Abstract

Background: Selective androgen receptor modulators (SARMs) are a class of Performance Enhancing Drugs (PEDs)that are increasingly being abused in the fitness industry. SARMs are ligands that act differently at androgen receptorsin different tissues in the body. Because of their anabolic qualities, they were initially developed for the treatment ofhypogonadism, muscle wasting disorders and osteoporosis. There are currently no SARMs that have received FDAapproval but still they are in use by professional athletes and recreational gym-goers which is concerning due to adverseeffects like hepatotoxicity, testicular atrophy and acne.Objective: This study aims to systematically review the existing literature and compile the beneficial and adverse effectsof SARM.Methods: The authors conducted a systematic review including articles published from 2010 to April 2023 to discoverand evaluate effects of SARMs. PubMed, Google Scholar and ScienceDirect were used to search for articles using thesearch term: ("Selective Androgen Receptor Modulator" OR SARM OR SARMs OR "Selective Androgen ReceptorModulators") AND (Effect OR Effects). Using PRISMA guidelines 2020 (Checklist), a systematic review wasperformed. The authors did not perform a meta- analysis. The quality of included studies was not assessed. The Includedarticles reported physiologic or anatomic effects of SARMs in human subjects only. Only full-length articles written inEnglish, published between 2010 and April 2023 were included. Articles discussing in vitro effects or discussing thesynthesis, molecular properties, molecular signaling and doping control analysis of SARMs were not added. Nonoriginalarticles (reviews, letters, editorials, conference reports) were also not included.Results: Out of 19 studies reviewed, 6 out of 19 (31.6%) discussed increase in lean body mass, 3 out of 19 (15.8%)reported increase in stairs climbing speed and 2 studies (10.52%) found out increase in leg press strength of the users. Asingle study (5.26%) reported a decrease in breast cancer lesion. Drug induced liver injury was the most common sideeffect in the users as reported by 9 out of 19 (47.3%) studies. 3 studies (15.8 %) reported hormonal imbalances and 1study (5.26%) talked about mood swings and testicular atrophy in the users of Selective Androgen ReceptorModulators.Conclusion: Selective Androgen Receptor Modulators are arising as a potential treatment for variety of diseases likecancer cachexia and limitation in movement due to chronic illnesses. But SARMs are related to drug induced liverinjury and hormonal imbalances so their use must be discouraged by physicians. Clinical trials must be conducted toassess their uses in clinics.