Health Risks and Side Effects of Doping

The use of performance enhancing substances may lead to serious health risks and even death. This article highlights some of the side effects of performance enhancing substances and methods so as to help readers to make better choices to protect their health and to say ‘no’ to doping.

What are the health risks of doping?
Any performance enhancing substance or method included in the Prohibited List has its own potential risks and/or adverse side effects. Some of the prohibited substances are intended for therapeutic purposes and should only be prescribed by registered physicians. Those substances that are offered to athletes are often manufactured and sold illegally and are likely to contain impurities. When these substances are used, they can cause severe health problems.

What will happen if a person takes more than one drug?
As complex interactions can occur among various types of drugs, the side effects of taking a combination of drugs are likely to be much more severe and serious and thus increase the risk of a harmful or fatal outcome.

Are drugs addictive? Will they cause permanent health damage?
Yes, drugs can create both physical and psychological dependence. When the drug is discontinued, withdrawal symptoms may occur as a result of this dependence. Prolonged use of large dosages of performance enhancing substances may also cause permanent and irreversible side effects.


Commonly-abused Performance Enhancing Substances

Anabolic Agents

Anabolic agents (e.g. steroids) are synthetically produced substances which mimic the effects of testosterone, a hormone naturally derived in the body. Anabolic steroids increase protein synthesis and enhance muscle growth. They also have androgenic effects, including the development and maintenance of masculine characteristics such as the growth of the vocal cords and body hair. Anabolic agents are prohibited both in-competition and out-of-competition.

Side effects

Steroids can cause serious side effects on a person’s health. Most of these side effects are dose-dependent. In general, steroids increase the risk of cardiovascular disease, liver disease, and high blood pressure. Common psychological/behavioral changes include mood swings, aggression, mania, depression, and dependence. For male users, steroids can lead to acne, breast tissue development, permanent baldness, and the shrinking of testicles. In females, steroids can cause acne, growth of facial hair, and the deepening of the voice. In children, administration of steroids can cause the stunting of growth and pre-mature puberty.

In a study on the long-term effects of steroid abuse in a group of 62 elite powerlifters in Finland in 2000, it was shown that the premature mortality rate of the powerlifters during the 12 years of follow up was 4 times higher than that of the controlled population.

Stimulants, for example amphetamine and cocaine, are substances that act on the central nervous system. Stimulants can increase alertness, reduce tiredness, and increase competitiveness and aggression in athletes. Stimulants are prohibited in-competition.

Side effects

The use of certain stimulants can cause serious cardiovascular and psychological problems, as well as other side effects, such as dependence and addiction, increased and irregular heart rate, dehydration, overheating of the body, and dry mouth, etc.

A number of fatalities have occurred in sports where the causes of death were associated with the use of stimulants. In the 1960 Olympics and the 1967 Tour de France, two cyclists died of heat-stroke and cardiac arrest respectively. Traces of methamphetamine and amphetamine, stimulants that can increase body temperature and the risk of stroke, were found in their bodies during autopsy.

Cannabinoids (Cannabis)
Cannabinoids are substances that can be found in the dried flowers, leaves or resin of the Cannabis plant. Cannabis is also known as marijuana, pot, hash, ganja, green, or weed. The use of cannabis causes the body to feel euphoria and relaxation.

Cannabis use is most commonly associated with recreational or social settings but regardless of the environment in which it is taken, if it is found in an athlete’s body during competition, the concerned athlete will be sanctioned.

Side effects
Long term risks of cannabis use may include mood swings, feelings of anxiety or paranoia, memory impairment, chronic bronchitis, and the increased risk of lung, mouth, tongue, and throat cancer. Other effects on the body include impaired balance, co-ordination, and concentration, slowed reaction time, drowsiness, and dry mouth.

Other common prohibited substances/methods and their potential side effects
Other common substances and methods which are prohibited in sports and their potential side effects are tabled below for reader's reference:

Substances and methods prohibited at all times
(in-competition and out-of-competition)
Substance/Method Potential Side Effects
Peptide hormones, growth factors, and related substances and mimetics
(e.g. growth hormone, erythropoietin (EPO))
  • Varies for different substances.
  • Growth hormones can lead to heart disease, carpal tunnel syndrome, and overgrowth of hand, feet, and face.
  • EPO can lead to thickening of blood, increase risk of heart attack, strokes, and pulmonary embolism.
Beta-2 Agonists
  • Increased heart rate and blood pressure, insomnia, nausea, and tremors.
Hormone and metabolic modulators
(e.g. anti-estrogenic substances)
  • Anti-estrogenic substances can cause hot flushes, sweating, insomnia, and osteoporosis.
Diuretics and masking agents
  • Diuretics can cause dehydration, muscle cramps, blood volume depletion, and severe electrolyte imbalance.
Manipulation of blood and blood components
  • Thickening of blood, increased risk of infection, development of blood clot, heart attacks, strokes, and pulmonary embolism.
Gene doping
  • The technology is new and dangerous. Side effects are unpredictable.

Substances prohibited in-competition only
Substance Potential Side Effects
  • Increased pain threshold and failure to recognize injury, illusion of athletic prowess beyond inherent ability, and sedation.
  • Immunosuppression, hyperglycemia, reduced bone density, adrenal insufficiency, weight gain, muscle breakdown, and menstrual irregularities.

Substances prohibited in particular sports
Substance Potential Side Effects
  • Fatigue, dizziness, cold hands, sleep disorders, sexual dysfunction, and depression.

This is not the full list. For complete and detail information, please refer to the most current Prohibited List.