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Ergogenic is derived from the Greek word ergon, which means “work” or “work creating” (Gropper, Smith & Goff, 2005). Therefore, ergogenic aids have the common attributes of enhancing work, such as performance (Stone, Stone & Sands, 2007). An ergogenic aid does not need to be nutritional because it can also be mechanical, for instance, a running shoes or body suit in order to improve aerodynamics are also considered as mechanical ergogenic aid.

The idea of ergogenic aids or performance enhancers is not new, and ergogenic aids have been long used in most of the daily work endeavours and activities, especially in those stressful situations like warfare (Stone, Stone & Sands, 2007).

It is considered as substances that if added to the diet may directly improve the sports performance. They are commonly divided into three general classes, which include: macronutrients, micronutrients and metabolic intermediaries. Generally, macronutrients, including supplemental carbohydrate, amino acids as well as medium-chain triglycerides (MCTs), help to contribute in improving the athletic performance by offering additional energy or vital substrates that are required in order to fuel the body before and during the exercise and refuel or prepare the body after the exercise. On the other hand, micronutrients (vitamins and minerals) act in order to improve overall health and improve the performance in indirect manner (Drinkwater 2008).

            Ergogenic aids are drugs and supplements thought to improve performance which include medications, herbs as well as food supplements, and procedures. Doping is banned by the National Collegiate Athletic Association (NCAA) and the International Olympic Committee (IOC), because it contravenes the ethics of both sport and medical science, which pressures the honor and decorum of Olympic sports, wear away public confidence in the Olympic Movement, and put at risk the health and well-being of athletes (Swedan, 2001).

            This paper will focus on the reasons why performance enhancing drugs shouldn’t be allowed in any sports in the world. Thus, it will focus on the impact of ergogenic aids in the performance of individuals in the field of sports, at the same time, focuses on the different advantages and disadvantages of using performance enhancing drugs in the performance, ethics and overall well-being of sportsmen. With this, it will focus on the different policies and regulations that are being applied and implemented by different sports organizations in the world, including Olympic Committee and World Anti-Doping Agency (WADA). Furthermore, it will also explore the perceptions and attitude of the public and athletes in using performance enhancing drugs in sports.

            In doing this paper and study, different resources were used including online and offline articles, journals as well as books, which focuses on analyzing problems and issues that are related with performance enhancing drugs. Furthermore, it will also use documents and reports taken from the website of Olympic Committee and WADA.


Use of Ergogenic Aids in Sport

            Being competitive is a part of the basic nature of mankind. This competitive nature is central in sport. Athletes make their effort in order to outperform their opponents or actually may compete with themselves in the process of attempting in creating personal records. Due to this competitive spirit, humans have developed an array of tools in order to improve their performance (Stone, Stone & Sands 2007, p. 139). The desire to win has been pushed to far greatest level and even beyond the ethical environment in order to seek some personal gratification, at the same time seek recognition by the monetary value (Swedan 2001). These tools are known as the use of ergogenic aids. Ergogenic aids started a long time ago, during the ancient Olympics (Stone, Stone & Sands 2007). Athletes from the past began to do activities and take medications and drugs which will help them to improve their performance. As a result, using these tools was very prominent in the sports industry during that time. This had helped in order for the athletes to go beyond the limit of their capabilities, which enables them to have advantages from their competitors.

            However, as time goes by, government, together with different sports agencies and non-governmental organizations started to raise the issue of using ergogenic aids or performance enhancing drugs in sports. This is because of the different health and ethical aspects. This certainly goes to the topic that is related to doping in sports.

Doping in Sports

            The root of the world doping is an interesting topic; dope pertains on a stimulant drink that is used in the tribal ceremonies in South Africa in 18th century. Dope first appeared and used in an English dictionary in 1889 and was described as a narcotic potion for racehorses which help in order to reduce their performance. Contemporary use has extended the definition which includes the improvement of the performance. As a result, a practice has been developed which made the definition to describe the maintenance of performance and manipulation of the testing procedures by using doping classes and methods (Mottram 2003). Doping is used in order to define not just the misuse of the drugs by sportsmen and women, but also other methods that are being used in order to improve performance or attempt to manipulate the test (Mottram 2003). Doping is an activity which can be observed from the past. The extensive use of medical products for lessening and improving the symptoms of disease can be rooted to the Greek physician, Galen during the 3rd century B.C. Fascinatingly, it was Galen who reported that the ancient Greek athletes were using stimulants in order to enhance and improve their physical performance. During the Ancient Olympic Games, athletes had special diets and reportedly took different substances in order to improve their physical capabilities and skills (Mottram, 2003). Furthermore, during the Roman times, gladiators used stimulants in order to sustain the levels of their energy after injury. Similar behavior by medieval knights has also been noted, (Donohoe & Johnson (1986). Historically, there are several examples which showed that athletes have sought a magic potion in order to give them the extra advantage or edge, which enabled them to take a short cut in order to achieve a good performance or enable them to compete under circumstances when otherwise it might not been impossible, such as injury or illness (Mottram, 2003).

