A Systematic Review of the Use of Androgenic Anabolic Steroids (AAS) and Their Possible Side Effects in the Arab Countries

Abstract

Background: The use of Androgenic Anabolic Steroids (AAS) has gained significant attention in public health, due to its rising prevalence and associated possible health risks. This systematic review aims to elucidate the prevalence, motivations, awareness, and health implications of AAS use in the Arab world. Methods: Adhering to PRISMA-2020 guidelines, we conducted a comprehensive search across several databases, including Web of Science, Scopus, and PubMed. We used a set of related keywords to capture a diverse range of relevant studies. We applied a prespecified set of inclusion and exclusion criteria to the retrieved records and selected the appropriate studies through a two-phased screening process. After the final inclusion of the studies, we extracted the relevant data and narratively presented the results. Results: A total of 17 studies with a total number of 10,948 participants, the selected studies were from Saudi Arabia, Egypt, and Kuwait. These studies indicated a high prevalence of AAS use, particularly among male gym attendees, with significant variations across countries. A common motivation for AAS use is the enhancement of physical appearance. Alarmingly, there is a substantial gap in the awareness of its health risks. Most users rely on non-scientific sources for information. Conclusion: This review underscores the urgent need for comprehensive public health strategies including targeted health education and support systems, to address the widespread and risky use of ASS in the Arab world. It also highlights the necessity for future longitudinal studies to understand the long-term impact of AAS use.