Saarbrucken, Germany  - For professional cyclists, track and field athletes and weightlifters the use of steroids and other performance-enhancing drugs is a serious offence.

But amateur athletes and people who are simply dedicated to a chosen sport routinely use pills, powders and injections, according to a German government health report.

"Doping among non-professional athletes continues to be underestimated and more widespread than is commonly accepted," warned professor Wilfried Kindermann of the Institute for Sports and Preventative Medicine at the University of Saarland in Saarbrucken.

Recently, more large-scale studies have been undertaken to find out more about doping in fitness studios. According to these surveys, at least 10 per cent of the people who work out in gyms abuse performance enhancers such as anabolic steroids. Abuse among men is clearly greater than among women.

Anabolic steroids are the most common. The derivative of the male sex hormone testosterone leads to rapid increase in muscle mass.

"People who take the drugs for a long time see only the intended positive effects," said Mario Thevis, a professor at Germany's centre for preventative doping research in Cologne. "They think they have everything under control and that they are one of the people unaffected by side effects." But these appear only after long-time use.

Joerg Boerjesson of Dorsten, Germany, was 19 when he started training excessively at the gym and taking pills. He thought he was immune from the side effects, but health problems started to appear after years of abuse. He suffered nosebleeds and stomach and intestinal cramping. Ultimately, he had to have surgery. His testosterone ingestion over time had resulted in the growth of breasts, and a suspected case of breast cancer.

Today the former bodybuilder and ex-doper considers himself a "preventologist." He goes to schools, contributes to a German-language website specializing in helping people get off performance-enhancing drugs and assists at a telephone hotline that also helps people who want to quit.

"I talk to a whole lot of people who are intent on increasing their performance - in sports or in their professions, for example, in the military. They know exactly what they are doing and they accept the risks," Boerjesson said.

Achieving a certain look often plays a role among steroid users who work out at the gym or at fitness studios.

"According to surveys, appearance is the main reason for using steroids for more than half the people who work out at the gym," said Thevis. There is usually a narcissistic motivation for using steroids among people who work out in their free time, especially among bodybuilders, Kindermann added. "They would like to impress others with their athletic bodies."

There are other supplements beyond anabolic steroids available for sale on the internet, on the black market, from fellow athletes and also through prescriptions and over-the-counter at the drug store. These include stimulants such as ephedrine, which increases performance and willingness to take risks. Growth hormones such as erythropoietin (epo), increase stamina. Acetylsalicylic acid and anti-rheumatic agents suppress pain resulting from excessive training.

"Often a cocktail concoction is taken without a doctor's oversight," said Thevis. People tap into internet forums and relevant literature for guidance on how to use the drugs, but the consumer has no chance to assess the interaction of the drugs, Thevis said. "He can't check and reassess the concentration and the dosage."

Up to 30 per cent of the substances available don't contain what they say they contain. The long-term results of abusing the substances includes stunted growth, sexual dysfunction, enlarged heart, liver cancer and psychological consequences such as increased aggression. (dpa)