Anabolic Steroids | The Side Effects of Anabolic Steroids

​Anabolic steroids are the synthetic derivatives of endogenous male sex hormone which includes testosterone, dihydrotestosterone (DHT), and other agents that perform like these androgens. Male sex hormones arouse the advancement of male sexual characteristics such as deepening of the voice, facial hair growth and maturity of male sex organs.

Anabolic steroids assist in fuelling many other types of tissues, particularly bone and muscle. Increased production of red blood cells is also part of anabolic effects. They are performance enhancing agents and act by increasing lean muscle protein synthesis and body weight all the while without increasing fat mass. The study published by The New England Journal of Medicine concludes that doses of testosterone, when combined with strength training, increase fat-free mass and muscle size and strength in healthy men.

Doctors prescribe steroids to those who are suffering from an acute deficiency of testosterone. It is also used for many other medical conditions as well. Anabolic steroids can be provided through injection, taken by mouth, or used externally. There is, however, a possibility of serious adverse effects and a high potential for abuse if steroids are taken without proper direction.

Why are steroids used?

Anabolic steroids are used to treat many medical conditions. For instance, they can be used to treat the muscle wasting seen in AIDS and to treat delayed puberty or loss of testicular function as well.

Steroids are also used to treat the following conditions 

• Hypogonadism or the condition of reduction or absence of hormone secretion or other physiological activity of the gonads
• Breast cancer in women
• Anemia, a condition in which there is a deficiency of red cells or of hemoglobin in the blood
• Osteoporosis or heightened bone weakness which increases the risk of a broken bone
• Weight loss disease in HIV
• Endometriosis, the condition resulting from the appearance of endometrial tissue outside the uterus which results in pelvic pain, especially associated with menstruation
• Other conditions related to hormonal imbalance

Side Effects of Steroids

Abuse of anabolic steroids can cause a broad range of serious and acute side effects. Unchecked use of steroids can alter the normal hormonal production in the body and subsequently lead to severe conditions. Although most side effects can be reversed if the intake of steroids is stopped, some may persist. Side effects are presented differently in case of male and female.

Male-Specific Side Effects

The Medical Journal of Australia published a study which documented the adverse effects of anabolic-androgenic steroid (AAS) used in community-based users attending a medical clinic. According to the study, the following side effects are found from the 58 men participated in the clinical test.

Gynecomastia

About 37% of anabolic steroid users in the test were found to be affected by gynecomastia. It is the condition of swelling up of the breast tissue in boys or men which is mainly caused by an imbalance of the hormones estrogen and testosterone. Domination of estrogen which controls female traits, including the growth of breasts, in the male body leads to gynecomastia.

Genitourinary issues

 Conditions relating to the genital and urinary organs can also be expected by steroid abuse.

• Testicular atrophy - 46% of participants of the aforementioned study reported reduced testis volume. Testicular atrophy is the term used to refer condition of shrinking of testicles. Testicles are the two male reproductive glands located in the scrotum. The scrotum’s key purpose is to regulate the temperature around the testicles, which it does by shrinking in response to cold temperatures and relaxing in reaction to warmer temperatures. This makes the testicles appear larger or smaller than usual. But testicular atrophy refers to shrinkage in your actual testicles and not the scrotum outside. Usually, this can be due to several things such as an injury, an underlying condition, or exposure to certain chemicals. Steroid abuse can also lead to testicular atrophy.
• Testicular cancer - British Journal of Cancer published a study claiming that men who use steroids may develop testicular cancer. Among the 900 men surveyed for the study, 356 had been diagnosed with testicular cancer. The researchers also quote that men who used such steroids increased their risk of developing testicular cancer by 65 %. Men who used more than one type of muscle building supplement had a 177 % increase in risk. Men who used the supplements for three years or more had a 156 % increase in risk while men who started using such supplements at the age of 25 or younger had a 121 % increase in risk.
• Infertility - The study titled Anabolic steroids abuse and male infertility researched the matter in depth. According to WHO, infertility is defined as the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse, and 50 % of all infertile couples is due to the male partner. This is mainly due to causes like decreased sperm count. The study concludes that anabolic steroids abuse is likely to cause infertility and went on to discourage its use.

Prostate gland issues -

• Prostate enlargement - British Journal of Urology published a study which found that the administration of anabolic steroids has demonstrated to have deep effects on the human prostate gland, including an increase in prostatic volume and reduction in urine flow rate. This condition is also known as benign prostatic hyperplasia (BPH).
• Increased risk of prostate cancer - Both BPH and prostate cancer affects the prostate gland. The symptoms of both conditions are profoundly similar. Yet, it can't be conclusively said that BPH leads to prostate cancer. However, all the above-mentioned studies have shown that anabolic steroids are capable of altering prostate functions and feature which may exhibit risks of prostate cancer.

