Anabolic steroids are synthetic (artificial) derivatives of the main male hormone testosterone. Testosterone is responsible for both promoting and maintaining muscle growth, and for the development of secondary male sex characteristics such as deepening voice and facial hair.
Also called anabolic-androgenic steroids (AAS), these drugs have a legitimate use in medicine for certain medical conditions. However, because of their unique ability to enhance muscle mass, AAS are used illegally in professional, competitive, non-competitive and school sports settings.
Chronic non-medical uses of AAS are associated with adverse effects, including heart problems and aggression.
Here are some key points about anabolic steroids. More detail and supporting information is in the main article.
- The idea of developing steroids with anabolic (ability to build up biomolecules) properties arose not long after the hormone androsterone was identified in the 1930s
- The first reports of AAS use occurred following the 1954 world weightlifting championships
- The International Olympic Committee banned AAS medications in 1975
- Athletes - including adolescent ones - use anabolic steroids along with diet and exercise with hopes of improving their athletic performance or appearance
- Anabolic steroid abusers will take doses 10 to 100 times higher than what is the normal prescription dose
- Presently, using AAS is referred to as "doping", and banned by most major sporting bodies
- Anabolic steroids are prescriptive controlled substances in Australia, Argentina, Brazil, Canada, the UK and the US. In most countries, however, anabolic steroids are legal and can be sold without a prescription for non-medicinal purposes
- When making a synthetic steroid, it is not possible to have only the anabolic (muscle building) effects without the androgenic (secondary male sexual) characteristics
- Nearly every cell in the human body has receptors for steroids and so every organ system is susceptible to their effects
- One of the most dangerous adverse effects associated with AAS use is the increased risk of heart attack or stroke.
What are anabolic steroids?
Anabolic-androgenic steroids are synthetic versions of the primary male hormone, testosterone. They produce their effects in many parts of the body, including the muscles, bones, hair follicles, liver, kidneys, blood, immune system, reproductive system and the central nervous system.
Anabolic steroids can be taken orally, injected or applied directly to the skin.
During puberty, increases in testosterone levels are responsible for the development of male characteristics such as beard and body hair growth, linear growth (height), deepening voice, sex drive and muscle mass accumulation.
Testosterone also promotes the laying down of bone mineral and can contribute to competitiveness, self-esteem and aggressiveness.
Anabolic steroids can be taken orally, through injections or transdermal delivery (creams or gels applied directly to the skin).
Once ingested, anabolic steroids travel through the bloodstream to the muscle tissue where they bind to an androgen receptor. The drug can subsequently interact with the cell's DNA and stimulate the protein synthesis process that promotes cell growth.
For non-medical purposes, anabolic steroids are typically taken in cycles of about 6-12 weeks (the on period) followed by 4 weeks to several months off. This cyclical pattern is an attempt to reduce the likelihood of undesirable effects. Despite the risk, however, some bodybuilders will take AAS almost continuously.
Continuous use of AAS can lead to tolerance and may even cause the body to stop producing its own testosterone. In addition, users often combine several different types of steroids or incorporate other supplements (stacking) in an attempt to maximize the effectiveness of the steroids.
Alternative names for anabolic steroids
- Gym candy
- Weight trainers
- Balls and bulls.
Common trade or slang names
- Fluoxymesterone (Halotestin) - "Halo"
- Mesterolone (Proviron)
- Methandienone (Dianabol) - "Dbol"
- Methyltestosterone (Virilon)
- Mibolerone (Cheque)
- Oxandrolone (Anavar, Oxandrin) - "Var"
- Oxymetholone (Anadrol) - "Drol"
- Stanozolol (Winstrol) - "Winny."
- Boldenone undecylenate (Equipoise) - "EQ"
- Methenolone enanthate (Primobolan) - "Primo"
- Nandrolone decanoate (Deca Durabolin) - "Deca"
- Nandrolone phenpropionate (Durabolin) - "NPP"
- Testosterone cypionate (Depotest)
- Testosterone enanthate (Andro-Estro)
- Testosterone propionate (Testex)
- Trenbolone acetate (Finajet) - "Tren."
Extent of anabolic steroid use
The legal status of these medications varies from country to country. In the US, AAS is a schedule III controlled substance available only by prescription, and their use is only legal when prescribed by a medical provider.
Most illegal users of anabolic steroids are men involved in bodybuilding, weightlifting and professional sports.
Medical conditions (primarily male) treated using AAS include anemia, wounds, malnutrition, delayed onset of puberty, osteoporosis and hypogonadism. Testosterone and several of its esters, as well as methyltestosterone, nandrolone decanoate and oxandrolone, are the main anabolic-androgenic steroids currently prescribed in the US.
