Tips For Teens – Steroids

What are anabolic steroids?

Anabolic steroids are synthetic, or human-made, variations of the male sex hormone testosterone. The proper term for these compounds is anabolic-androgenic steroids. “Anabolic” refers to muscle building, and “androgenic” refers to increased male sex characteristics. Some common names for anabolic steroids are Gear, Juice, Roids, and Stackers.

Health care providers can prescribe steroids to treat hormonal issues, such as delayed puberty. Steroids can also treat diseases that cause muscle loss, such as cancer and AIDS. But some athletes and bodybuilders misuse these drugs in an attempt to boost performance or improve their physical appearance.

The majority of people who misuse steroids are male weightlifters in their 20s or 30s. Anabolic steroid misuse is much less common in women. It is difficult to measure steroid misuse in the United States because many national surveys do not measure it. However, use among teens is generally minimal. The 2016 NIDA-funded Monitoring the Future study has shown that past-year misuse of steroids has declined among 8th and 10th graders in recent years, while holding steady for 12th graders.

How do people misuse anabolic steroids?

People who misuse anabolic steroids usually take them orally, inject them into muscles, or apply them to the skin as a gel or cream. These doses may be 10 to 100 times higher than doses prescribed to treat medical conditions.

Commons patterns for misusing steroids include:

  • cycling—taking multiple doses for a period of time, stopping for a time, and then restarting
  • stacking—combining two or more different steroids and mixing oral and/or injectable types
  • pyramiding—slowly increasing the dose or frequency of steroid misuse, reaching a peak amount, and then gradually tapering off to zero
  • plateauing—alternating, overlapping, or substituting with another steroid to avoid developing a tolerance

There is no scientific evidence that any of these practices reduce the harmful medical consequences of these drugs.

How do anabolic steroids affect the brain?

Anabolic steroids work differently from other drugs of abuse; they do not have the same short-term effects on the brain. The most important difference is that steroids do not directly activate the reward system to cause a “high”; they also do not trigger rapid increases in the brain chemical dopamine, which reinforces most other types of drug taking behavior.

Misuse of anabolic steroids might lead to negative mental effects, such as:

  • paranoid (extreme, unreasonable) jealousy
  • extreme irritability and aggression (“roid rage”)
  • delusions—false beliefs or ideas
  • impaired judgment
  • mania

What are other health effects of anabolic steroids?

Anabolic Steroids and Infectious Diseases

People who inject steroids increase their risk of contracting or transmitting HIV/AIDS or hepatitis.

Read more about this connection by visiting:

Aside from mental effects, steroid use commonly causes severe acne. It also causes the body to swell, especially in the hands and feet.

Long-Term Effects

Anabolic steroid misuse might lead to serious, even permanent, health problems such as:

  • kidney problems or failure
  • liver damage and tumors
  • enlarged heart, high blood pressure, and changes in blood cholesterol, all of which increase the risk of stroke and heart attack, even in young people
  • increased risk of blood clots

Several other effects are gender- and age-specific:

  • In men:
    • shrinking testicles
    • decreased sperm count
    • baldness
    • development of breasts
    • increased risk for prostate cancer
  • In women:
    • growth of facial hair or excess body hair
    • decreased breast size
    • male-pattern baldness
    • changes in or stop in the menstrual cycle
    • enlarged clitoris
    • deepened voice
  • In teens:
    • stunted growth (when high hormone levels from steroids signal to the body to stop bone growth too early)
    • stunted height (if teens use steroids before their growth spurt)

Some of these physical changes, such as shrinking sex organs in men, can add to mental side effects such as mood disorders.

Are anabolic steroids addictive?

Even though anabolic steroids do not cause the same high as other drugs, they can lead to a substance use disorder. A substance use disorder occurs when a person continues to misuse steroids, even though there are serious consequences for doing so. The most severe form of a substance use disorder is addiction. People might continue to misuse steroids despite physical problems, high costs to buy the drugs, and negative effects on their relationships. These behaviors reflect steroids’ addictive potential. Research has further found that some steroid users turn to other drugs, such as opioids, to reduce sleep problems and irritability caused by steroids.

