Anabolic Steroids
Anabolic steroid abuse is a widespread phenomenon not limited to professional and top
amateur athletes. High school students are also using anabolic steroids. This fact sheet will
help to dispel some of the many misconceptions about anabolic steroid use and abuse.
WHAT ARE ANABOLIC STEROIDS AND HOW ARE THEY USED?
Anabolic steroids are testosterone or testosterone-like drugs which produce anabolic
activity (greater muscular bulk) by increasing protein synthesis and androgenic activity
(enhanced secondary sexual characteristics). Natural testosterone is produced in larger
quantities in the male, but is also present in the female.
It should be noted that doses used by athletes often greatly exceed doses recommended
for legitimate medical reasons, causing the potential for even greater negative consequences.
Moreover, many athletes will use more than one anabolic steroid simultaneously, a process
known as "stacking." Usually, anabolic steroids are taken in cycles, i.e., "on" for three months,
then "off" for three months. This practice may be less harmful than continuous use, but it is not
totally without dangers.
Anabolic steroids are either taken by mouth or injected into a muscle. The "orals," as they
are called, are tablets or capsules taken by mouth. These forms are reportedly more toxic to
the liver. Often the orals are taken in conjunction with injectable forms.
The injectable forms are known as "oils" or "waters". The oils refer to the long-acting
types. They are injected into a muscle, usually the buttocks, and the steroid is released slowly
over time. Typically, these drugs are injected only a couple of times a week. The "waters" are
short-acting forms. Again, these are injected, usually in the buttocks, but they work much
faster and are eliminated much more quickly.
WHAT HAPPENS WHEN THE BODY GETS TOO MUCH?
Since anabolic steroids are synthetic versions of the naturally- occurring male hormone
testosterone, they have very similar pharmacological actions and side effects. In mature males,
the body secretes 2.5-10 mg. of testosterone each day to promote various body processes.
Steroid use often introduces up to an additional 100 mg. of testosterone into the system daily.
When levels become too high, the brain shuts down the body's own production of the
testosterone, as well as other substances necessary for the proper functioning of the body.
Some of the body systems at risk include:
Male reproductive system
Too much testosterone or related substances (i.e. anabolic steroids) prompts the pituitary
gland to stop producing the hormone gonadotropin. This in turn also prevents the production
of other intermediate substances which leads to testicular atrophy (decreased size and
function), lowered sperm count, sterility (reversible), painful, frequent or prolonged erections
and prostate enlargement. When steroid use ceases, the entire testosterone-producing
function may remain shut down, possibly leading to a permanent imbalance of hormone.
Female reproductive system
These side effects are the result of masculinization due to increased testosterone and
include enlargement of the clitoris*, uterine atrophy, irregularity or cessation of menstrual
cycle, increased body hair*, deepening of the voice*, shrinkage of breast size and
masculinization of female fetuses in pregnant women. (*permanent effects)
The heart and blood vessels
Anabolic steroids cause fluid retention, which can lead to high blood pressure. Steroids
also lower high-density lipoproteins (HDLs) in the blood. These HDLs help rid the body of
cholesterol. With steroid use, production of cholesterol laden low-density lipoproteins (LDLs)
is increased, which has been shown to be a risk factor for cardiovascular disease i.e. heart
attack and stroke. Deaths related to cardiovascular problems have been reported in both
young and older athletes.
Adolescents
Bone growth is among the body processes that can shut down with steroid use.
Adolescents on anabolic steroids may find their muscles bulking up, but bone growth stops
with premature fusion of the epiphysis (growth center) of long bones. The result is
permanently stunted growth. There is risk until bones stop growing.
WHAT ARE THE PSYCHOLOGICAL EFFECTS?
Steroids can affect individuals in many ways, with psychological changes being one of
them. There have been a number of clinical studies where the psychological changes with
testosterone and/or testosterone-like drug use have been observed by the athlete and/or their
peers. Furthermore, in personal interviews, well known athletes who admittedly abused
testosterone have unconditionally stated that psychological changes not only occurred, but
many times were detrimental to themselves as well as relationships. As proposed in a paper
by Pope et al. (see Further Reading section), there is no ethical way to accurately assess the
psychological effects of steroid use that mimics the massive doses of several steroids taken
simultaneously over prolonged periods. The best alternative, "naturalistic" studies, have
provided information on the following psychological changes:
Aggression
Feelings or irritability and aggression may appear so subtly that the athlete may barely
notice, but his friends or family will. Taking anabolic steroids keeps an athlete constantly "on
edge." Situations that normally would not disturb the individual can, with steroid use, generate
strong feelings of anger and hostility (the "roid rage"). Athletes who take anabolic steroids
often have difficulty dealing with people because of these uncontrollable feelings. Users may
experience paranoia. Anxiety can disturb sleep patterns.
Depression
When the athlete discontinues taking the steroids, body size decreases and self-esteem is
usually lowered. Due to these changes as well as through other mechanisms (See Addiction
and Dependence), depression may occur, often inducing users to take steroids again.
Addiction and Dependence
Anabolic steroids can also produce psychological addiction. Users may find they have
become dependent and experience withdrawal symptoms of severe depression (including
suicidal thoughts), insomnia, loss of energy or appetite, sweating, nausea, headaches and
craving for anabolic steroids. Withdrawal symptoms will last one to three weeks. Weight loss
will also occur. As with any addicting drug, withdrawal should be done under a physician's
care.
In The Media
Recently, an article published in the New England Journal of Medicine has been the
subject of attention by several weight lifting magazines (i.e. Joe Weider's Flex). The media has
touted the findings in this article as proof that "roid rage" is a myth. This type of journalism can
be very misleading. Although minor psychological evaluation was performed secondarily, the
objective of the study was not to measure psychological effects (as performed by psychiatric
researchers), but to measure muscle growth and strength. This study used testosterone
enanthate, a well known androgenic steroid for one short-term treatment at admittedly lower
doses than those seen in gyms and as opposed to the common "stacking" regimen, where
several steroids are used for a greater number of treatment periods. In addition, this study
only used 11 men in the testosterone treated group. Several "naturalistic" studies (with people
who are actually abusing steroids) designed to measure psychological effects using much
larger numbers of athletes suggest that these changes do occur. Furthermore, within the New
England Journal article, the authors stated that with extended use, anabolic steroids have the
potential for serious side effects involving the cardiovascular system, prostate, lipid
metabolism, and insulin sensitivity.
WITH KIDS, HOW DO YOU KNOW?
Athletes who use steroids in conjunction with a weight training program can often be
identified by their unusually quick muscle and weight gain. Other symptoms and adverse
effects:
Head:
Headaches, hair loss, puffy cheeks
Sore throat, unpleasant breath odor, sore tongue
Deepening of voice in females
Chest:
Increased breast tissue on male pectorals
Decrease of breast size in female
Rapid heart rate, heart attack
Skin:
Increased oiliness and acne
Flushed or yellowish skin
Bruising, even with small injuries
Increased perspiration
Pronounced stretch marks
Facial and chest hair on female
Rash or hives
Psychological effects:
Strained relationships with friends and family
Hyperactivity (restlessness, insomnia, irritability)
Uncharacteristic hostility or aggressive behavior
Feelings of frustration and anxiety without provocation
Psychotic symptoms (paranoia, delusions, hallucinations)
Psychological effects of withdrawal:
Severe depression
Feelings of inadequacy and weakness as body size decreases
Suicidal thoughts
Lethargy and listlessness
Lack of interest in exercise or sports
Inability to maintain normal sexual functions
Desire to return to steroid use
Genitals and abdomen:
Testicles decrease in size
Clitoris enlarges
Changes in bowel and urinary habits
Kidney stones, gallstones, liver tumors
Extremities:
Joint stiffness, pain, swelling
Increased chance of injury to muscles, tendons, and ligaments
Stunted growth in adolescents
HOW CAN PARENTS HELP?
Typically, athletes who take steroids are ambitious and want to make their friends and
families proud of them. Parents are an important source of emotional support for their
children. Let your aspiring athletes know you are proud of them and praise their
accomplishments, no matter what the level, win or lose. Be there if they come to you for help.
HOW CAN COACHES HELP?
Coaches are under great pressure to produce winning teams. Requests to "bulk up", "get
stronger" or "speed up" without proper guidance may be misinterpreted by athletes to include
steroid use. The athlete's efforts and integrity must be valued more than winning. As teachers,
friends and models for young athletes, coaches are in an excellent position to communicate
these values to young people while encouraging safe methods of improving speed, strength
and technique.
written by Joe Maxxell