Lance Armstrong, seven-time winner of the Tour de France and Olympic medalist in Sydney 2000, lost all his titles and much of his legacy when it was confirmed that he had used banned substances to enhance his performance. All the prestige accumulated over the years collapsed in 2012.
The case of Italian tennis player Jannik Sinner also caused a stir: he was suspended for three months earlier this year after testing positive for clostebol, an anabolic steroid.
And more recently, Isaac Alarcón, a Mexican offensive lineman, received a six-game suspension for ingesting a banned substance through a protein drink. After serving the sanction, he was fired by the San Francisco 49ers and reinstated only to the practice squad.
These are examples of the high cost that the use—voluntary or involuntary—of performance-enhancing substances (PEDs) can have. Finally during a broadcast of the Oprah show, Armstrong admitted his consumption; Sinner and Alarcón argue that they did so unintentionally. Whatever the case, the result is the same: damage to health, impact on career and loss of credibility.
But the phenomenon is not limited to high-performance sports. Various studies show that the use of PEDs has spread among bodybuilding enthusiasts and people who train for aesthetics or recreational performance. The numbers support this trend: some estimates place the global anabolic steroid market at tens of billions of dollars, with annual growth rates ranging between 5% and 10% over the next decade, depending on the source and type of product considered. The rise of culture fitnesspressure for quick results and misinformation contribute to this expansion.
Read more: The 100 most powerful women in the world in 2025 according to Forbes; Sheinbaum is number 5
Main substances used to improve performance
Below is a synthesis of the most common substances, among which anabolic steroids stand out:
Table: Main performance-enhancing substances (PEDs)
| Substance category | Frequent subtypes | Declared objective/sought effect | Documented Side Effects |
| Anabolic androgenic steroids (AAS) | Testosterone, Nandrolone, Stanozolol, Methandienone, Boldenone, Clostebol | Increase in muscle mass, strength and recovery, reduction of fatigue | Liver damage, hypertension, arrhythmias, infertility, gynecomastia, severe acne, mood changes, aggressiveness, increased cardiovascular risk |
| Growth hormone (hGH) | Synthetic somatotropin | Increased tissue regeneration, lean mass, accelerated recovery | Diabetes, abnormal organ growth (acromegaly), edema, joint pain, risk of cancer in predisposed people |
| Erythropoietin (EPO) | Recombinant EPO, analogues | Increase red blood cells for better oxygenation and greater aerobic endurance | Thrombi, heart attacks, hypertension, strokes; more viscous blood |
| Stimulants | Amphetamines, ephedrine, methylphenidate, modafinil | Increased energy, concentration, alertness; fatigue delay | Arrhythmias, anxiety, dependence, psychosis, insomnia, loss of appetite, cardiovascular risk |
| Prohibited methods (non-substances) | Blood doping, transfusions, microdosing | Better oxygenation, greater resistance | Infections, circulatory failures, risk of shock, fatal complications |
It is true that the World Anti-Doping Agency (WADA) since the beginning of this century has strengthened regulations that favor fair play and ethics, but also the health of athletes. In 2020, the global market related to anti-doping control systems exceeded $800 million and continues to increase each year, due to the increase in regulations, tests and substances that are increasingly difficult to detect.
However, for amateur athletes, there is no such restriction, since they are not subject to controls, and it is estimated that around 10% of them could be consuming PEDs many times without knowing it, since some supplements contain undeclared or adulterated substances.
Real risks: addiction, mental health and physical harm
The consumption of steroids – the most used substance among PEDs – can lead to a substance use disorder in up to 32% of cases, which implies continuing to consume despite the negative consequences, increasing doses, developing tolerance and dedicating more and more time and resources to obtain them. Added to this are significant physical risks, such as hypertension, liver damage, arrhythmias, infertility, gynecomastia, severe acne and increased cardiovascular risk, as well as psychological effects including aggressiveness, extreme irritability, manic episodes and delusions. In addition, steroid use increases the likelihood of using other drugs, which further aggravates the impact on health, especially in adolescence.
Those who develop a substance use disorder require comprehensive care:
- Individual and group psychological therapy,
- Psychiatric evaluation and follow-up,
- Medical support, ideally from an endocrinologist.
Recommendations
The use of these substances is not harmless. Prevention is the best strategy, especially during adolescence, a critical stage of hormonal and brain development. Some basic recommendations are:
- Avoid consuming food supplements or vitamins without the supervision of a doctor.
- Carefully read the labels of everything you eat.
- Do not consume unregulated products or products of dubious origin.
- Talk openly with young people who play sports or train in the gym, offering reliable information about the real risks of using PEDs.
- Promote healthy strategies to achieve physical goals without resorting to steroids or other substances that can harm health.
The author is an opinion leader in addictions at a national and international level. He was director of Monte Fénix and is the founder of the Monte Fénix Center for Higher Studies, Claider Clinics and AMESAD. He is co-author of the book Addictions, the growing challenge and has been recognized for his career with various awards, currently developing the Espinosa-Larrea Foundation. His vision has marked a before and after in the treatment of addictions in Latin America.
You may be interested in: CDMX expects 13 million people for the festival of the Virgin of Guadalupe
