parallel and prohibiting doctors from prescribing the medication tends to further increase this illegal network.

“I’m not in favor of using it, but anyone who takes anabolic steroids and no longer has the follow-up of a doctor will end up resorting to coaches and low-skilled professionals who are piled high on the internet. In addition, they will tend to consume counterfeit products in an even more risky way “, justifies the doctor.

A study published in 2018 in the Brazilian Journal of Sports Science showed that 63% of users had access to products through friends. The research associated the data with the large-scale supply of the illicit market. In March, Anvisa (National Health Surveillance Agency) seized fake batches of anabolic steroids, bringing to the fore the debate about counterfeits.

Another point raised by Caseri concerns hormone therapy for transgender men, which is not prohibited. “Why can’t a person without hormonal imbalance take the medicine because it’s harmful, but a trans person can? This shows how partial the rule is and should be reviewed”, he questions.

Doctor Andressa Soares, on the other hand, argues that the case of trans people is specific and involves a multidisciplinary team made up of a gynecologist, urologist, psychologist and other specialists, in order to minimize any damage. “It is a complex process, which requires careful monitoring, in addition to a consent form. So, it is not possible to compare”, she says.

The specialist considers the council’s decision to be important due to the warning that the measure brings. “It is necessary to change the idea that it is ok to prescribe and consume this type of product for aesthetic purposes. The resolution changes this mentality”, she says.