People who misuse steroids might experience withdrawal symptoms when they stop use, including:

  • fatigue
  • restlessness
  • loss of appetite
  • sleep problems
  • decreased sex drive
  • steroid cravings

One of the more serious withdrawal symptoms is depression, which can sometimes lead to suicide attempts.

How can people get treatment for anabolic steroid addiction?

Some people seeking treatment for anabolic steroid addiction have found a combination of behavioral therapy and medications to be helpful.

In certain cases of addiction, patients have taken medicines to help treat symptoms of withdrawal. For example, health care providers have prescribed antidepressants to treat depression and pain medicines for headaches and muscle and joint pain. Other medicines have been used to help restore the patient’s hormonal system.

Points to Remember

  • Anabolic steroids are synthetic variations of the male sex hormone testosterone.
  • Health care providers can prescribe steroids to treat various medical conditions. But some athletes and bodybuilders misuse these drugs to boost performance or improve their physical appearance.
  • People who abuse anabolic steroids usually take them orally, inject them into the muscles, or apply them to the skin with a cream or gel.
  • People misuse steroids in a variety of doses and schedules.
  • Misuse of anabolic steroids might lead to short-term effects, including paranoid jealousy, extreme irritability and aggression, delusions, impaired judgement, and mania.
  • Continued steroid misuse can act on some of the same brain pathways and chemicals that are affected by other drugs, including dopamine, serotonin, and opioid systems.
  • Anabolic steroid misuse might lead to serious long-term, even permanent, health problems.
  • Several other effects are gender- and age-specific.
  • People who inject steroids increase their risk of contracting or transmitting HIV/AIDS or hepatitis.
  • Even though anabolic steroids do not cause the same high as other drugs, they can lead to addiction.
  • Some people seeking treatment for anabolic steroid addiction have found behavioral therapy and medications to be helpful. Medicines can help treat symptoms of withdrawal in some cases.

Learn More

For additional information about anabolic steroids, visit:


Are Steroids Worth the Risk?

Reviewed by: Steven Dowshen, MD

en españolEsteroides: ¿vale la pena el riesgo?

What Are Steroids?

Steroids (sometimes referred to as “roids” or “juice”) are the same as, or similar to, certain hormones in the body. The body makes steroids naturally to support such functions as fighting stress and promoting growth and development.

But some people use steroid pills, gels, creams, or injections because they think steroids can improve their sports performance or the way they look.

Anabolic steroids are artificially produced hormones that are the same as, or similar to, androgens, the male-type sex hormones in the body. There are more than 100 variations of anabolic steroids. The most powerful androgen is testosterone (pronounced: tess-TOSS-tuh-rone). Although testosterone is mainly a mature male hormone, girls’ bodies produce smaller amounts. Testosterone helps build muscle and promotes the masculine traits that guys develop during puberty, such as deepening of the voice and growth of body hair. Testosterone levels can also affect how aggressive a person is.

Athletes sometimes take anabolic steroids because of their testosterone-like effects.

Other steroids, sometimes called steroidal supplements, contain dehydroepiandrosterone (DHEA) and/or androstenedione (also known as andro). For the most part, steroidal supplements, which used to be found at health food stores or gyms, are now illegal and require a prescription. DHEA is one of the few exceptions and can still be bought over the counter.

Steroid supplements are weaker forms of androgen. Their effects aren’t well known, but it’s thought that, when taken in large doses, they cause effects similar to other androgens like testosterone. But research studies suggest that they do very little or nothing to improve athletic performance.

Here’s what is known about steroidal supplements: Companies that make them often use false claims, and very little is known about the long-term effects some of these substances have on the body. That’s one reason why the government took action to protect citizens by passing laws controlling steroid distribution.

How Do Anabolic Steroids Work?

Anabolic steroids stimulate muscle tissue to grow and “bulk up” in response to training by mimicking the effect of naturally produced testosterone on the body. Anabolic steroids can remain in the body anywhere from a couple of days to about a year. Steroids have become popular because they may improve endurance, strength, and muscle mass. However, research has not shown that steroids improve skill, agility, or athletic performance.

