CFM bans anabolic steroids for aesthetic and sports purposes – 04/10/2023 – Health

The CFM (Conselho Federal de Medicina) prohibited the medical prescription of hormonal therapies with androgenic and anabolic steroids (AAS) for aesthetic purposes, to gain muscle mass and/or improve sports performance. The resolution appears in the Official Gazette of this Tuesday (11).

The justification is the lack of scientific proof of the benefits and safety of these therapies. According to the CFM, there are no good quality clinical studies that demonstrate the magnitude of the risks associated with these hormones at levels above physiological levels, both in men and women.

The resolution also prohibits the holding of courses, events and advertising with the aim of encouraging the use or advocating the possible benefits of these androgenic therapies for aesthetic purposes, muscle mass gain or improvement in sports performance.

A Sheet found several advertisements on the internet offering online and face-to-face courses and events aimed at training physicians to prescribe anabolic steroid hormones. Average prices are R$ 3,600.

Anabolic steroids are drugs originally prescribed to patients who do not produce hormones properly and need replacement. But in recent years they have been used, more and more, by bodybuilding and fight gym goers or for aesthetic purposes to gain muscle mass and lose fat in a period that the body alone would not be able to.

The CFM’s decision comes after a joint request by medical societies for the issue to be regulated. The document is signed by the societies of endocrinology and metabolism, cardiology, urology, sports medicine, dermatology, geriatrics and gerontology, in addition to the federations of gynecology and obstetrics and gastroenterology.

According to the president of the CFM, José Hiran Gallo, faced with an exponential increase in the irregular prescription of these products, the council heard several experts on the subject, who were unanimous in stating that the benefits of using them for these aesthetic and sporting purposes do not outweigh the risks. . “There is no minimum safe dose, as some users claim. Therefore, we are banning this practice.”

He cites numerous adverse effects, such as cardiovascular problems, including cardiac hypertrophy, arterial hypertension and acute myocardial infarction, liver diseases such as drug-induced hepatitis and acute liver failure, as well as depression, erectile dysfunction, decreased libido, infertility, increased aggressiveness and dependence. .

According to a study by the Instituto do Coração of Hospital das Clínicas de São Paulo, those who ingest anabolic steroids are at greater risk of plaque formation in the coronary arteries, which impede blood flow and oxygen supply. These complications lead to atherosclerosis, which can cause problems like strokes and heart attacks.

According to the survey, 25% of young people, with an average of 29 years old, who use this product, have these plaques in up to three coronary arteries. Another risk factor is that good cholesterol, or HDL, in addition to being present in smaller amounts in the body, also has its functionality impaired.

Gallo, from CFM, reinforces that nothing changes in relation to the indications of anabolic hormones already provided in the medical literature, for example, in the treatment of diseases such as hypogonadism, late puberty, neonatal micropenis and cachexia. They may also be indicated in crossed hormone therapy in transgenders and, in the short term, in women diagnosed with hypoactive sexual desire.

The banning of courses on the prescription of anabolic steroids for aesthetic and sports purposes was also a request from medical organizations, which, according to them, are aimed at newly graduated doctors. “Seduced by promises of high income, differentiation and quick placement in the job market, they end up following these paths, which are presented as easy shortcuts”, says the text of the medical societies.

For the entities, abuse is fostered by a perception of impunity, due to the constant presence of spokespersons for these events in different social media.

“In recent years, a narrative of normality has been created and this worries us a lot because it especially endangers a younger population, which has no way of assessing the risks to which it is being subjected”, says Paulo Augusto Carvalho Miranda, president of SBEM (Brazilian Society of Endocrinology and Metabology).

According to him, the doses used for aesthetic purposes or to improve performance in sports are usually much higher than those used clinically, and there is a misleading discourse of minimizing side effects that can put users at risk.

One of the hormones that have been advertised by “tiktokers fit” is oxandrolone, for aesthetic purposes with a focus on women. The substance binds to the testosterone receptor and has similar effects to that male hormone. “It causes enlargement of the clitoris, deepening of the voice, growth of hair and hair loss”, warns the president of the CFM.

The council also vetoed the prescription and disclosure of hormones advertised as “bioidentical” in a “nano” formulation or with commercial nomenclatures without due scientific proof of clinical superiority for the purpose foreseen in the resolution, as well as selective modulators of the androgen receptor ( Sarms) for any indication.

According to CFM advisor and rapporteur Annelise Meneguesso, the number of people using such medications illegally is growing. “Concomitant with the use of EAA, there is an increase in the administration of growth hormone [GH] abused by athletes, amateurs and professionals, as an ergogenic drug, which is why GH is included in the list of anabolic substances by Anvisa, as well as in the list of drugs prohibited in sports by the World Anti-Doping Agency (Wada)” , said in a note.

Ergogenic drugs tend to improve physical performance by delaying fatigue, boosting muscle mass gain (anabolic property) and fat breakdown (lipolytic property).

Anabolic steroids have also been the object of several police operations. On the 31st, for example, the Civil Police of Maranhão arrested a nutritionist and a military policeman in São Luís, on suspicion of illegally selling anabolic steroids and other drugs not authorized by Anvisa.

On April 1, the court granted the doctor a release permit, but prohibited him from leaving the city. The CRM (Regional Council of Medicine) also opened an investigation to determine the conduct of the professional.

At the beginning of March, Anvisa determined the seizure of counterfeit units of hormones with anabolic action. In addition, it prohibited the commercialization, distribution and use of these products.