            However, as time goes by, sports organizations started to observe injuries, illness and deaths that are connected to doping. Deaths of sportsmen and women that have been recorded in history from the 1960s, which demonstrates how widespread drug abuse had become. During the 1960 Rome Olympics, Knud Jensen, the cyclist died on the opening day of the Games as he competed in the 100 km team time trial. Aside from that, two of his teammates had been taken to hospital why? (Mottram, 2003). The post-mortem revealed traces of amphetamine and nicotinic nitrate in the blood of Jensen. In addition, British cyclist Tommy Simpson died in 1967, during the Tour de France this was televised across the globe. It was eventually revealed that there were traces of amphetamine, methyl amphetamine and cognac found in his body. The next year, two additional deaths were reported in cycling and football. The admission of the British athlete, Alan Simpson showed that there was an increase in amphetamine abuse in 1966 Commonwealth Games (Mottram, 2003).   

Impacts of Performance Enhancement Drugs in Sports

            WADA defines the spirit of sport using a long list of words (WADA 2003), which include: (1) ethics, (2) health; (3) excellence in performance, (4) character and education, (5) fun and joy, (6) teamwork, (7) dedication and commitment, (8) respect for rules and laws, (9) respect for self and other participants, (10) courage, and (11) community and solidarity. It is important to consider that doping is connected with these definitions, particularly regarding health and ethics.


Health Risks

            Any discussion addressing the different issues that are connected with the use of performance enhancing drugs must focus on the substances and products whose use is proscribed in sport. The advent of the World Anti-Doping Agency (WADA) and its code in 2003 meant that for the first time a universally applied list of forbidden products was applied across an array of sports and nations. The resulting consistency was as welcome as was the more formalized and transparent process used to develop the Prohibited List. The list is assembled on the basis of recommendations emanating from a group of sport clinicians and scientists, which are distributed for comment to stakeholders within the sport community and ultimately ratified by the Executive Committee of WADA (Fourcroy 20085, p. 178).

            Table 1 shows the different prohibited substances including their unwanted effects to health.


Table  SEQ Table \* ARABIC 1 Health Risks of Prohibited Substances


Prohibited Substance

Health Risk

Anabolic – Androgenic Steroids

Cardiovascular effects:

  • Elevated blood pressure, decreased high-density lipoproteing;

  • Increased risk of atherosclerosis (Ebenbichler C F et al 2001)

  • 25% to 27% decrease in HDL cholesterol and increase in diastolic blood pressure after 8 weeks of use (Kuipers 1991);

  • Hypertension, myocardial ischemia and sudden cardiac deaths (Fieschi V et al 2001 and Parssinen M et al 2002);

Hepatic Effects

  • Hepatotoxicity

  • Neoplasm

Reproductive – Endocrine Effects

  • Libido changes;

  • Increased aggressiveness and sexual appetite which might result in aberrant sexual and criminal behavior;

  • For males: impotence

  • For females: masculinization/hirsutism;

  • For children: premature epiiphyseal;

Psychological Effects

  • Mood swings, aggression, mania, depression, withdrawal, depression;

  • Disturbances in personality profiles (Cooper C J et al. 1996);

  • Less control of aggression (Midgley et al 2001);

Dermatologic Effects

  • Acne, striae, alopecia;

  • Gynecomastia

  • Collagen reducing skin elasticity;

Musculo – Skeletal System

  • Muscle tightness and cramp;

  • Stiff tender, muscle strains or rupture;

Long – Term Health Risks

  • Impaired diastolic filling, arrhythmia;

  • Increased risk of myocardial infarction and sudden death (Melchert R B & Welder A 1995);

  • Cancer (Parssinen M et al. 2002)


  • Increased heart rate, palpitation, cardiac irregularitiesl

  • Insomnia, anxiety, tremor, aggressiveness;

  • Inhibited judgment/decision making;

  • Increased potential for dehydration;

  • Amphetamines: anxiety, ventricular dysrhythmias, hypertension, hallucinations, addition, death;