Dangers of Steroids

Anabolic steroids cause many different types of problems. Some of the common side effects are:

  • acne
  • premature balding or hair loss
  • weight gain
  • mood swings
  • aggression
  • problems sleeping
  • high blood pressure
  • greater chance of injuring muscles and tendons
  • jaundice (yellowing of the skin); liver damage
  • stunted growth
  • increased risk of developing heart disease, blood clots, stroke, and some types of cancer

Risks for Girls

Specific risks for girls associated with anabolic steroids include:

  • increased facial and body hair growth
  • development of masculine traits, such as deepening of the voice, and loss of feminine body characteristics, such as shrinking of the breasts
  • enlargement of the clitoris
  • menstrual cycle changes

Risks for Guys

Specific risks for guys include:

  • testicular shrinkage
  • pain when urinating
  • breast development
  • impotence (inability to get an erection)
  • reduced sperm count and infertility

Other Problems

Steroids can also have serious psychological side effects. Some users may become aggressive or combative, believe things that aren’t true (delusions), or have extreme feelings of mistrust or fear (paranoia). And people who use steroids also appear to be at higher risk for using other drugs, such as alcohol or cocaine, often to counteract some of the negative effects of steroids.

Steroid users who inject the drugs with a needle are at risk for infection with HIV (human immunodeficiency virus), the virus that causes AIDS, if they share needles with other users. People who use dirty needles are also at risk for contracting hepatitis, a liver disease, or bacterial endocarditis, an infection of the inner lining of the heart.

Steroids: Stacking and Addiction

Some people “cycle” their steroid doses. This means they take multiple doses of steroids over a period of time, stop for a period, then start up again. “Stacking” means taking two or more different anabolic steroids. Other steroid users may “pyramid” their steroids, starting with a low dose and gradually increasing the dose, frequency, or number of anabolic steroids taken, then tapering off to complete a cycle. Users believe that stacking enhances the effects of each individual drug, pyramiding allows the body to get used to high doses of steroids, and steroid-free periods help the body recuperate from the drugs. There is no scientific evidence to support any of these claims.

A lot of people tell themselves they’ll only use steroids for a season or a school year. Unfortunately, steroids can be addictive, making it hard to stop taking them.

And once users stop taking steroids, they can have withdrawal symptoms such as loss of appetite, tiredness, restlessness, insomnia, mood swings, and depression.

Strong Alternatives to Steroids

Anabolic steroid use is illegal and banned by professional sports organizations and medical associations. In spite of this, some athletes continue to take steroids because they think it gives them a competitive advantage. As seen in high-profile cases, if an athlete is caught using steroids, his or her career can be destroyed. And there are serious health consequences.

When it comes right down to it, harming your body or getting disqualified aren’t smart ways to try to improve your athletic performance. Being a star athlete means working hard and training the healthy way: eating the right foods, practicing, and strength training without the use of drugs.


11 FACTS ABOUT STEROIDS

Welcome to DoSomething.org, a global movement of millions of young people making positive change, online and off! The 11 facts you want are below, and the sources for the facts are at the very bottom of the page. After you learn something, Do Something! Find out how to take action here.

