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Dicho uso está prohibido por las normas de los órganos rectores de la mayoría de los deportes. El uso de AAS ocurre entre los adolescentes, especialmente entre los que participan en deportes competitivos. La alquilación a nivel de la posición 17 α determina la eficacia de los andrógenos por vía oral, ya que el hígado metaboliza más lentamente los derivados alquílicos. Algunos estudios muestran una asociación entre abuso de EAA y otras drogas, o con otras conductas de riesgo (peleas, carreras de motocicletas, llevar armas, conducir en estado de embriaguez), lo que avalaría la hipótesis de que el abuso de EAA es parte de un "síndrome de conducta de riesgo" más que una conducta aislada11,12. Su funci�n principal es controlar el dopaje,realizar estudios de Biodisponibilidad, de Farmacocin�tica y deBioequivalencia. Se encuentra en estrecho v�nculo al Laboratorio Central deCriminal�stica, al Centro Nacional de Toxicolog�a y al Instituto de Medicina Legal. Constituye el quintode su tipo en Am�rica ybrinda servicios a los pa�ses del Tercer Mundo, con el fin decontribuir a la lucha contra el flagelo de las drogas que corrompe,enga�a y mata a los atletas promoviendo as� el juego limpio, la Educaci�ny Cultura de atletas, entrenadores,dirigentes y federativos. Finalmente, en 1968, el Comité Olímpico Internacional acuerda una definición de dopping y en los Juegos Olímpicos de Montreal en 1976 se prohíbe su utilización2. Los esteroides anabólicos incluyen la testosterona y todos los fármacos química y farmacológicamente relacionados con la testosterona que favorecen el crecimiento muscular; se dispone de numerosos fármacos. Los esteroides anabólicos se utilizan clínicamente para tratar los niveles bajos de testosterona en el hipogonadismo masculino. Y pese a los alegados beneficios a los que se asocian, pudieran acarrear efectos secundarios no deseados, reiteró la doctora Robles Bachiller. Por otro lado, la doctora mencionó efectos adversos cardiovasculares, endocrinológicos, hepáticos, reproductivos y dermatológicos. De manera que si una persona utiliza 500 mg de testosterona a la semana, estará bajo los efectos de una carga anabólica de 500. Los ésteres se unen a los esteroides para que tengan una vida más larga en sangre, es decir, para que tengan un efecto más sostenido en el tiempo y se eliminen más lentamente, ya que si inyectasemos, por ejemplo, la testosterona pura, solo ejercería su efecto durante unos minutos. Siendo los ladrillos de la obra, los aminoácidos y proteínas que acabarán formando parte del tejido muscular creado. Y cuando esto ocurre en el músculo esquelético, produce como consecuencia un aumento del contenido de proteínas contráctiles, es decir, el músculo aumenta de tamaño. La oferta precise del mercado español es limitada con respecto al whole de sustancias que se consumen de manera ilícita fuera y dentro de España (tabla 2). 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La educación sobre los esteroides anabólicos debe comenzar por el principio de la escuela media. Puede ser útil la implementación de programas que enseñan maneras alternativas y saludables para aumentar el tamaño de los músculos y mejorar el rendimiento a través de una buena nutrición y técnicas de entrenamiento con pesas. La presentación de los riesgos y los beneficios del uso de esteroides anabólicos parece ser una manera más eficaz para educar a los adolescentes sobre los efectos negativos del uso ilícito de esteroides. El signo más característico del consumo de esteroides anabólicos es un rápido aumento de la masa muscular. Los pacientes que toman dosis fisiológicas tienen un crecimiento lento y a menudo imperceptible; los que toman megadosis pueden aumentar el peso corporal magro varias libras por mes. Los aumentos en el nivel de energía y la libido (en los varones) aparecen, pero son más difíciles de cuantificar. En última instancia, estos efectos aumentan el tamaño de los músculos esqueléticos con mayor fuerza. No se sabe claramente el mecanismo de injuria pero se ha propuesto como mecanismo la necrosis tubular aguda secundaria a la colestasis severa y el incremento de la excreción renal de bilirrubina7. La capacidad reducida de un feto XY-cariotipo para responder a los andrógenos puede dar lugar a una de varias afecciones, incluida la infertilidad y varias formas de condiciones intersexuales. Los andrógenos tienen un papel potencial en la relajación del miometrio a través de vías no genómicas, independientes de los receptores de andrógenos, que previenen las contracciones uterinas prematuras en el embarazo. Es decir, los niveles circulantes naturales de andrógenos cancelan los efectos negativos del aislamiento social en la