Anabolic steroids are one of, if not the most powerful performance enhancing drugs someone can put in their body. Used in proper doses they can help people suffering from AIDS and other muscle wasting diseases build muscle again. They can also help older males suffering from testosterone deficiency, and help with delayed puberty. When abused by weightlifters and athletes they can produce tremendous muscle gains that may be impossible to reach without the use of steroids.
Anabolic steroids work by binding to receptor molecules which activate specific genes to synthesize proteins (Fahey, 1976.) This affects the muscle by inducing hypertrophy, causing the muscle tissue to grow much faster than it would naturally. Anabolic steroids have anabolic and androgenic properties. The anabolic effects result in growth of muscle tissue, bone, and blood cells. The androgenic properties cause changes in primary and secondary sexual characteristics (Fahey, 1976). Sexual characteristic changes steroids may cause include testicular atrophy, deepening of the voice, increased aggressiveness and the increased growth of hair on the face, underarms, and genital regions. The effects steroids may cause a person differ between males and females. While the negative effects of increasing synthetic testosterone, a male sex hormone, in women may be very significant it does not stop women from using the drug.
One of the first countries to implement anabolic steroid use to women athletes was Germany in the 1970’s (Franke & Berendonk, 1997). They experimented with the use of steroids on women shot putters. Frank and Berendonk (1997) found a German woman shot putter, from released results of an East German sports program, to increase her throwing distance from just under seventeen meters to nineteen and a half meters over a twelve week cycle of anabolic steroids. This is a huge increase over a very short amount of time. The woman studied could throw nearly 15% further while using anabolic steroids compared to her maximum throwing output prior to taking anabolic steroids. Malarkey and coworkers (Malarkey et al. 1991) reported elevations up to 30-fold of normal levels of muscle strength and size in women who self-administered anabolic-androgenic steroids. Although these studies do show an increase in muscle strength with administration of anabolic steroids, there are various studies that show otherwise. Wilson (1988) found anabolic steroids to have no effect on muscle growth, and stated the effects were purely psychological. This is a hard statement to accept knowing the chemical properties of anabolic steroids. While some users do see increase in muscle growth and athletic performance it is important to take into consideration all the potential negative side effects steroids may cause.
One of the most prevalent behavioral side effects reported by steroid users is increased aggression. Roid rage is the common term given to this increased aggression some steroid users may experience. Morrison and co workers (Morrison et al. 2015) found male syrian hamsters treated with anabolic steroids ten times more likely to express aggressive behavior compared to non steroid injected hamsters. While hamsters may not be the most accurate representation of how a human would react to a drug, this is the most ethical way of testing a drugs affects. Choi and Pope (Choi & Pope 1994) found anabolic steroid users, while on a steroid cycle, report significantly more fights, verbal aggression, and fights with significant others compared to periods of non use. Choi and Pope also stated, It is the taking of several steroids simultaneously that is causally related to violent behavior. A cause and effect relationship between steroids and aggression has not been confirmed through any studies, but the growing evidence in this field is suggestive there might be a relationship between the two. However, Lindman and colleagues (Lindman et al. 1992) found that hormonal changes in testosterone levels were not specifically associated with violent behavior. Lindman’s study was conducted on males arrested for spousal abuse. Even though Lindman found the testosterone levels to be similar between the sober subjects and the referenced males, there are flaws in how this study was conducted. There is no timetable of when the arrested males are tested for their testosterone levels, as the stopping of consistent steroid usage can cause changes in testosterone production. Rasmussen and co workers (Rasmussen et al. 2016) found 27% of former anabolic steroid users studied had low testosterone levels (>12.1 nmol/l), none of the control group reported levels this low. While some studies may find testosterone levels not to be associated with violent behavior, many users report experiencing increased aggression while using anabolic steroids. This increased aggression can be dangerous and potentially lead to violent behavior. While aggression is a potentially dangerous behavioural trait it can be beneficial for athletes competing in physical sports.
Anabolic steroids are still prevalent in sports today. However they are not used as commonly nowadays as they were in the mid to later 1900’s. Between the time periods of 1950-1974 anabolic steroids were commonly used among athletes to improve performance. It wasn’t until 1975 that anabolic steroids were banned in sport competition (Verroken & Mottram, 2005). When anabolic steroids were banned by the IOC, International Olympic Committee, their use in sport decreased. Although this did not stop all athletes from using anabolic steroids. Many professional, collegiate, and high school athletes still use anabolic steroids to improve their performance today. All of the four major sports leagues (NHL, NBA, NFL, MLB) require regular drug testing to all athletes. However this does not stop them from using steroids and trying to beat the drug tests. Anabolic steroids are prevalent among all four major sports leagues and track & field athletes, however the majority of athletes who have gotten caught using steroids are baseball and track & field athletes. This may be due to harsher drug tests, or a higher usage of the drug among these sports. Over the last decade many big names in the MLB have been caught, or admitted steroid usage in their playing careers. A few big names being Barry Bonds, Mark McGuire, Manny Ramirez, and Ryan Braun. The fact that there are so many more steroid usage cases in baseball compared to some other sports may be due to the physical characteristics that lead to baseball players success. Baseball is a power sport, the faster you can swing a bat the harder you can hit a ball. Anabolic steroids can increase muscle strength which in turn help a baseball player swing a bat faster. The increase in strength steroids may cause can greatly tempt an athlete to use the substance. Although professional athletes still use anabolic steroids to enhance performance today, they are less prevalent than they were in the past.
The use of anabolic steroids has expanded to a new population than seen in the past. Non-athletic recreational steroid use has become fairly prevalent all across the world. Bolding and co workers (Bolding et al. 2002) studied the use of steroids and health risks among homosexual men in Central London gyms. Their questionnaire asked questions regarding age, ethnicity, education, employment, steroid usage, and HIV test information. Bolding and his colleagues found 13.5% of men used anabolic steroids in the past twelve months. They also found 59.6% of users injected steroids, while 40.4% took them orally. Anecdotal reports from the study suggested the majority of anabolic steroid users took them to try and achieve their desired body shape. This has become a very common reason for people to use anabolic steroids. The muscle you can potentially gain in such a short period of time through the use of steroids is practically impossible to achieve without them. This ideology of using anabolic steroids to achieve a more desirable body image can cause self-esteem issues. While a steroid user might be trying to improve their body image, anabolic steroids can cause serious mental effects that may be irreversible.
The abuse of anabolic steroids can lead to many metal health effects. Some effects being depression, anxiety, insomnia, and mood swings. Depression can be caused by many factors, one of which is hormone imbalance. Taking steroids can potentially create a hormone imbalance, the main hormone affected being testosterone. Lindqvist and colleagues (Lindqvist et al. 2013) looked at the mental health of anabolic steroid using elite Swedish athletes vs. non anabolic steroid using elite Swedish athletes. The study took place thirty years after the end of their careers. 13% of the steroid using athletes sought professional help for depression, and 5% of the non-users sought professional help for depression. 13% of anabolic steroid users sought help for anxiety, and 6% of the non-users did the same. When asked if they worried for their own mental health, 8% of the anabolic steroid users said yes they did worry for their health, along with 3% of the non-users. Rasmussen and co workers (Rasmussen et al. 2016) also found 24.2% of anabolic steroid users studied felt depressive symptoms. Athletes are looked up to all across the world and glorified for their accomplishments. While these athletes may have been some of the best in their sport, the mental effects steroids may cause can be irreversible and these athletes will live with them the rest of their lives.
Along with the mental health effects steroids may cause, there are plenty of undesirable physical changes as well. Physical effects steroids cause can be desirable for example; increased muscle growth. However there are many negative physical effects that come with it. One common side effect of anabolic steroids is acne. Melnik & Grabbe (Melnik & Grabbe 2007) found 43% of anabolic steroid users studied reported an increase in acne while taking steroids. Acne is treatable and there are many precautions steroid users can take to try and lessen the severity of acne. However an effect that can be caused by steroids that isn’t so easy to treat is gynecomastia. Gynecomastia is the swelling of male breast tissue due to a hormone imbalance. Melnik & Grabbe (Melnik & Grabbe 2007) found 637 (14.7%) of anabolic steroid users reported gynecomastia as a side effect of steroids. The only treatment for gynecomastia is surgery to remove the excess breast tissue. Or someone suffering from this condition could wait for it to regress on its own without treatment. However it could take a very long time in a long term steroid user, as they’d have to wait for their hormones to rebalance on their own, eventually leading to the decrease in breast tissue. Testicular atrophy is another potential negative side effect of using anabolic steroids. Bolding an colleagues (Bolding et al. 2002) found 51% of anabolic steroid users reported testicular atrophy caused by steroids. Rasmussen and co workers (Rasmussen et al. 2016) conducted a study on testicular volume in current anabolic steroid users, former steroid users, and non-users. They found current anabolic steroid users to have the smallest testicular volume at 12.2ml, former users had a volume of 17.4ml, and non users had a volume of 22.2ml on average. These differences in testicular volume are very significant, as non users have almost two times the testicular volume compared to current users. As testicular atrophy is a common physical side effect of steroids, users libido may be affected as well.
Anabolic steroids have potential to cause an increase or decrease in an individual’s sex drive. Melnik & Grabbe (Melnik & Grabbe 2007) found 61% of anabolic steroid users surveyed reported changes in libido. However these changes varied in the participants, some experienced increased sex drive, and some decreased. Anabolic steroids affect everyone differently so it’s impossible to say they will increase or decrease your libido but they definitely can have an impact on it. As comparison Rasmussen and co workers (Rasmussen et al. 2016) found 40.1% steroid users surveyed experienced decreased sex drive. Anecdotal reports suggest that while using steroids most users experience enhanced sex drive, but after the withdrawal of the drug sex drive tends to decrease. Although there are no studies directly on this issue, the decrease in sex drive after the withdrawal of anabolic steroids may be due to hormone imbalance. When putting synthetic testosterone into your body your natural testosterone production decreases due to an influx from an external source. After taking steroids for an extended period of time your body must adjust to not receiving that influx of testosterone anabolic steroids give it. Thus leading to a lower production of testosterone and decreased sex drive. While decreased sex drive may be a side effect of steroid withdrawal among abusers, if used properly steroids can increase sex drive in men with low testosterone.
Testosterone therapy is the treatment of middle-older aged men with synthetic testosterone in order to treat hypogonadism, decreased libido, mood, cognition, muscle mass, bone density, and red blood cell production (Morgentaler, 2009). Allan and co workers (Allan et al. 2008) found men, with low testosterone levels, treated with testosterone experienced significant improvement in sexual desire. The men studied and treated with testosterone were all men with low testosterone to begin with. There was also a placebo group who believed they were receiving testosterone treatment as well, they did not experience any increase in sexual desire.
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