Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Adverse effects and potential benefits among selective androgen receptor modulators users: a cross-sectional survey

Abstract

Selective androgen receptor modulators (SARMs) are a class of androgen receptor ligands that bind androgen receptors and display tissue selective activation of androgenic signaling. SARMs have selective anabolic effects on muscle and bone, and were originally synthesized for treatment of muscle wasting conditions, osteoporosis, breast cancer. To date, no SARM has been clinically approved and little is known about the beneficial effects and other adverse effects on users. We examined the adverse effects and potential benefits of SARMs amongst users. We performed an internet survey assessing the demographics of users via a 32-question survey. Using reddit as a platform, we distributed the survey through various subreddits that included potential SARMs users. Out of the 520 responses, 343 participants admitted having used SARMs. Most were males (98.5%), between the ages of 18–29 (72.3%). More than 90% of users acquired SARMs via the internet and did not consult with a physician. More than half of SARMs users experienced side effects including mood swings, decreased testicular size, and acne. More than 90% of men reported increased muscle mass and were satisfied with their SARMs usage. Despite having seemingly positive effects, more than 50% of SARMs users report significant adverse effects. Chi square was the main method of statistical analysis. Future studies should focus on comprehensive reproductive evaluation of men using SARMs.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Bhasin S, Jasuja R. Selective androgen receptor modulators as function promoting therapies. Curr Opin Clin Nutr Metab Care. 2009;12:232–40.

    Article  CAS  Google Scholar 

  2. Narayanan R, Mohler ML, Bohl CE, Miller DD, Dalton JT. Selective androgen receptor modulators in preclinical and clinical development. Nucl Recept Signal. 2008;6:e010.

    Article  Google Scholar 

  3. Rambhatla A, Mills JN, Rajfer J. The role of estrogen modulators in male hypogonadism and infertility. Rev Urol. 2016;18:66–72.

    Google Scholar 

  4. Narayanan R, Coss CC, Dalton JT. Development of selective androgen receptor modulators (SARMs). Mol Cell Endocrinol. 2018;465:134–42.

    Article  CAS  Google Scholar 

  5. Barbara M, Dhingra S, Mindikoglu AL. Ligandrol (LGD-4033)-induced liver injury. ACG Case Rep. J 2020;7:e00370.

    Article  Google Scholar 

  6. Van Wagoner RM, Eichner A, Bhasin S, Deuster PA, Eichner D. Chemical composition and labeling of substances marketed as selective androgen receptor modulators and sold via the internet. JAMA 2017;318:2004–10.

    Article  Google Scholar 

  7. Basaria S, Collins L, Dillon EL, Orwoll K, Storer TW, Miciek R, et al. The safety, pharmacokinetics, and effects of LGD-4033, a novel nonsteroidal oral, selective androgen receptor modulator, in healthy young men. J Gerontol A Biol Sci Med Sci. 2013;68:87–95.

    Article  CAS  Google Scholar 

  8. Session tCs. S.2895 - SARMs Control Act of 2019 [Control Act]. United States Congress; 2019 [updated 1/19/2019; cited 2020 9/15/2020]. 1]. Available at https://www.congress.gov/bill/116th-congress/senate-bill/2895/text.

  9. Christiansen AR, Lipshultz LI, Hotaling JM, Pastuszak AW. Selective androgen receptor modulators: the future of androgen therapy? Transl Androl Urol 2020;9:S135–S48.

    Article  Google Scholar 

  10. Curry D Reddit Revenue and Usage Statistics (2021) [Webpage]. Businessofapps.com: Business of Apps; 2021 [cited 2020 11/13/2020]. Available at https://www.businessofapps.com/data/reddit-statistics/.

  11. Agency WA-D THE 2008 PROHIBITED LIST INTERNATIONAL STANDARD [Website]. WADA2008 [cited 2020. WADA Prohibited List (2008)]. Available at https://www.wada-ama.org/sites/default/files/resources/files/WADA_Prohibited_List_2008_EN.pdf.

  12. Cohen J, Collins R, Darkes J, Gwartney D. A league of their own: demographics, motivations and patterns of use of 1,955 male adult non-medical anabolic steroid users in the United States. J Int Soc Sports Nutr. 2007;4:12.