Otherwise, under the Controlled Substance Act, unlawful possession and distribution is subject to federal and state laws. Most athletes consume AAS on a trial-and-error basis using information gained from other athletes, coaches, websites or gym "gurus."
The prevalence of anabolic steroid use in adults is estimated to be in the hundreds of thousands. Most users are men involved in weightlifting, bodybuilding and professional sports, but use among women and adolescents is also on the rise.
In the 2012 Monitoring the Future (MTF) study, 1.2%, of eighth graders, 1.3% of tenth graders and 1.8% of twelfth graders reported using steroids at least once in their lifetimes.
Illegal steroids are obtained from black market sources and trade, and can be purchased through dealers just as any other illegal drug is obtained. The Internet is the most widely used means of buying and selling anabolic steroids. However, there is also evidence of diversion through unscrupulous pharmacists, doctors and veterinarians.
Side effects of anabolic steroids
The adverse effects associated with anabolic-androgenic steroids are dependent on the age and sex of the user, the amount used and the duration of use.
Typical side effects of legally prescribed normal-dose anabolic steroids may include acne, fluid retention, gynecomastia (enlarged male breasts), increased red cell count and changes in cholesterol levels. Users should follow up with their prescribing clinician and take periodic blood tests to monitor for these effects. Studies of men taking physiological doses of AAS medications found no changes in aggressive behavior.
In adolescents, use of anabolic steroids can permanently stunt growth. In women, use of the drugs can induce permanent physical changes including deepening of the voice, increased facial and body hair growth and the lengthening of the clitoris. In men, use of AAS can cause shrinkage of the testicles, enlargement of the male breast tissue and sterility. Anabolic steroid use can damage the liver and can cause an increase in cholesterol levels.
Anabolic steroid use can also induce psychological effects such as aggression, increased feelings of hostility, psychological dependence and addiction. Upon abrupt termination of long-term anabolic steroid use, abusers may experience withdrawal symptoms including severe depression.
Health risks of anabolic steroids
Numerous health risks are associated with chronic steroid abuse, including liver and kidney damage, severe acne, fluid retention, trembling, high blood pressure, enlargement of the heart and increased risk of stroke in individuals of all ages.
Adolescent steroid users put themselves at risk for stunted growth and other problems as they are already in a vulnerable position due to changing hormones.
The use of anabolic steroids can lead to many undesirable changes to the human body.
Female abusers could experience body and facial hair growth, male-pattern baldness, changes in the menstrual cycle, shrinking breasts, increased sex drive, acne and a deepening voice. Some of these changes are permanent, even when the anabolic steroids are stopped.
Abusers who inject their steroids run the added risk of contracting or transmitting blood-borne infectious diseases such as HIV or Hepatitis via shared needles.
Finally, chronic AAS users can also experience psychiatric symptoms such as severe mood swings, paranoia, delusions, impaired judgment, feelings of invincibility, mania and anger ("roid rage") that may lead to violence. These extreme unwanted effects are more likely to be seen in those who have a predisposition to these types of behaviors.
There is no evidence in the available literature that legitimate medical use of AAS leads to abuse or dependence. However, long-term AAS abuse can affect some of the same brain pathways and chemicals that are affected by other drugs such as opiates, resulting in dependency and even addiction.
Treatment for anabolic steroid abuse
Individuals who abuse anabolic steroids can experience withdrawal symptoms when they stop taking them. Withdrawal symptoms include fatigue, restlessness, mood swings, depression, fatigue, insomnia, reduced sex drive and cravings. Research shows that some abusers turn to other drugs such as opioids to counteract the negative effects of chronic AAS use.
The first step in treating anabolic steroid abuse is to get the individual to stop using these drugs and seek medical attention in order to address any psychiatric or physical symptoms they might have. Referral to an addiction treatment facility or counselor may be indicated.
Since sports were invented, people have cheated. From figure skaters breaking competitors' legs, to marathon runners disappearing into the crowd and taking the subway, scandal populates sporting history.
Teens are risking their health in order to "bulk up" and "get toned" by using anabolic steroids and drinking protein shakes, according to a report conducted by researchers at the University of Minnesota and published in the journal Pediatrics.
Anabolic-androgenic steroids are synthetic versions of the naturally occurring hormone testosterone and have legitimate medical uses. When legally prescribed and supervised by a medical provider, anabolic steroids are considered safe and therapeutic medications.
However, the majority of use of these drugs is among bodybuilders and athletes in order to enhance their muscle strength or appearance. Heavy AAS abuse can lead to potentially severe and sometimes irreversible negative health consequences, including early heart attack, stroke, depression and severe aggressive behavior.