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Pediatricians see many adolescent patients who present for sports physical examinations, camp physical examinations, or immunizations. One area of concern in the health of these patients should be the use of performance-enhancing substances (PES), which may be better known as ergogenic aids or performance-enhancing drugs. The use of these agents has grown significantly among athletes to help performance and among nonathletes to improve appearance. Use of substances such as anabolic steroids, creatine, and dietary supplements is widespread among adolescents and is related to numerous pressures to excel in academics, at home, and on the athletic field.

To be prepared to discuss PES with our patients, we should know the names of the substances, how they are believed to work, and problems associated with their use. We should be aware of the current epidemiology, prevalence, and popular attitudes. We also should know...

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