  • Ephedrine: anxiety, ventricular dysrhythmias, hypertension, hallucinations, addition


  • Increased pain threshold and failure to recognize injury;

  • Loss of balance and coordination;

  • Illusion of athletic prowess beyond inherent ability;

  • A false feeling of invincibility;

  • Sedation

Peptide Hormones

Erythropoietin (EPO)

  • Thickening of blood clots

  • Risk of heath attacks, myocardial infarction and strokes, pulmonary embolism

Growth Hormone (GH)

  • Acromegaly

  • Heart diseases, myopathic muscle

  • May develop resistance to long-term use

  • Carpal tunnel syndrome

  • Increased oil gland production in the skin and increased sweating

Insulin-Like Growth Factor (IGF-1)

  • Hypoglycemia;

  • Musculoskeletal changes such as enlargement of the heart, headaches and joint pains.


  • Hypoglycemia (low blood sugar)

  • Nausea, weakness, shortness of breath

  • Drowsiness, coma, brain damages and death

Chorionic Gonadotrophins (HCG)

  • Same effects as anabolic steroids

  • Gynecomastia may be more common

Corticotrophins (ACTH)

  • Stomach irritation and ulcer

  • Softening of connective tissue

  • Osteoporosis

(Foddy & Savulescu n.d.)


On the other hand, table 2 shows the prohibited methods and their health risks.

Table  SEQ Table \* ARABIC 2 Prohibited Methods and Their Health Risks

Prohibited Methods

Health Risks

Blood Doping

  • Allergic reaction

  • Acute hemolytic reaction with kidney damage;

  • Delayed transfusion reaction that can be fatal;

  • Transmission of infectious diseases

  • Overload of circulatory system and blood clots; and

  • Metabolic shock

Artificial Oxygen Carriers and Plasma Expanders

  • Vary significantly and can be extremely serious, as it is difficult to measure correct doses;

  • Fever, reduced platelet count, hypertension, vasoconstriction, kidney damage and iron overload.

Gene Doping

  • The chance of success are very low and risk is very high;

  • Quite dangerous (Friedmann 2005)

Food (Nutritional) Benefits

Copper – antioxidant protection

  • Gastrointestinal distress, nausea, vomiting, diarrhea, intravascular hemolysis (Lukaski H C 1995)

Zinc – well-being mineral

  • Interfere with absorption of iron and copper (Schwenk T L 2002);

  • Nausea and vomiting


  • Gastrointestinal upset, nausea, vomiting and diarrhea;

  • Interfere with absorption of calcium

B-Complex and Multivitamins

  • Vitamin A, D, B3 and B6 can be toxic at excessive doses;

Vitamin C

  • Competition for copper bioavailability;

  • Risk of renal calculi due to urine acidification


  • Interfere with the absorption of Zinc and Iron;

  • Risk of renal calculi due to urine acidification


  • Hepatic damage and cirrhosis;

  • Hemochromatosis

  • Gastrointestinal upset, constipation, black stools which may be confused with gastrointestinal bleeding.


  • Interfere with iron metabolism and zinc absorption


  • Nausea and vomiting, abdominal pain and fatigue (William M H 1998)


  • Flushing, tachycardia, anxiety and trembling


  • Overuse can cause hypertension, insomnia, diarrhea and irritability


  • Increased body weight;

  • Muscle cramping

  • Gastrointestinal upset and dehydration

Dehydroepinadrosterone (DHEA)

  • Liver toxicity and prostate cancer

  • Increased facial hair

  • Decreased high-dentisity lipoprotein cholesterol in women.

(Foddy & Savulescu n.d.)

            With this, long list, it can be said that the primary reason why performance enhancement drugs must be prohibited in sports, is because of the fact that these drugs can cause health risks to the athletes. Thus, with using this, the spirit of sport will not be practiced properly, because according to WADA, it is important to focus on ensuring about the health of the athletes.

            On the other hand, aside from different health risks of ergogenic aids in sports, it is also important to focus on the different ethical aspects that are related with the problem.



Ethical Issues

            Fairness is considered as one of the most important principles in sports. It is important to ensure that each and every athlete will fight in fair and equal way. According to International Olympic Committee (IOC), together with its Medical Commissions, “psychological substances in abnormal amounts, attaining an artificial and unfair increase of performance in competition.” Therefore, this clearly states that any individual or athlete using performance enhancement drugs are not being fair with his or her competitors.

