Testosterone was isolated in 1935, but in the middle 1950s was the discovery that an artificial version of testosterone was being used to enhance weight lifting performance.

Since then, sport has seen an ever expanding array of so-called anabolic-androgenic steroids (AAS); synthetic derivatives designed to enhance anabolic properties and minimise androgenic actions. Anabolic means "building" (in particular muscle building) while androgenic refers male sex characteristics.

AAS are effective in enhancing athletic performance due to their anabolic effects, provided the player also consumes adequate protein and trains intensely. The trade-off, however, is the myriad of adverse side-effects that jeopardise health.

Damage to the liver, heart and vessel diseases, hormonal disturbances (including infertility), behavioural changes, psychological problems as well as tendon lesions are typical not wanted consequences of their use.

Testing for anabolic agents in the urine was implemented during the 1976 Montreal Olympic Games. Testosterone and the related hormones have their own category in the list of forbidden substances: S1. To prove AAS abuse in sports, the laboratory has to differentiate between the naturally produced steroids and the artificial steroids.

As a first step, the ratio of testosterone to epitestosterone (T/E) can be used to screen for possible abuse since the intake of testosterone causes characteristic changes in this ratio in the urine. If this ratio exceeds a certain value, further tests are conducted on that urine sample which may verify or exclude intake of AAS. The finding of synthetic steroids in the urine is a severe doping offence.