Female Specific Side Effects

Women have been using anabolic steroids since the 1930s to promote muscle growth, improve athletic performance, and enhance cosmetic appearance. The American College of Obstetricians and Gynecologists conducted a study which states that there are significant negative physical and psychological effects of anabolic steroid use, which in women can cause significant cosmetic and reproductive changes. Other side effects reported by the study are -

• Voice - The above-mentioned study finds that deepening of voice can be expected in women who suffer steroids abuse. Such a low-pitched voice is a part of male characteristics, and most women find it difficult to lead a life with such a condition.
• Hirsutism - It is a condition of growing stiff and dark body hair, appearing on the body where women don't commonly have hair - primarily the face, chest, and back. Facial hair may significantly grow in women with such circumstances.
• Breast atrophy - Breast atrophy is a spontaneous shrinkage of the breasts in women. It commonly occurs in women during menopause when estrogen levels decrease rapidly. It can also be caused by hypoestrogenism in women in general or maybe after antiestrogen treatment for breast cancer, and in malnutrition such as that related to eating disorders. Hormonal imbalance caused by steroids can also lead to this condition.
• Masculinization - It is the abnormal development of male sexual characteristics in a female, significant muscle growth, in particular.
• Clitoromegaly - Clitoromegaly refers to the abnormal enlargement of the clitoris. Usually, clitoromegaly occurs during puberty, or even later in life, because of the unusual fundamental hormonal shift.
• Irregular menstrual cycles - The menstrual cycle in women is often disrupted by steroids abuse. Consequently, women may possibly experience fewer periods, lighter or heavier menstrual flow, erratic periods or unusual premenstrual symptoms.
• Infertility - Problems with the regulation of reproductive hormones by the hypothalamus or the pituitary gland, or problems in the ovary, can cause ovulation disorders which would lead to infertility.
• Psychiatric illness - A study published in Clinical Journal of Sports Medicine found out that female anabolic steroid users are more likely to be diagnosed with the psychiatric illness.

Commonly seen side effects in both males and females

Journal of Sports Science and Medicine published a study which reported the medical issues associated with anabolic steroids misuse. Some common side effects reported irrespective of gender is -

Face

• Severe acne - Those who have been taking moderate or high doses of oral steroids for several weeks are likely to be affected by severe acne. The most obstinate acne is called cystic acne. This is a severe form of acne where pimples grow into small cysts.
• Oily skin - Improper use of the anabolic steroids stimulates the oil-producing sebaceous glands. Over-production of sebum leads to acne as mentioned above.
• Male pattern baldness - It does not appear to be a common adverse effect, but is often discussed as a potential side effect associated with steroid use. This is possibly related to the role that androgens have in regulating hair growth.

Liver

• Increased risk of liver tumors and liver damage - Liver being the primary site of steroid clearance may end up damaged. Liver cancer and disease were reported in athletes consuming anabolic steroids. Many studies have been conducted based on several case studies that have documented liver disease in bodybuilders using anabolic steroids.
• Steroid-induced jaundice - Journal of Clinical Gastroenterology published a study which stated that anabolic steroids produced clinical jaundice in some of the recipients.

Cardiovascular

• According to the studies titled Cardiac effects of anabolic steroids and Heart lesions associated with anabolic steroid abuse: comparison of post-mortem findings in athletes, the following conditions can be expected from steroids abuse.
• Enlargement of the heart causing heart diseases, such as cardiac deaths
• Alterations in cholesterol and other blood lipids
• High blood pressure

Psychological Effects  

• The studies titled Long-Term Psychiatric and Medical Consequences of Anabolic-Androgenic Steroid Abuse and Mood Symptoms in Steroid Users reported the following psychological effects caused by improper use of steroids.
• Mood swings
• Mania
• Irritability
• Increased aggression
• Increased anxiety and tension
• Depression or suicidal tendencies

Musculoskeletal

• American Journal of Physical Medicine and Rehabilitation published a study which investigated the association between anabolic steroids use and the occurrence of musculoskeletal injuries in a group of retired professional football players. The following injuries are reported by the study.
• Joint and cartilaginous injuries
• Disc herniations
• Knee ligamentous injury
• Elbow injuries
• Neck burner
• Spine injury
• Foot/toe/ankle injuries
• Premature epiphyseal plate closure
• Increased risk of tendon tears
• Intramuscular abscess

Side effects seen in teens

Teenagers who use anabolic steroids may be at an increased risk for some medical side effects compared with adults. For instance, men who start using anabolic steroids during the teen years show heightened impulsivity and decreased attention, compared to men who began using steroids in their later years in adulthood.

There does not appear to be any documented reports on the occurrence of premature stunted growth in teens taking anabolic steroids. However, the dosages that most athletes use may create a greater risk than the doses studied so far in rodents. Consequently, for teens using anabolic steroids, the risk of premature epiphyseal plate closure may exist. This may lead to stunted growth in teens.

Conclusion

Some side effects naturally disappear as the use of anabolic steroids is stopped permanently. Unfortunately, sometimes people get extremely addicted to the substance that they find it difficult to stop using it.

Users of anabolic steroids can become both physically and psychologically addicted to the drugs. This claim is backed by drug-seeking behavior such as continued use even with adverse effects, and physical withdrawal symptoms like mood swings, fatigue, restlessness, loss of appetite, insomnia and reduced libido. Treatments and medication interventions are sometimes required for severe anabolic addiction. Medications that are used for treating steroid withdrawal let the natural hormonal system to restore.

Nevertheless, there is no need for such medications and treatments if you haven't fallen for steroid abuse in the first place. You can always depend on alternative methods for muscle growth such as resistance training and consuming the right type of foods and supplements.