Over the years, different factors or parts of the wording of the IOC statement and its interpretation have ignited debates. During the spring of 1975, in the meeting organized by the IOC Medical Commission in Porto Allegre, Brazil, where sport nutrition was on the agenda, the representative of Italy motioned that carbohydrate nutraceutical supplements and muscle glycogen loading was considered as a doping offence, therefore, it must be prohibited or banned and punishable. The practice of ‘carbohydrate loading’ regime helps to increase and enhance muscle glycogen and was introduced in the late 1960s and quickly won world wide approval and admiration among such endurance athletes as marathoners, racing cyclists, cross-country skiers and triathletes. No measures were taken by the Medical Commission about the Italian motion. The lack of action was interpreted by the international sports community as detrimental by the IOC Medical Commission (Karlsson, 1997, 178).

            With this, enhancement, in all of its forms, may reduce inequality, injustice and unfairness by ensuring that everyone receives a fair go and the widespread and legal access to performance enhancing tools and technologies would reduce any competitive advantage that one athlete has over another (Magdalinksi 2008).

            Both the health risks and ethical issues connected with performance enhancement drugs and ergogenic aids, policies and regulations were implemented in order to ensure fairness in sports events, at the same time, ensure the safety and health of the athletes.

World Anti-Doping Agency (WADA)

            WADA was founded in 1999 as an international independent agency composed and funded equally by different sports movements and governments of the world. Its mission is to promote, coordinate and monitor the fight against doping in sports in all its form. The organization’s key activities are: scientific research, education, development of anti-doping capacities and monitoring of the World Anti Doping Code (WADA 2010).

            World Anti-Doping Code is a document which harmonizes regulations regarding anti-doping in all sports and all countries. Compliance with the code is the situation in which an anti-doping organization (ADO) – and International Sport Federation (IF), a National Anti-Doping Organization (NADO), a Major Games Organizer, etc. – finds itself after completing a three-step process in connection with the code (WADA n.d.).

            The compliance to the said code is mandatory because it will help in order to ensure the efficiency of the harmonized fight against doping in sports, at the same time, ensure a fair sports environment for the athletes.

            WADA is responsible in monitoring the implementation and enforcement of the Code by its signatories. This is can be achieved by different ways, such as assisting ADOs, with partnership with Regional Anti-Doping Organizations (RADOs) in different areas in the world and contributes with the costs of different anti-doping services launched by the Sportaccord (WADA n.d.).

            Above all, WADA focuses on the different researches and studies that will help in order to monitor and assess the different changes in doping activities and ergogenic aids which can help in order to update and improve the current Code, by ensuring that the lists of the prohibited drugs and methods are updated.


            Sport is considered as the oldest activities in the world. As of now, it is considered as one of the major resource of self-actualization and team-work. It enables people to compete for their own name and reputation of their group or country.

            However, doping or the use of performance enhancement drugs (ergogenic aids) are considered as one of the major problems or issues being faced by the global sports industry, particularly because it can cause health risks and ethical problems. There are different studies which were presented in this paper, which showed that doping can cause physical and mental illness which can be short – and long – term. With this, government and sports organizations in the world started to realize that application of international standards and policies regarding the matter will be effective in order to ensure that death, illness and ethical problems will be prevented in the field of sports.

            With this, WADA is an international independent agency which focuses on implementing programmes and activities that will help to monitor and prevent doping activities. With the help of intensive researches and studies, the organization had been able to focus on the different actions that must be done, with the help of the Code, in order to ensure that each and every athlete will follow the rules.



Foddy, B. & Savulescu, J., Ethics of Performance Enhancement in Sport: Drugs and Gene Doping, [Accessed 09 March 2010].


Fourcroy, J. 2008, Pharmacology, Doping and Sports: A Complete Scientific Guide for Athletes, Coaches, Physicians, Scientists and Administrators, Taylor & Francis.


Gropper, S. A. S., Smith, J. & Groff, J. (2005). Advanced Nutrition and Human Metabolism. Cengage Learning.


Magdalinkski, T. (2008). Sport, Technology and the Body: The Nature of Performance. Taylor & Francis.


Mottram, D. (2007). Drugs in Sport. New York: Routledge.


Stone, M., Stone, M. & Sands, B. (2007). Principles and Practice of Resistance Training, Human Kinetics.


Swedan, N. (2001). Women’s Sports Medicine and Rehabilitation. Lippincott Williams & Wilkins.


Drinkwater. B. (2000). Women in Sport, Volume 8. Wiley-Blackwell.


WADA (2010). World’s Anti-Doping Agency. [Accessed 09 March 2010].






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