Doping, Performance-Enhancing Drugs, and Hormones in Sport

1. Overview: Doping in SportHistory and Current State of the ProblemPrevalence by Sport, Country, Level of CompetitionWorld Anti-Doping Agency and Legal ProblemsEthical Issues of Usage, Sportsmanship, CharacterAre There Situations in Which Athletes Can Use PEDs?—Therapeutic Use ExemptionClose-Up: Sports Doping in Ancient Civilization—Nothing New Under the SunReferences2. Anabolic Androgenic SteroidsTreatment of Endocrine DisruptionsThe Athletic Drive to Increase Muscle MassIntracellular Biochemical and Nuclear ActionsEarly Paradoxes and Later Confirmations in Research FindingsEffects of Abuse, Reversible and NonreversibleOther Anabolic SubstancesClose-Up: The Victims of the East German Medal Machine 1970s to 1990sReferences3. StimulantsLosing Weight, Staying Awake, Gaining FocusStaying Athletically Lean and on TaskNeurochemistryPerformance Enhancement EvidenceSpeeding and CrashingConclusionClose-Up: Weight Loss and Body Composition—What’s the Difference Between Lean Body Mass, Fat-Free Mass, and Muscle Mass, and Why Do Athletes Care?4. GlucocorticoidsAnti-Inflammatory and Pulmonary ActionsHelping Athletes Recover Faster, Breathe Better, and Burn More FatEndocrine and Immune ActionsDo They work? Yes, No, and MaybePseudo-Cushing’s Syndrome and Mineralocorticoid Actions?ConclusionClose-Up: Primum non nocere—Glucocorticoids and an Ethical Dilemma in Sports Medicine References5. Peptide-Protein HormonesOffsetting Endocrine Defects and DysfunctionsIncreasing Muscle Mass and Enhancing Oxygen DeliveryRamping Up Hormone Actions Within CellsIt Works, Within LimitsAcromegaly, Blood Hyperviscosity, and DeathConclusionClose-Up: Can Altitude Training Alone Have the Same Effects as Taking EPO?References6. Beta-2 AgonistsAsthma Prevention and TreatmentBreathing More and Easier Building Muscle in SportBronchodilation Adrenergic Actions and ReactionsAsthmatics, Yes. ! Everyone Else?Tachycardia, Arrhythmias, SyncopeConclusionClose-Up: Use of Inhalers by Asthmatic Athletes—Is This Really Doping?If My Child Uses an Inhaler for Asthma, Is That Doping?References7. Hormone and Metabolic ModulatorsEstrogen and Androgen Modulation in Health and DiseaseThe Balance Between Gender-Based HormonesSelective Receptor Modulation DrugsContradictions and Ambiguous EvidenceThrombosis, Embolisms, Hot Flashes, and HyperandrogenismConclusionClose-Up: Selective Estrogen Receptor Modulators and Exercise as Treatments for Breast Cancer SurvivorsReferences8. NarcoticsIn the arms of MorpheusThe Athletic Need to Push Through the PainThe Opioid System and PainSubstances that Work too WellAddiction, Addiction, and AddictionClose-Up: Pain Management in Athletes—How do Physicians Deal with this Issue when Narcotics are WADA Banned Substances?References9. Beta BlockersCardiovascular Modulation and HealthStaying Calm, Cool, and Collected on the Battlefield of SportBlocking the Actions of Neurotransmitters and HormonesStrong Evidence of Performance EnhancementFrom Lethargy to Impotence: Undesirable EffectsClose-Up: Sometimes the Consequences of Doping Can Be Quite SevereReferences10. Athlete Testing, Analytical Procedures, and Adverse Analytical FindingsWADA Testing ProceduresBiospecimen Analysis TechniquesStrengths and Weaknesses of the Bioanalytical ProceduresWays in Which Athletes Avoid DetectionWhat Happens When an Athlete Gets a Positive Test Result?Close-Up: Fox Guarding the HenhouseReferences11. The Future of Performance Enhancement in SportCan Prevention and Detection Deter Doping?Education of Athletes: Is That Enough?Staying Ahead of the Doping Athlete: Is it Possible?Genetic Doping: Is it the Future?Should Doping be Legalized and Regulated?Binary Gender Constructs and the FutureWhat’s Next?Close-Up: Women Athletes—Taller, Faster, Stronger, and HyperandrogenismReferences