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Responsible and judicious anabolic steroid use among healthy adult males is a significantly different situation in comparison to anabolic steroid use among children, teenagers, and females. In the young, the prevalence and dose of steroids is relatively low. In those who are older than 15, however, the prevalence is high with up to 2 to 3 times the dose of both anabolic androgens in the young and females. The onset of this sexual difference may reflect the need in adulthood for maintenance of physiological testosterone levels and may reflect increased age at sex change. This difference in prevalence may also reflect the high frequency of young individuals who are using anabolic steroids.In order of prevalence, the two most common forms of steroid use among young adults are testosterone replacement therapy (TRT), as assessed by a physician with a good reputation, as well as testosterone replacement therapy use as defined in this article. We also identified 3 prescription methods of testosterone replacement therapy that are not covered by insurance, as well as 1 other, which are covered by insurance but may not have a good reputation.DISCUSSIONThe high prevalence and dose of anabolic steroids among children, teenagers, and healthy adult males (18–25 years old) has been studied in several recent studies.3,9-11 For young males aged 14 years and younger, anabolic steroids are most commonly prescribed in combination with dihydrotestosterone [DHT] at 1 mg/d. However, the presence of dihydrotestosterone alone or in combination with testosterone in males has not been reported. We included only data from patients with the diagnosis of hyperandrogenism (as defined in the latest DSM-IV-TR5) because some providers may give a higher dose of steroids, perhaps because of the fear or embarrassment of giving large doses of testosterone.13 We also included subjects with a diagnosis of either male pattern baldness or male pattern growth retardation. Although these conditions are often accompanied by signs of hypogonadism, the lack of an effect of testosterone on hair growth has been reported.13The prevalence of use of steroids among young males has remained stable for recent decades. This is perhaps due to a decrease in the costs of erectile dysfunction treatment and to the increasing use of effective hormonal replacement medications with fewer side effects.14 Anabolic steroids are the most widely prescribed drug by older adults in America, and the prevalence of use has not changed appreciably over the past few years.Among healthy adult males, androgens are not as often prescribed. Among adolescents and women, anabolic steroid use is the most common condition for which the prescription of the drug is authorized. Although anabolic steroids haveSimilar articles: