Many
athletes, body builders and run-of-the-mill gym-goers will be exposed to, or
tempted to use, anabolic steroids at some point in their life. Understanding what anabolic steroids are, how
they are used and mis-used is critical in making an informed decision on
whether to accept the risks associated with steroid use.
Anabolic-androgenic
steroids (AAS) have been available for medical use for nearly fifty years
(Hershberger et al 1953) and were originally designed to treat a range of medical
issues arising from the under, or over, performance of various glands and
organs within the body. Due to the
ergogenic effects of AAS, bodybuilders and weightlifters have used AAS since
the 1950s (Yesalis et al 1989).
Today,
weight training athletes often self-administer AAS to improve performance and
to remain competitive (Hurley et al 1984). In 1989, it was estimated that there
were over 1 million AAS users in the US alone. Di Pasquale, (1992b) feels
competitive and recreational athletes often use AAS due partly to a lack of
self-esteem; a common problem in society. He feels practices are somewhat
similar to other societal "solutions" such as cosmetic surgery.
Unfortunately, most ASS users lack the opportunity to make informed judgment
regarding the use of these substances (Yesalis et al 1989).
AAS are
still widely used despite their association to numerous physiological and
psychological effects. Many athletes are aware of these potential side effects
yet the allure of becoming the “best” at any cost often outweighs the risks. As
a result, they often implement strategies learned from other users to improve
the benefit to risk ratio. Athletes often simultaneously use different AAS
commonly referred to as "stacking". Athletes often begin with a low
dosage of a particular compound and then increase the dosage along with the
number of compounds, until a peak intake is reached. After peaking, dosages and
compounds are gradually reduced, or "tapered". A cycle usually lasts
6 to 16 weeks and may be repeated throughout the athlete’s career (Balon,
Horowitz, & Fitzsimmons, 1992; Kleiner, Bazzare, & Litchford, 1990).
Long Term Effects
- The long term effect of AAS in general are still largely unknown
- Specifically, as related to:
- Type of AAS
- Dose
- Frequency of use
- Age at initiation
- Concurrent drug use
- Other confounds
- Varied AAS practices of individuals
- large dosages for prolonged time
- therapeutic dosages intermittently
- Investigation has been proposed
- Study the long term effects of AAS
- Costing approximately $1 million
- Approved but never funded
Physical effects
- All effects are fully reversible in adult males
- Within several months after cessation
- Except postulated changes in the myocardium
- Effect vary significantly
- Types of AAS
- Dosages of AAS
- Individuals
- Other situations
- Best documented effects
- Liver
- Serum lipids
- Reproductive system
- Other effects
- Psyche and behaviour
- Glucose tolerance and hyperinsulinism
- Cerebrovascular accidents
- Prostatic Changes
- Immune function
- Cardiovascular risk factor
- Hyperinsulinism and decreased glucose tolerance
- Changes in lipoprotein fraction
- Increased triglyceride levels
- Increased concentration of several clotting factors
- Hypertension
- Changes in myocardium
- Liver structure and function
- Cholestatic jaundice
- Peliosis hepatitis
- Hepatocellular hyperplasia
- Hepatocellular adenomas
- Associated with 17 alpha-alkylated (oral) steroids
- Male reproductive system
- Decreased endogenous testosterone
- Decreased gonadotrophic hormones
- Decreased sex hormone-binding globulin (SHBG)
- Decreased testicle size
- Sperm
- decreased count
- decreased mobility
- altered morphology
- Gynecomastia
- Women
- Some of the effects are not reversible
- Menstrual abnormalities
- Deepening of the voice
- Shrinkage of the breasts
- Male pattern baldness
- Increased libido, acne, body hair, clitoris size
- Greatly increased testosterone levels
- Decreased sex hormone-binding globulin (SHBG)
- Decreased follicle-stimulating hormone
- Decreased thyroid-binding proteins
Psychological
- Research has only been conducted in the last half century
- AAS used for mood & mental disorders
- Generally positive findings
- Self-reported changes
- Increased self-acknowledged acts of violence
- Mood
- Behaviour
- Somatic perceptions
- Case reports noted by steroid users
- Hypomania
- Schizophrenic episodes
- Psychotic episodes
- Transient upon discontinuation
- Seem to be related to type not dosage
- Unclear factors
- Previous history
- Genetic susceptibility
- addictions or mental disorders
- Environmental and peer influences
- Individual expectations
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