Side Effects of Anabolic Steroid Abuse (long term and short term)
Many reasons have been given as to why men and to a lesser degree, women choose to abuse steroids. Among most abusers, it boils down to two simple concepts of performance and self-image. For over half a century, anabolic steroids have been used to enhance athletic ability.
Most often, the answer lies in a need to improve a particular type of performance. Whether the goal is an increase in physical size, strength, speed or stamina, in the mind of an abuser, it is a worthwhile endeavor, regardless of the risk.
Secondly, many abusers report a greater sense of fulfillment and a healthier self-image when taking steroids. Many young men report taking steroids simply because they want to look built, to emulate the bodybuilders they see in magazines, or even more importantly, to be more appealing to women. Moreover, a form of reverse anorexia seems to be prevalent in young males who are interested in fitness. The National Institute of Drug Abuse shows in recent studies that 325,000 teenage boys and 175,000 teenage girls are using steroids.
The number of adult abusers is even higher. (Consider that often, steroid abusers are private about their use and never report it. The actual number of abusers could be far greater.) The idea that they can never be big enough, fast enough or strong enough dominates their perception of self. Anabolic steroids would seem to be the answer to their prayers.
Abusers can seem pretty well educated on the subject of their vice, however, the problem lies in the quality of the information. Most often, it’s hearsay or internet chatter, combined with a skewed rationale that explains away all the bad. Many abusers will tell you the doses they take aren’t harmful because they “cycle” (come off of steroids for a period of time and then begin again) or they only take a certain “good” steroid or not enough of a dose to harm them.
This couldn’t be further from the truth. When doctors prescribe steroids, it is generally to treat patients with a rare or specific disorder, and the drug is administered in the lowest possible dose as to minimize the negative side effects. But this isn’t about medicine; this is about unregulated, unsupervised abuse of a synthetic drug for the purpose of maximum muscle development and performance. Massive doses are required to achieve the results most abusers are looking for. When this is the case, there is no safe use.
In both cases of performance and image, abusers throw caution to the wind as their sense of achievement far outweighs their consideration of the enormous risks involved. Medical research shows steroid users subject themselves to over 70 side effects ranging in severity from liver cancer to acne, and include psychological as well as physical reactions. The liver and cardiovascular and reproductive systems are most seriously affected by steroid abuse. When discussing the powerful effects of anabolic steroids on the human body, we look at the short term effects, which can take from a few weeks to a few years to present themselves and the long term effects, some taking up to a decade or more to appear.
SHORT TERM SIDE EFFECTS
The short term, more immediate side effects of steroid abuse are a veritable buffet of problems. Let’s start with the men. Acne, testicular atrophy, decreased sperm count, gynecomastia (enlarged breasts in men), high blood pressure, increased LDL (bad) cholesterol, decreased HDL (good) cholesterol, fluid retention, abnormal liver function, and prostate enlargement, just to name a few.
Anabolic steroids can affect women differently than men, and in some cases, dramatically so. Women can experience many of the same dangerous effects as men including high blood pressure, high cholesterol, and liver damage. Many of the problems, however, are exclusively feminine representations of natural male characteristics such as male pattern balding, deepening of the voice, facial and body hair growth, and coarsening of the skin.
For both sexes, increased aggressiveness, otherwise known as "roid rage," commonly accompanies the use of steroids.
Now let’s break some of these down into further detail.
One common side effect is the onset of acne or, in cases of adolescents where acne is already present, a much more severe case can present itself. The scientific explanation is quite colorful. Steroids enlarge the sebaceous glands in the skin. Then, they cause these glands to increase sebum (oil) production. The increased sebum leads to plug formation and serves as "food" for bacteria.
Normal hormones surge at puberty, which is why teens develop armpit and pubic hair, and why boys develop facial hair and deeper voices. This hormonal surge also contributes to the cause of acne in teens. Introducing steroids to this delicate balance is just asking for trouble.
