Sexual Quality Of Life Among Users Of Anabolic Androgenic Steroid Supplements: Prevalence Study In Baghdad Fitness Centers

Abstract

Background: Sexuality is a fundamental human activity. It relates to how individuals perceive or express their sexuality. sexual health is considered an important contributor to overall quality of life among adults across different age groups. Objective: To assess the sexual quality of life, among users of Anabolic Androgenic Steroid supplements among gym-attendants in Baghdad, and its associated factors. Method: A cross-sectional study carried out in Baghdad city in the period from 1st of Jan through Mar 2026. Data were collected from 20 gym centers in Baghdad city (10th from Al-Kharkh and 10 from Al-Resafa), 157 Married males, who regularly attend the gyms and currently use dietary or fitness supplements, were collected using standardized questionnaire.  Results: Poor sexual wellbeing, poor sexual experiences related distress and poor sexual experiences regarding certain mental health aspects during the last 4 weeks were observed among AAS users compared to those using other supplements (P. value =0.003,0.001,0.001) respectively. Significant differences were found in the mean values of all hormones, with higher levels of total testosterone, LH and FSH, among participants who get their AAS from their friends, with lower prolactin levels (P-value = 0.038, 0.022, 0.016,0.022, respectively). Participants who experienced erectile dysfunction had significantly lower prolactin level of 6.7 ± 2.5 ng/ml, compared to 11 ± 3.3 ng/ml in those who did not have this side effect of AAS (P-value=0.001). Conclusions: Androgenic anabolic steroids were the third most common supplement used by gym attendees, especially among older age, married, and those with longer duration of gym membership and more frequent days of attendance gym-goers. A negative association was found between using Androgenic anabolic steroids and levels of Sexual Wellbeing and Sexual experiences. lower testosterone levels were detected among users of Androgenic anabolic steroids. Also the current study found that using AAS was associated with high rates of side effects where they reported by (64.3%) of the study participants, the main reported side effects were decreased libido, erectile dysfunction, mood changes, acne/hair loss, gynecomastia and infertility, all these side effect can contribute to poor QoL about both physical and sexual aspects. On the other hand, we found that the use of AAS was significantly associated with poor sexual wellbeing and poor sexual experiences.