  1. “Corticosteroids” are types of drugs used to treat medical conditions. “Anabolic steroids” are drugs that replicate human sex hormones like testosterone and estrogen, which are taken illegally — and often abused — to alter one’s physical appearance.
  2. Anabolic steroids can be authorized by a doctor in the case of delayed puberty, cancer, or AIDs, but should never be self-prescribed.
  3. Often times, drug abusers of steroids take 10 to 100 times more than would be prescribed by a physician to treat a condition or illness.
  4. Teenage girls use steroids as a way to improve or change their body shape. The side effects include male pattern baldness, a permanently deepened voice, breast shrinking, and detrimental changes to the menstrual cycle. Write positive messages on your school’s bathrooms to brighten your classmates’ day.
  5. Common side effects of steroids are mood swings, manic behavior, insomnia, irritability, and lack of good judgement.
  6. For men in particular, steroids often cause shrinking of testicles, breast growth, hair loss, infertility, and a higher risk of prostate cancer.
  7. Steroid use among teens has seen a slight increased in the last few years. In 2010, 2% of high school seniors admitted to trying steroids. However, 2.1% percent had experimented with them in 2013.
  8. Anabolic steroids are commonly used among teenage athletes to bulk up. Unfortunately, the improper use of steroids (even at a young age) causes stunted growth, kidney impairment or failure, liver damage, and increased risk of heart attack or stroke.
  9. Steroids are serious drugs and drugs are addictive. Discontinuing use often leads to withdrawal and depression, which creates a lack of physical drive or social interaction among users.
  10. One way steroids are taken is through injection directly into the muscles. Because drug injection equipment is not always sterile, users are vulnerable to life-threatening diseases like HIV/AIDs or hepatitis.
  11. A program has been developed for both male and female high school sport teams (ATLAS for guys, ATHENA for girls) for coaches and leaders to enforce the danger in using these drugs. So far, new steroid use has decreased by 50% amongst these teens.

Know the facts:

What are some slang terms or prescription brand names?
Juice, Roids, Gym Candy, Pumpers, Oxandrin, Android, Anadrol
See table below for a more complete list.

What are steroids?
Anabolic androgenic steroids are a group of powerful compounds closely related to the male sex hormone testosterone. There are very few legitimate medical uses of anabolic androgenic steroids, including treatment of severe testosterone deficiency and certain kinds of anemia. Body builders, long-distance runners, cyclists and other athletes who may use these substances illegally claim that anabolic steroids give them a competitive advantage and/or improve their physical appearance.1

What do steroids look like?
Steroids can come in tablet, capsule or liquid form, as well as gels, creams and patches.

SIGNS OF USE:
  • Acne
  • Oily skin
  • Excess hair growth
  • Deepening of the voice
  • Shrinking testicles (in males)
  • Baldness (in males)
  • Development of breasts (in males)
  • Growth of facial hair (in females)
  • Changes in body contour (in females)
  • Disruption of menstrual cycle (in females)
  • Deepened voice (in females)
RELATED DRUGS:

How are steroids used?
Steroids are taken orally, applied to the skin or injected. Athletes and other people who misuse steroids typically take them in cycles of weeks or months (called “cycling”), rather than continuously. Cycling involves taking multiple doses of steroids over a specific period of time, stopping for a period, and starting again. In addition, people misusing steroids frequently combine several different types to maximize their effectiveness while minimizing negative effects, a process known as stacking.2

What do young people hear about it?
Steroids have a reputation for increasing lean muscle mass, strength, and the ability to train longer and harder.

What are the risks of steroids use?
The minor side effects of steroid use include acne, oily skin, excess hair growth, and deepening of the voice. The major side effects include an increased risk of cancer, increased risk of heart and liver disease, jaundice, fluid retention, reduction in HDL-C (“good cholesterol”), high blood pressure and changes in blood clotting.

Side effects specific to men can include testicular atrophy (the shrinking of the testicles), reduced sperm count, infertility, baldness, and the development of breasts. For women, side effects can include enlargement of the clitoris, changes in the body contour, growth of facial hair, disruption of the menstrual cycle, deepened voice.

An increase in androgenic (male) hormones may also lead to aggressive behavior. Research also indicates that people who use steroids often suffer from paranoid jealousy, extreme irritability, delusions, and impaired judgment stemming from feelings of invincibility.

Teens who misuse steroids are at a significant risk of suffering irreversible side effects, including stunted growth, accelerated puberty changes and abnormal sexual development.2

List of Brand Names & Slang Terms

 Generic Drug Composition Brand Name
Oxandrolone Oxandrin
Methyltestosterone Testred, Android, Methitest
Oxymetholone Anadrol
Fluoxymesterone Androxy, Halotestin

www.dea.gov/factsheets/steroids.

www.getsmartaboutdrugs.gov/drugs/steroids.


Anabolic steroids: What you should know

Anabolic steroids are used for some medical conditions, but people also use them illegally in some sports settings. They use them to boost muscle mass, performance, and endurance and to shorten recovery time between workouts.

The drugs are artificially derived from the main male hormone testosterone. Testosterone is important for promoting and maintaining muscle growth and developing secondary male sex characteristics, such as a deepening voice and facial hair.

Anabolic steroids, also called anabolic-androgenic steroids (AASs), can build muscle and improveTrusted Source athletic performance, but they can also have significant adverse effects, especially when used incorrectly.

Long-term, non-medical uses are linked to heart problems, unwanted physical changes, and aggression. There is growing concern worldwide about the non-medical use of steroids and its effects.

Street names include Arnolds, gym candy, pumpers, roids, and stackers.

Fast facts on anabolic steroids

  • Steroids are sometimes used in medicine, but illegal use of AASs may involve doses 10 to 100 times higher than the normal prescription dose.
  • In the United States, AASs need a prescription, but this is not the case in many countries.
  • All synthetic steroids combine muscle-building effects with the development of secondary male sexual characteristics.
  • AAS use has been linked to a higher risk of heart attack or stroke.
What are anabolic steroids?

AASs are synthetic versions of the primary male hormone, testosterone. They affect many parts of the body, including the muscles, bones, hair follicles, liver, kidneys, blood, immune system, reproductive system and the central nervous system.

During puberty, increases in testosterone levels enable the development of characteristics such as facial and body hair growth, increased height and muscle mass, a deepening voice, and the sex drive.

Testosterone can also contribute to competitiveness, self-esteem, and aggressiveness.

Types:

There are up to 32 types of anabolic steroid listed on commercial websites.

Some have only medicinal uses, such as Nebido. Anadrol is an example of a steroid with both medicinal and performance uses.

Others, such as anadur, have no therapeutic use, but athletes use them.

People choose different types for different purposes:

  • bulking steroids for building muscle
  • performance steroids for strength and endurance
  • cutting steroids for burning fat

Other reasons for use include healing and recovery and enhancement of metabolism.

For both medical and illegal purposes, AASs can be taken:

  • by mouth
  • as pellets implanted under the skin
  • by injection
  • through the skin as a cream or gel

Oral forms are taken by mouth. They include:

  • Fluoxymesterone (Halotestin), or “Halo”
  • Mesterolone (Proviron)
  • Methandienone (Dianabol), or “Dbol”
  • Methyltestosterone (Virilon)
  • Mibolerone (Cheque)
  • Oxandrolone (Anavar, Oxandrin), or “Var”
  • Oxymetholone (Anadrol), or “Drol”
  • Stanozolol (Winstrol), or “Winny”

Injectable forms include:

  • Boldenone undecylenate (Equipoise), or “EQ”
  • Methenolone enanthate (Primobolan), or “Primo”
  • Nandrolone decanoate (Deca Durabolin), or “Deca”
  • Nandrolone phenpropionate (Durabolin), or “NPP”
  • Testosterone cypionate (Depotest)
  • Testosterone enanthate (Andro-Estro)
  • Testosterone propionate (Testex)
  • Trenbolone acetate (Finajet), or “Tren”

AASs 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.

Medical uses:

Some types of steroid are commonly used for medical treatment. For example, corticosteroids can help people with asthma to breathe during an attack.

Testosterone is also prescribed for a number of hormone-related conditions, such as hypogonadism.

However, AASs are not commonly prescribedTrusted Source as a treatment.

In the U.S., an AAS is a schedule III controlled substance available only by prescription. The use of these drugs is only legal when prescribed by a medical provider.

Medical conditions they are used to treat include:

Testosterone and several of its esters, as well as methyltestosterone, nandrolone decanoate, and oxandrolone, are the main anabolic-androgenic steroids currently prescribed in the U.S.

Steroids in sport:

Non-medical use of steroids is not permitted in the U.S. Under the Controlled Substance Act, unlawful possession and distribution are subject to federal and state laws.

As it is not legal for athletic purposes, there is no legal control over the quality or use of drugs sold for this purpose.

Illegal steroids are obtained through the internet and through informal dealers, like other illegal drugs. However, they may also be available through unscrupulous pharmacists, doctors, and veterinarians.

“Designer” steroids are sometimes produced to enable athletes to pass doping tests. Their composition and use are entirely unregulated, adding to the hazards they pose.

Athletes often consume steroids on a trial-and-error basis, using information gained from other athletes, coaches, websites or gym “gurus.” As a result, they do not have access to medical information and support that can keep them safe while using these drugs.

The adverse effects of AAS use depend on the product, the age and sex of the user, how much they use, and for how long.

Legally prescribed normal-dose anabolic steroids may have the following side effects:

  • acne
  • fluid retention
  • difficulty or pain when urinating
  • enlarged male breasts, known as gynecomastia
  • increased red cell count
  • lower levels of “good” HDL cholesterol and higher levels of “bad” LDL cholesterol
  • hair growth or loss
  • low sperm count and infertility
  • changes in libido

Users will attend follow-up appointments and take periodic blood tests to monitor for unwanted effects.

Non-medical use of steroids can involve quantities from 10 to 100 times the amount used for medical purposes.

Incorrect use of steroids can lead to an increased risk of:

In adolescents, it can result in:

  • permanently stunted growth

In men, there may be:

  • shrinking testicles
  • sterility
  • enlarged breasts

Women may experience:

  • changes to the menstrual cycle
  • deepening of the voice
  • lengthening of the clitoris
  • increased facial and body hair
  • shrinking breasts
  • increased sex drive

Some of these changes may be permanent, even after stopping use.

There is also a risk of:

  • liver damage
  • aggression and feelings of hostility
  • mood and anxiety disorders
  • reckless behavior
  • psychological dependence and addiction

People who suddenly discontinue AAS after using them for a long time may experience withdrawal symptoms, including severe depression.

Apart from these adverse effects, there are other health risksTrusted Source.

  • Sharing needles to inject steroids increases the chance of contracting or transmitting blood-borne infectious diseases, such as hepatitis or HIV.
  • The use of unlicensed products carries a risk of poisoning.

Psychiatric symptoms can develop in people who use steroids for a long time.

These include:

  • severe mood swings
  • paranoia and delusions
  • impaired judgment
  • feelings of invincibility
  • mania and anger — known as “roid rage” — that may lead to violence

These extreme and unwanted effectsTrusted Source can affect those who are already prone to these types of behaviors.

Long-term, unregulated use of AASs can affect some of the same brain pathways and chemicals that are affected by other drugs, such as opiates. This can result in dependency and possibly addiction.

The American Psychological Association’s (APA) Diagnostic and Statistical Manual fifth edition (DSM-5) considers abuseTrusted Source of and dependence on AASs a diagnosable condition.

Withdrawal

Misuse of steroids can lead to withdrawal symptoms when the person stops taking them.

Withdrawal symptoms include:

  • fatigue
  • restlessness
  • mood swings
  • depression
  • fatigue
  • insomnia
  • reduced sex drive
  • cravings

The first step in treating anabolic steroid abuse is to discontinue use and to seek medical help in order to address any psychiatric or physical symptoms that might occur.

An addiction treatment facility or counselor may help.


Performance-enhancing drugs: Know the risks

Hoping to gain a competitive edge by taking performance-enhancing drugs? Learn how these drugs work and how they can affect your health.

By Mayo Clinic Staff

Most serious athletes will tell you that the drive to win is fierce. Besides the satisfaction of personal accomplishment, athletes often pursue dreams of winning a medal for their country or securing a spot on a professional team. In such an environment, the use of performance-enhancing drugs has become increasingly common.

But using performance-enhancing drugs (doping) has risks. Take the time to learn about the potential benefits, the health risks and the many unknowns regarding so-called performance-enhancing drugs such as anabolic steroids, androstenedione, human growth hormone, erythropoietin, diuretics, creatine and stimulants. You may decide that the benefits aren’t worth the risks.

Anabolic steroids

What are they?

Some athletes take a form of steroids — known as anabolic-androgenic steroids or just anabolic steroids — to increase their muscle mass and strength. The main anabolic steroid hormone produced by your body is testosterone.

Testosterone has two main effects on your body:

  • Anabolic effects promote muscle building.
  • Androgenic effects are responsible for male traits, such as facial hair and a deeper voice.

Some athletes take straight testosterone to boost their performance. The anabolic steroids used by athletes are often synthetic modifications of testosterone.

These hormones have approved medical uses. But improving athletic performance isn’t one of them.

Why are these drugs so appealing to athletes? Besides making muscles bigger, anabolic steroids may reduce the muscle damage that occurs during a hard workout, helping athletes recover from the session more quickly and enabling them to work out harder and more frequently. Some athletes, as well as nonathletes, may like the muscular appearance they get when they take the drugs.

Designer steroids

A particularly dangerous class of anabolic steroids are the so-called designer drugs — synthetic steroids that have been illicitly created to be undetectable by current drug tests. They are made specifically for athletes and have no approved medical use. Because of this, they haven’t been tested or approved by the Food and Drug Administration (FDA) and represent a particular health threat to athletes.

Risks

Many athletes take anabolic steroids at doses that are much higher than those prescribed for medical reasons. Anabolic steroids have serious physical side effects.

Men may develop:

  • Prominent breasts
  • Shrunken testicles
  • Infertility
  • Prostate gland enlargement

Women may develop:

  • A deeper voice, which may be irreversible
  • An enlarged clitoris, which may be irreversible
  • Increased body hair
  • Baldness, which may be irreversible
  • Infrequent or absent periods

Both men and women might experience:

  • Severe acne
  • Increased risk of tendinitis and tendon rupture
  • Liver abnormalities and tumors
  • Increased low-density lipoprotein (LDL) cholesterol (the “bad” cholesterol)
  • Decreased high-density lipoprotein (HDL) cholesterol (the “good” cholesterol
  • High blood pressure (hypertension)
  • Heart and blood circulation problems
  • Aggressive behaviors, rage or violence
  • Psychiatric disorders, such as depression
  • Drug dependence
  • Infections or diseases such as HIV or hepatitis if you’re injecting the drugs
  • Inhibited growth and development, and risk of future health problems in teenagers

Taking anabolic-androgenic steroids to enhance athletic performance is prohibited by most sports organizations — and it’s illegal. In the past 20 years, more-effective law enforcement in the United States has pushed much of the illegal steroid industry into the black market.

This poses additional health risks because the drugs are either made in other countries and smuggled in or made in clandestine labs in the United States. Either way, they aren’t subject to government safety standards and could be impure or mislabeled.

Androstenedione

What is it?

Androstenedione (andro) is a hormone produced by the adrenal glands, ovaries and testes. It’s a hormone that’s normally converted to testosterone and a form of estrogen (estradiol) in both men and women.

Andro is available legally only by prescription and is a controlled substance. Its use as a performance-enhancing drug is illegal in the United States.

Manufacturers and bodybuilding magazines tout andro’s ability to allow athletes to train harder and recover more quickly. Scientific studies that refute these claims show that supplemental androstenedione doesn’t increase testosterone and that your muscles don’t get stronger with andro use.

Risks

Side effects of andro in men include:

  • Acne
  • Diminished sperm production
  • Shrinking of the testicles
  • Enlargement of the breasts

In women, side effects include:

  • Acne
  • Masculinization, such as deepening of the voice and male-pattern baldness

In both men and women, andro can damage the heart and blood vessels, increasing the risk of heart attack and stroke.

Human growth hormone

What is it?

Human growth hormone is a hormone that has an anabolic effect. Athletes take it to improve muscle mass and performance. However, it hasn’t been shown conclusively to improve either strength or endurance.

Human growth hormone is available only by prescription and is administered by injection.

Risks

Adverse effects related to human growth hormone range in severity and may include:

  • Joint pain
  • Muscle weakness
  • Fluid retention
  • Diabetes
  • Vision problems
  • Carpal tunnel syndrome
  • Impaired glucose regulation
  • Enlarged heart (cardiomegaly)
  • High blood pressure (hypertension)

Erythropoietin

What is it?

Erythropoietin is a type of hormone used to treat anemia in people with severe kidney disease. It increases production of red blood cells and hemoglobin — the protein that carries oxygen to your body’s organs.

Taking erythropoietin improves the movement of oxygen to the muscles. Epoetin, a synthetic form of erythropoietin, is commonly used by endurance athletes.

Risks

Erythropoietin use among competitive cyclists was common in the 1990s and allegedly contributed to at least 18 deaths. Inappropriate use of erythropoietin may increase the risk of stroke, heart attack and blockage in an artery in the lung (pulmonary embolism).

Diuretics

What are they?

Diuretics are drugs that change your body’s natural balance of fluids and salts (electrolytes), which can lead to dehydration. This loss of water can decrease an athlete’s weight, which many athletes prefer. Diuretics may also help athletes pass drug tests by diluting their urine and are sometimes referred to as a “masking” agent.

Risks

Diuretics taken at any dose, even medically recommended doses, predispose athletes to adverse effects such as:

  • Dehydration
  • Muscle cramps
  • Dizziness
  • Potassium deficiency
  • Drop in blood pressure
  • Loss of coordination and balance
  • Death

Creatine

What is it?

Many athletes take nutritional supplements instead of or in addition to performance-enhancing drugs. Supplements are available over-the-counter as powders or pills. Creatine monohydrate is a supplement that’s popular among athletes.

Creatine is a naturally occurring compound produced by your body that helps your muscles release energy. Scientific research indicates that creatine may have some athletic benefit by producing small gains in short-term bursts of power.

Creatine appears to help muscles make more adenosine triphosphate (ATP), which stores and transports energy in cells, and is used for quick bursts of activity, such as weightlifting or sprinting. But there’s no evidence that creatine enhances performance in aerobic or endurance sports.

Risks

Possible side effects of creatine that can decrease athletic performance include:

  • Stomach cramps
  • Muscle cramps
  • Weight gain

Weight gain is sought by athletes who want to increase their size. But with prolonged creatine use, weight gain is more likely the result of water retention than an increase in muscle mass. Water is drawn into your muscle tissue, away from other parts of your body, putting you at risk of dehydration.

It appears safe for adults to use creatine at the doses recommended by manufacturers. But there are no studies investigating the long-term benefits and risks of creatine supplementation.

Stimulants

What are they?

Some athletes use stimulants to stimulate the central nervous system and increase heart rate and blood pressure.

Stimulants can:

  • Improve endurance
  • Reduce fatigue
  • Suppress appetite
  • Increase alertness and aggressiveness

Common stimulants include caffeine and amphetamines. Cold remedies often contain the stimulants ephedrine or pseudoephedrine hydrochloride.

Energy drinks, which are popular among many athletes, often contain high doses of caffeine and other stimulants. The street drugs cocaine and methamphetamine also are stimulants.

Risks

Although stimulants can boost physical performance and promote aggressiveness on the field, they have side effects that can impair athletic performance, including:

  • Nervousness and irritability, which make it hard to concentrate on the game
  • Insomnia, which can prevent an athlete from getting needed sleep
  • Dehydration
  • Heatstroke
  • Addiction or tolerance, meaning that athletes need greater amounts to achieve the desired effect, so they’ll take doses that are much higher than the intended medical dose

Other side effects include:

  • Heart palpitations
  • Heart rhythm abnormalities
  • Weight loss
  • Tremors
  • Mild high blood pressure (hypertension)
  • Hallucinations
  • Stroke
  • Heart attack and other circulatory problems

The bottom line

Do performance-enhancing drugs boost performance? Some athletes may appear to achieve physical gains from such drugs, but at what cost?

The long-term effects of performance-enhancing drugs haven’t been rigorously studied. And short-term benefits are tempered by many risks. Not to mention that doping is prohibited by most sports organizations.

No matter how you look at it, using performance-enhancing drugs is risky business.


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