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 receptors
in different tissues in the body. Because of their anabolic qualities, they were initially developed for the treatment of
hypogonadism, muscle wasting disorders and osteoporosis. There are currently no SARMs that have received FDA
approval but still they are in use by professional athletes and recreational gym-goers which is concerning due to adverse
effects like hepatotoxicity, testicular atrophy and acne.
Objective: This study aims to systematically review the existing literature and compile the beneficial and adverse effects
of SARM.
Methods: The authors conducted a systematic review including articles published from 2010 to April 2023 to discover
and evaluate effects of SARMs. PubMed, Google Scholar and ScienceDirect were used to search for articles using the
search term: ("Selective Androgen Receptor Modulator" OR SARM OR SARMs OR "Selective Androgen Receptor
Modulators") AND (Effect OR Effects). Using PRISMA guidelines 2020 (Checklist), a systematic review was
performed. The authors did not perform a meta- analysis. The quality of included studies was not assessed. The Included
articles reported physiologic or anatomic effects of SARMs in human subjects only. Only full-length articles written in
English, published between 2010 and April 2023 were included. Articles discussing in vitro effects or discussing the
synthesis, molecular properties, molecular signaling and doping control analysis of SARMs were not added. Nonoriginal
articles (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. A
single study (5.26%) reported a decrease in breast cancer lesion. Drug induced liver injury was the most common side
effect in the users as reported by 9 out of 19 (47.3%) studies. 3 studies (15.8 %) reported hormonal imbalances and 1
study (5.26%) talked about mood swings and testicular atrophy in the users of Selective Androgen Receptor
Modulators.
Conclusion: Selective Androgen Receptor Modulators are arising as a potential treatment for variety of diseases like
cancer cachexia and limitation in movement due to chronic illnesses. But SARMs are related to drug induced liver
injury and hormonal imbalances so their use must be discouraged by physicians. Clinical trials must be conducted to
assess their uses in clinics.