Androgens are potent drugs requiring prescription for valid medical indications but are misused for invalid, unproven, or off-label reasons as well as being abused without prescription for illicit non-medical application for performance or image enhancement. Following discovery and first clinical application of testosterone in the 1930s, commercialisation of testosterone and synthetic androgens proliferated in the decades after World War II. It remains among the oldest marketed drugs in therapeutic use, yet after 8 decades of clinical use the sole unequivocal indication for testosterone remains in replacement therapy for pathological hypogonadism, organic disorders of the male reproductive system. Nevertheless, wider claims assert unproven, unsafe, or implausible benefits for testosterone, mostly representing wishful thinking about rejuvenation. Over recent decades this created an epidemic of testosterone misuse involving prescription as a revitalizing tonic for anti-ageing, sexual dysfunction and/or obesity, where efficacy and safety remains unproven and doubtful. Androgen abuse originated during the Cold War as an epidemic of androgen doping among elite athletes for performance enhancement before the 1980s when it crossed over into the general community to become an endemic variant of drug abuse in sufficiently affluent communities that support an illicit drug industry geared to bodybuilding and aiming to create a hypermasculine body physique and image. This review focuses on the misuse of testosterone, defined as prescribing without valid clinical indications, and abuse of testosterone or synthetic androgens (androgen abuse), defined as the illicit use of androgens without prescription or valid indications, typically by athletes, body-builders and others for image-oriented, cosmetic or occupational reasons.

中文翻译：

---

雄激素滥用和滥用

雄激素是一种强效药物，需要为有效的医学适应症开处方，但由于无效、未经证实或标签外的原因而被滥用，并且在未经处方的情况下被滥用以用于性能或图像增强的非法非医学应用。随着 1930 年代睾酮的发现和首次临床应用，睾酮和合成雄激素的商业化在二战后的几十年中激增。它仍然是治疗用途最古老的上市药物之一，但经过 8 年的临床使用后，睾酮的唯一明确适应症仍然是用于治疗病理性性腺功能减退症、男性生殖系统器质性疾病的替代疗法。然而，更广泛的说法声称睾酮的益处未经证实、不安全或难以置信，主要代表了对复兴的一厢情愿。近几十年来，这造成了睾酮滥用的流行，涉及处方作为抗衰老、性功能障碍和/或肥胖的振兴补品，其有效性和安全性仍未得到证实和怀疑。雄激素滥用起源于冷战时期，在 1980 年代之前，雄激素兴奋剂在精英运动员中流行以提高成绩，当时它跨入普通社区，成为足够富裕社区的一种地方性药物滥用变体，支持非法药物行业健美和旨在创造一个超男性的体质和形象。本综述重点关注睾酮的滥用，定义为在没有有效临床适应症的情况下开处方，以及滥用睾酮或合成雄激素（雄激素滥用），