    Article  Google Scholar 

  13. Sagoe D, Molde H, Andreassen CS, Torsheim T, Pallesen S. The global epidemiology of anabolic-androgenic steroid use: a meta-analysis and meta-regression analysis. Ann Epidemiol. 2014;24:383–98.

    Article  Google Scholar 

  14. Crawford J, Prado CM, Johnston MA, Gralla RJ, Taylor RP, Hancock ML, et al. Study design and rationale for the phase 3 clinical development program of enobosarm, a selective androgen receptor modulator, for the prevention and treatment of muscle wasting in cancer patients (POWER Trials). Curr Oncol Rep. 2016;18:37.

    Article  Google Scholar 

  15. GTx I GTx Announces Top-Line Results from Placebo-Controlled ASTRID Trial of Enobosarm in Women with Stress Urinary Incontinence [Webpage]. Bloomberg.com: Bloomberg; 2018 [cited 2020 11/15/2020]. Available at https://www.bloomberg.com/press-releases/2018-09-21/gtx-announces-top-line-results-from-placebo-controlled-astrid-trial-of-enobosarm-in-women-with-stress-urinary-incontinence.

  16. Ponnusamy S, Sullivan RD, Thiyagarajan T, Tillmann H, Getzenberg RH, Narayanan R. Tissue selective androgen receptor modulators (SARMs) increase pelvic floor muscle mass in ovariectomized mice. J Cell Biochem. 2017;118:640–6.

    Article  CAS  Google Scholar 

  17. Osterberg EC, Bernie AM, Ramasamy R. Risks of testosterone replacement therapy in men. Indian J Urol. 2014;30:2–7.

    Article  Google Scholar 

  18. Smit DL, de Ronde W. Outpatient clinic for users of anabolic androgenic steroids: an overview. Neth J Med. 2018;76:167.

    CAS  Google Scholar 

  19. Patel AS, Leong JY, Ramos L, Ramasamy R. Testosterone is a contraceptive and should not be used in men who desire fertility. World J Mens Health. 2019;37:45–54.

    Article  Google Scholar 

  20. Catalani V, Arillotta D, Corkery JM, Guirguis A, Vento A, Schifano F. Identifying new/emerging psychoactive substances at the time of COVID-19; a web-based approach. Front Psychiatry. 2020;11:632405.

    Article  Google Scholar 

  21. Leas EC, Hendrickson EM, Nobles AL, Todd R, Smith DM, Dredze M, et al. Self-reported cannabidiol (CBD) use for conditions with proven therapies. JAMA Netw Open. 2020;3:e2020977.

    Article  Google Scholar 

  22. Ibarra JL, Agas JM, Lee M, Pan JL, Buttenheim AM. Comparison of online survey recruitment platforms for hard-to-reach pregnant smoking populations: feasibility study. JMIR Res Protoc. 2018;7:e101.

    Article  Google Scholar 

  23. Wang M, Wu G, Gunasekaran V, Chen V, Vani A, Kim D. Internet survey: health screening in sports. J Atr Fibrillation. 2016;9:1471.

    Article  Google Scholar 

Download references

Acknowledgements

The authors have no financial disclosures. No funding was provided for this study.

Author information

Authors and Affiliations

Authors

Contributions

All listed authors contributed equally to writing of this manuscript.

Corresponding author

Correspondence to Iakov V. Efimenko.

Ethics declarations

Competing interests

There are no competing financial interests in relation to the work described. Dr. Ranjith Ramasamy has the following disclosures: Acerus Pharmaceuticals (Consultant); Boston Scientific (Consultant, Grant recipient); Coloplast (Consultant, Grant recipient); Endo Pharmaceuticals (Consultant, Grant Recipient); Metuchen (Consultant); Nestle Health (Consultant).

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Efimenko, I.V., Valancy, D., Dubin, J.M. et al. Adverse effects and potential benefits among selective androgen receptor modulators users: a cross-sectional survey. Int J Impot Res 34, 757–761 (2022). https://doi.org/10.1038/s41443-021-00465-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41443-021-00465-0

This article is cited by

Search

Quick links