Testicular atrophy, a fancy term for shrunken balls, isn’t just a cosmetic problem. Because an outside source of testosterone is being introduced to the body, the testes no longer get the signal to produce their share. The brain is also being told to slow down the sperm factory, and that the body is getting sperm from an outside source, usually the hypodermic needle. The brain then sends a signal back to the testicles to take a break. This new function can cause temporary sterility, and the jury is still out on whether steroids are linked with permanent sterility or not. But why take the chance?
Gynecomastia, a pretty word for man-boobs, is another not-so-good side effect of abuse that comes from the improper balance of testosterone. When the body converts the additional testosterone into estrogen and other female hormones in the male body, female breast tissue is sometimes formed. Often, surgery with a painful recovery time is the only method of removing the female tissue build-up. Basically, the surgeon enlarges the area to be liposuctioned with a large amount of sterile fluid then employs ultrasonic liposuction using sound waves to break up the fat. The surgery can cost upwards of $10,000 and you will be hard pressed to find insurance that will cover steroid abuse.
HIGH BLOOD PRESSURE
The next effect on our list is high blood pressure, which is caused when the steroid forces the body to hold onto extra salt and water, rather than flushing it out as usual. Steroids also cause an increase in the body's red blood cell count and hematocrit levels, resulting in higher blood pressure. The long term effects of high blood pressure are a list all their own. It causes the heart to get larger, which may lead to heart failure. Small bulges (aneurysms) can form in blood vessels, the main artery from the heart (aorta), arteries in the brain, legs, and intestines; and the artery leading to the spleen. Blood vessels in the kidney can narrow, which may cause kidney failure. Arteries throughout the body can "harden" faster, especially those in the heart, brain, kidneys, and legs. This can cause a heart attack, stroke, kidney failure or amputation of part of the leg. Blood vessels in the eyes may burst or bleed, which can cause vision changes and can result in blindness.
High blood pressure is also often a result of high (LDL) bad cholesterol levels and/or low (HDL) good cholesterol levels. Steroids change the levels of lipoproteins that carry cholesterol in the blood. Steroids, particularly oral steroids, increase the level of low-density lipoprotein (LDL) and decrease the level of high-density lipoprotein (HDL). This increases the risk of atherosclerosis, a condition in which fatty substances are deposited inside arteries and disrupt blood flow. If blood is prevented from reaching the heart, the result can be a heart attack. If blood is prevented from reaching the brain, the result can be a stroke.
Let’s move on to the liver, where just about everything you put in your body gets processed. In other words, just try to live without your liver. It won’t happen. Steroid abuse has been associated with liver tumors and a rare condition called peliosis hepatis, in which blood-filled cysts form in the liver. Both the tumors and the cysts can rupture, causing internal bleeding. Keep in mind, we’re talking short term effects. Long term liver effects, you don’t want to know, but we’ll get into that a little later.
Next, the issue of prostate enlargement, which is a problem seen with aging males. This is not something you typically see in younger men, unless they’re taking anabolic steroids. Over the course of an average life span, the male prostate gland naturally grows thirty times its original size. It doesn’t need the help of additional testosterone to grow to the size of a grapefruit. However, when large amounts of synthetic testosterone are involved, the prostate grows faster. The long term effect of that is prostate cancer. It is medically proven that the cancer loves the taste of testosterone, which feeds the growth of cancer cells.
Baldness in women steroid abusers is caused by the body’s confused over-production of DHT- a hair inhibitor enzyme, which generally affects both sexes similarly. Women see this change occurring first around the scalp line and can eventually cause balding that is irreversible.
MALE CHARACTERISTICS IN FEMALES
A deepening voice is another naturally male characteristic that can develop in women abusers simply because of the large amounts of testosterone sending male signals to the brain, the control room for hormone production, and the various glands that manage the hormone output. Steroids play havoc with the entire system.
Excess facial and body hair growth and coarse skin, both male characteristics, are unsavory by-products of steroid abuse by women caused by an overabundance of male hormones. While aggressiveness and heightened libido are side effects that can be experienced by both genders, some effects are uniquely female. For example, the enlarged or lengthened clitoris is inherently female as well as a confused and erratic menstrual cycle. Other traits may include shrinking breasts, anxiety, depression, and high levels of stress. All of these characteristics can be caused by introducing the amounts of synthetic steroids in the female body necessary to see a change in muscle development.
In both men and women steroid abusers, evidence of “roid rage” or increased aggression from too much testosterone is a hotly contested topic. However, in animal studies, the relationship between steroids and aggression has always been pretty clear.
In some studies, more than 80 percent of steroid-treated animals become extremely aggressive. In humans, the picture has been clouded by alternative explanations and a lack of hard evidence. Only in recent years have researchers been able to confirm that steroid-induced aggression is a real human phenomenon that can occur in individuals who take large doses of steroids for extended periods of time. This heightened aggression can lead to irritability, stress, and violence.
When the circuits in the brain that are responsible for impulse control are influenced by steroids, it affects this system that inhibits aggressive response, predisposing some abusers to violent outbursts. Researchers do not yet know the key as to why some abusers are more affected than others, but the correlation between steroids and aggressive behavior is a documented phenomenon.
LONG TERM SIDE EFFECTS
Only in recent years have researchers been able to define the long term effects of steroid abuse. They are learning more each year as abusers age and problems present themselves.
One of the deadliest side effects, scoffed at by many abusers, is HIV. Intravenous needle sharing, combined with a heightened sex drive and libido function can be a very dangerous combination. This is especially true in adolescent teens and young adults who often have weaker decision-making skills and a high susceptibility to peer pressure. HIV and AIDS-related deaths are on the rise and the epidemic is not as popular in the media as in past decades. Most people adopt a “that stuff happens to other people” attitude, and many steroid abusers, already practiced rationalizers don’t even consider it at all.
Peliosis Hepatitis, a condition where blood-filled cysts replace liver and spleen tissue, has been reported in patients receiving long-term anabolic steroid treatments. These cysts have been associated with liver failure. Discontinued use of steroids has shown a regression and sometimes a complete disappearance of these cysts; however, during the course of steroid use, the cysts can create tumors. These tumors are less evident and can be silent until a life-threatening abdominal hemorrhage occurs.
High blood cholesterol levels, as discussed earlier in this article, can lead to premature heart conditions, heart attacks and stroke. The increase in muscle mass can put undue strain on the rest of a body that is not prepared for the surprisingly fast new muscle development. The heart is put under more pressure to provide blood to more muscle tissue, while processing greater levels of bad cholesterol. Moreover, high blood pressure due to salt and water retention can put even further undue stress on the heart. No doubt, steroid abuse over long periods of time will inevitably cause damage.
Studies have shown that adolescents who abuse steroids are at risk of being short for life. Because the body responds to puberty by slowing and eventually stopping growth, the pubescent period of life is crucial to future development. When the adolescent brain senses a certain level of hormones in the body, it will send messages to the bones to stop growing, closing the growth plates in the long bones. Young male abusers can expect to be permanently shorter than average height.
LIGAMENT AND JOINT INJURY
Steroids increase muscle mass and muscle strength, but they leave the joints and ligaments out of the equation. Steroid abusers can expect to eventually put too much strain on ligaments that cannot properly anchor the new muscle strength, leading to possibly severe injury and future surgery to correct torn shoulder joints or knee ligaments. The muscles are exerted, and the joints simply can’t handle it.
Steroid abusers who stop abusing often deal with atrophied muscle mass which converts to fat. Many former abusers report a problem managing weight gain, or losing excess flab and soft tissue that occurs when the muscles are no longer being fed high doses of testosterone. Excess body weight contributes to a host of long-term problems including the aforementioned cardiovascular issues.
Studies have confirmed steroid abuse has a long term effect on the neurological pathways of the brain. Depending on the age when steroids are taken, the effects can sometimes be permanent. For example, abusing steroids in the teenage years of development has shown to affect the brain’s ability to properly produce serotonin, the enzyme tied with our sense of well-being. This tampering with serotonin can lead to permanent increases in depression and aggression. In women, this hormonal tampering can also lead to significantly lower levels of progesterone and estrogen, potentially upsetting the delicate balance of female chemistry and inducing severe anxiety and depression.
