Although individual case reports are extant in the literature, the exact incidence of serious or fatal adverse effects is unknown. It therefore remains difficult to assess accurately just how dangerous the use of AAS is. Intuitively, one can deduce that there is probably substantial underreporting of AAS use. Nevertheless, the overall incidence of serious and fatal complications is probably low. These isolated cases of pathology may represent idiosyncratic responses of susceptible individuals to the pharmacological doses used in AAS abusers; as a rule, however, the reported effects cannot be extrapolated to indicate a systematic generic/class effect of androgens—with the important exception of the 17α-alkylated compounds, the most harmful of the anabolic agents. It is sometimes claimed that the intermittent style of using anabolic steroids probably ameliorates the long-term side effects and that using anabolic steroids may not be as dangerous to well-being or as addictive as the use of other forms of recreational drugs. In the absence of any supporting data, however, such assertions should not be generally accepted at present.