neurogénesis del hipocampo adulto. Alrededor de la semana 6, los cordones sexuales epiteliales se desarrollan dentro de los testículos formadores e incorporan las células germinales a medida que migran a las gónadas. La presencia de efectos adversos está fuertemente relacionada con la formación de metabolitos producidos durante las transformaciones que sufre la testosterona en plasma.Entre esas tranformaciones predominan la formación de dihidrotestosterona (DHT) y Estrógenos. La formación de (DHT) se conoce como reducción y en esta reacción interviene la enzima denominada 5 alfa reductasa, este metabolito es el responsable de la Hipertrofia Prostática Benigna, Alopecia, formación de acné y agresividad. La formación de estrógenos se conoce como aromatización e interviene la enzima denominada aromatasa, este metabolito es el responsable de producir ginecomastia, retención de líquido, hipertensión arterial, lipogénesis y Atrofia Testicular (oligospermia). Todo esteroide anabólico androgénico puede causar algún grado de acné si se devour en cantidades altas. Esto es especialmente cierto con preparaciones andrógenas fuertes, las cuales pueden causar acné cicatrizante severo. También se ha comprobado que la erección producida por estimulación del área medial preóptica en ratas es dependiente de la testosterona33. Por tanto, los andrógenos parecen regular en el animal de experimentación los mecanismos neurológicos de la erección, tanto a nivel central como periférico. Otros estudios experimentales en ratas han demostrado que la testosterona regula la expresión y la actividad de las distintas isoformas (neuronal y endotelial) de la sintasa de óxido nítrico (NOS) en el cuerpo cavernoso34,35. El óxido nítrico es el mediador de la relajación del músculo liso trabecular y arterial intracavernoso. En animales castrados, la administración de testosterona o DHT restableció la función eréctil y la expresión de NOS en el cuerpo cavernoso34,35. También se ha demostrado que la testosterona regula la actividad de la fosfodiesterasa 5 (PDE5). Los médicos que tratan a los adolescentes y a los adultos jóvenes deben estar alertas a los signos de abuso de esteroides y enseñar a los pacientes sobre sus riesgos. Además de regular las vías implicadas en el desarrollo de las características masculinas,103 la activación de los receptores de andrógenos también produce un rápido aumento de los niveles de calcio en el músculo esquelético, el corazón y las células cerebrales.104 El calcio desempeña un papel importante en la señalización neuronal. Las hormonas masculinas, principalmente la testosterona, son parcialmente responsables de los tremendos cambios que ocurren durante la pubertad y la adolescencia. Los efectos androgénicos incluyen cambios en las características sexuales primarias y secundarias. Hipertensión, dolores de cabeza, aumento de la resistencia a la insulina, intolerancia a la glucosa, anomalías en el torrente sanguíneo y otros. Una mezcla de ellos podría producir un ataque cardiaco y muerte súbita por un fallo en la sangre o en el sistema circulatorio. Por supuesto, debe tratar de deshacerse de todo el aire de la jeringa antes de la inyección – la pequeña burbuja no nos matará, pero inyectada en la vena puede causar molestias y leves alteraciones en el ritmo cardíaco. Si teme por su cabello, puede obtener finasteride – una sustancia que limita la conversión de la testosterona en DHT (una hormona considerada como la principal causa de la calvicie). Por supuesto, causa la pérdida de cabello sólo en las personas que tienen una tendencia a la pérdida de cabello. Por cierto, vale la pena señalar que no hay consecuencias legales por comprar o poseer esteroides para tu propio uso. Después de que el ciclo termine, espere al menos 8-10 semanas (preferiblemente 12 semanas) antes de comenzar el siguiente. Como en la mayoría de las operaciones importantes de contrabando, el crimen organizado está involucrado. En Canadá, los investigadores han concluido que el uso de esteroides entre los estudiantes atletas está muy extendido. Un estudio realizado en 1993 por el Centro Canadiense para el Deporte Libre de Drogas encontró que casi 83,000 canadienses entre las edades de 11 y 18 años usan esteroides. Los AAS también son ilegales sin receta en Australia, Argentina, Brasil y Portugal, y están catalogados como Medicamentos Controlados de Clase C en el Reino Unido. La testosterona puede metabolizarse por la aromatasa en estradiol, y muchos otros AAS también pueden metabolizarse en sus correspondientes metabolitos estrogénicos. Como ejemplo, la metiltestosterona y la metandienona AAS alquiladas en 17α son convertidas por la aromatasa en metilestradiol. 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