Though proponents of steroid use may praise the benefits that steroids can have on muscular development and improved athletic performance, any properly informed individual will be hard pressed to deny the possibilities of detrimental side-effects.
Coming back to the reasons for steroid abuse, it is understandable that steroid abuse is so rampant considering the powerful influence of the human need to achieve or simply feel better about one’s self.
However, even when considering that no side effect is guaranteed to occur, the overwhelming evidence of dangerous side effects should be enough to persuade most people to steer clear of anabolic steroids. Unfortunately, that is not the case. Currently, over 2 million people reportedly abuse steroids in the United States.
Bibliography of Sources:
“Anabolic Steroids,” anonymous, CESAR, Center for Substance Abuse Research, 2007
“Anabolic Steroids- Hidden Dangers,” anonymous, Office of Diversion Control, March 2004
“Factors Contributing to the Cause of Acne,” anonymous, Facial Skin Care.com, 2007
“What Causes Prostate Cancer?,” anonymous, eHealthMD, October 2004
“Steroids:Anabolic.Androgenic,” anonymous, Focus Adolescent Services, 2005
“Dr. Delgado’s Gynecomastia FAQ,” Dr. A. Delgado, Gynecomastia.org, January, 2007
“High Blood Pressure FAQ’s,” anonymous, Aetna IntelliHealth, June 10, 2005
“What You Should Know About Steroids,” Steven Dowshen, MD, Miami Children’s Hospital.com, Feb. 2002
“Do Steroids Cause Stunted Growth,” Henry Bernstein, MD, Family Education, 2007
“Big Muscles Now May Mean Big Health Problems Later”, Valerie Gliem, University of Michigan Health System, Aug. 2001
“Anabolic Steroids: A Primer,” William Llewellyn, Muscular Development Magazine, 2006
“What is High Blood Pressure,” anonymous, National Heart and Blood Institute, April 2006
“What are the Health Consequences of Steroid Abuse,” Research Report Series- Anabolic Steroid Abuse, anonymous, National Institute on Drug Abuse, Sep. 2006
“Steroid Use Causes Long Term Aggression,” anonymous, Northeastern University, Nov. 2003
Anabolic Steroids, “Teens At Risk,” NIDA for Teens, 1997-2003
National Institute on Drug Abuse. “Steroid Abuse and Teens,”NIH Pub. No. 00—3721. Bethesda, MD: NIDA, NIH, DHHS. Printed 1991. Reprinted 1994, 1996. Revised April, 2000.
Pope, H.G., Jr.; Kouri, E.M.; and Hudson, J.I. Effects of supraphysiologic doses of testosterone on mood and aggression in normal men: A randomized controlled trial. Archives of General Psychiatry 57(2):133-140, 2000.
“Anabolic Steroid Abuse,” anonymous, University of New Mexico Student Health Center, 2004
“Steroid Phobia: myth vs. fact’” Andy Nish, MD, Allergy & Asthma Advocate: Summer 2004
“Kids and Steroids,” Dr. Fred Hatfield, Bodybuilding.com, 2006
“Drug Scheduling,” anonymous, U.S. DEA, 2006
“Steroid Medical Realities Outweigh Steroid Myths,” Colin Nelson, MedPage Today, March, 2005
Malarkey, W.B., Strauss, R.H., Leizman, D.J., Liggett, M., Demers, L.M. (1991) Endocrine effects in female weight lifters who self-administer testosterone and
anabolic steroids. American Journal of Obstetrics and Gynecology, 165, 1385-1390
Strauss, R.H., Liggett, M.T., Lanese, R.R. (1985) Anabolic steroids use and perceived effects in ten weight-trained women athletes. JAMA, 253, 2871-2873
Psychiatric and Medical Effects of Anabolic-Androgen Steroid Use, Harrison Pope, Jr., and David Katz, Archives of General Psychiatry, May, 1994, pp. 375-82.
“More Male than Male,” Etienne Benson, Monitor on Psychology, Vol. 33, No. 9 October 2002