Participants were 60 men (Mean age = 26.69, SD = 6.57) who identified as primarily heterosexual (95%, n = 57) with the remainder identifying as bisexual (3.3%, n = 2) or queer (1.7%, n = 1). A large portion of the sample resided outside Australia (68.3%, n = 41); Australian participants resided in Queensland (16.7%, n = 10), Victoria (6.7%, n = 4), New South Wales (6.7%, n = 4), and South Australia (1.7%, n = 1). Of these men 11.7% (n = 7) had competed in a bodybuilding competition.
Activities pre-COVID
The men in this sample were generally involved in weight training with 60% (n = 36) reporting involvement in weight training and cardio but primarily weight training, 33.3% (n = 20) reporting involvement in weight training with minimal cardio, 5% (n = 3) reporting weight training and cardio but primarily cardio, and 1.7% (n = 1) reporting cardio with minimal/no weight training. The most common training volume for these men was four or more days per week (95%, n = 57) which occurred at either a commercial gym (51.7%, n = 31), home gym (23.3%, n = 14), a local non-commercial gym (15%, n = 9), outdoor training (5%, n = 3) private studio (3.3%, n = 2), or a friend’s home gym (1.7%, n = 1). Most men in this group opted for training by themselves (91.7%, n = 55) rather than a group (8.3%, n = 5), with some men reporting having a coach/personal trainer (13.3%, n = 8) and training/preparing for a competition (20%, n = 12). In terms of training goals, 38.3% (n = 23) of men were aiming to add mass (‘bulking’), 33.3% (n = 20) were reducing body fat (‘cutting’), and 28.3% (n = 17) were in a maintenance phase.
With respect to PIED use, a majority of the sample opted to ‘blast-cruise’ (an initial high dose, followed by a lower maintenance dose; 71.7%, n = 43) as opposed to ‘cycling’ (using a dose for a defined period, then ceasing to use for a defined period; 28.3%, n = 17). Regarding the actual PIEDs used, these are presented in Table 1. In acquiring these compounds, a large proportion opted to do so online (51.7%, n = 31) and the darkweb (10%, n = 6), with 18.3% (n = 11) sourcing from a friend, 13.3% (n = 8) sourcing from a dealer, and 15% (n = 9) sourcing through other means. A small subgroup of men were tapering these compounds coming up to a bodybuilding show (8.3%, n = 5).
Table 1
Frequency of PIED use Pre-COVID.
PIED | Frequency |
Boldenone | 14 (23.3%) |
Masteron | 10 (16.7%) |
Primobolan | 3 (5%) |
Nandrolone | 8 (13.3%) |
Stanazolol (Inj) | 8 (13.3%) |
Testosterone | 42 (70%) |
Trenbolone | 17 (28.3%) |
Turinabol | 1 (1.7%) |
Halotestin | 1 (1.7%) |
Proviron | 5 (8.3%) |
Dianabol | 15 (25%) |
Anavar | 17 (28.3%) |
Anadrol | 8 (13.3%) |
Stanazolol (Oral) | 7 (11.7%) |
Clenbuterol/Albuterol | 10 (16.7%) |
Thyroid Hormones (T3/T4) | 3 (5%) |
Insulin | 5 (8.3%) |
Human Growth Hormone | 6 (10%) |
IGF-1 | 3 (5%) |
Peptides | 6 (10%) |
Prohormones | 5 (8.3%) |
SARMs | 4 (6.7%) |
Activities during COVID
During the COVID-19 restrictions there were some shifts in the sample’s general activity. For example, 16.7% (n = 10) stopped training altogether, with an increasing representation of cardiovascular activity among the sample (18.4%, n = 11). Of the men that continued to train, the sample stated that their training intensity decreased (31.7%, n = 19) or stayed the same (13.3%, n = 8), with some reporting an increase (15%, n = 9). There was a minor shift in the number of days those men were training with a larger proportion reporting under 4 days (13.4%, n = 8) while the remainder reported between 4 (6.7%, n = 4) and 7 (8.3%, n = 5) days of training; the largest proportion was still training between 5–6 days (25%, n = 15). The men that continued to train reported predominantly doing so in a home gym (35%, n = 21) or outdoors (6.7%, n = 4).
Two-fifth (45%; n = 27) reported a change in PIED use as a result of the restrictions, with 5% (n = 3) reporting this to be a result of difficulty in compound access. Reasons given by participants for this difficulty included increased post volume by postal services resulting in longer delivery times (e.g., 3 weeks for one participant's package to arrive). Another participant mentioned that due to difficulty in access they decided to drop back to a ‘cruising’ dose of testosterone. In light of health concerns during COVID-19, a majority of men (60%, n = 36) did not take any extra precautions relating to their PIED use (e.g., sterilising vials, not reusing needles) although some reportedly did (16.7%, n = 10). In terms of changes around compound access and sourcing, a majority reported no change in price (60%, n = 36) or quality (56.7%, n = 34). Lastly, 53.3% (n = 32) reported no issues with accessing needle and syringe programs.
A subgroup of men ceased using PIEDs completely (16.7%, n = 10) with the majority (80%, n = 8) of that subgroup following PCT of some kind. Of this subgroup a large proportion reported their use of alcohol and other drugs to change (80%%, n = 8). Half of the subgroup (50%, n = 5) reported issues accessing PCT compounds which were predominantly associated with peer networks (n = 1) or peer networks and GP refusal (n = 4). A small number of this subgroup (30%, n = 3) reported experiencing negative health effects as a resulting of PIED cessation. Two participants reported the common issues which arise as a result of sudden AAS cessation – e.g., depressed mood, little energy, and low libido. One participant expressed that their mental health declined significantly and experienced a number of symptoms such as depression, lethargy, anxiety, panic attacks, and suicidal ideation.