Indiscriminate Use of Hormonal Therapy for Aesthetic and Athletic Performance

A Literary Review

Abstract

Introduction: The pursuit of aesthetic beauty, combating aging, and enhancing physical performance has been sought after for centuries. Consequently, attempts have emerged to fulfill these desires. However, one of the fundamental principles of the medical profession is non-maleficence, which has been disregarded in the pursuit of these objectives, as seen in the case of androgenic anabolic steroids (AAS) and the "Beauty Chip," the popular name for subcutaneous hormonal implants. Objectives: To identify the effects of hormonal therapies and discuss the evidence regarding their use for aesthetics and athletic performance, aiming to understand their prohibition for such purposes and their actual indications. Methodology: A bibliographic search was conducted on the Scielo and PubMed platforms, including articles published from 2000 to 2024. Clinical studies and reviews evaluating the action of implants were included. The keywords "hormonal implants," "athletic performance," and "androgenic anabolic steroids" were used. Additionally, a search was performed in the resolutions of ANVISA (Brazilian Health Regulatory Agency), CFM (Federal Council of Medicine), and medical societies. Discussion: In 2023, the CFM issued a resolution banning hormonal therapies for aesthetic and athletic performance purposes; in 2024, ANVISA prohibited unapproved hormonal implants. Contrary to all resolutions, AAS and Beauty Chips have been used by individuals seeking to improve aesthetic and athletic performance. Originally, AAS are administered in the therapy of hypogonadism and conditions of protein metabolism deficiency. The side effects of AAS and implants include infertility; changes in lipid profiles, increased blood pressure, mood swings, and alterations in sexual characteristics. The lack of high-quality methodological clinical studies demonstrating the risks of androgenic hormonal therapy at supraphysiological levels hinders a long-term understanding of side effects. Regarding implants, they were initially indicated as contraceptive methods and began to be manipulated indiscriminately and without oversight of the doses and substances contained in the "Chip," with no pharmacokinetic or pharmacodynamic studies available. Conclusion: In light of the above, it is evident that hormonal therapies are being incorrectly and illegally indicated in the current scenario. Therefore, the urgency for robust surveillance and monitoring of steroids is clear, aiming for greater control of this harmful practice.