Anabolic Steroids: What They Are, Uses, Side Effects and Risks

What are anabolic steroids?

Anabolic steroids are synthetic substances similar to the male sex hormone testosterone. They promote the growth of skeletal muscle and the development of male sexual characteristics. These drugs are medically used to treat conditions like delayed puberty, some types of impotence, and body-wasting in patients with diseases like AIDS. However, anabolic steroids are often misused to enhance athletic performance and physical appearance, leading to potential health risks and side effects. Misuse can cause liver damage, cardiovascular issues, mood swings, and changes in secondary sexual characteristics.

List of anabolic steroids

Here are some common anabolic steroids:

● Testosterone (various forms including cypionate, enanthate, propionate)

● Nandrolone (e.g., nandrolone decanoate, nandrolone phenylpropionate)

● Methandrostenolone (Dianabol)

● Stanozolol (Winstrol)

● Oxandrolone (Anavar)

● Oxymetholone (Anadrol)

● Boldenone undecylenate (Equipoise)

● Trenbolone (various forms including trenbolone acetate, trenbolone enanthate)

● Methenolone (Primobolan)

● Drostanolone (Masteron)

● Fluoxymesterone (Halotestin)

● Chlorodehydromethyltestosterone (Turinabol)

● Mesterolone (Proviron)

These steroids vary in their potency, half-life, and specific medical uses or potential for misuse in performance enhancement.

What is the difference between steroids and anabolic steroids?

The term "steroids" encompasses a broad category of compounds, while "anabolic steroids" are a specific subset within that category. Here's a breakdown of the differences:

Steroids

■ Definition:

Steroids are a large group of organic compounds with a characteristic molecular structure containing four rings of carbon atoms. They include a variety of hormones, vitamins, and drugs.

■ Types:

▪︎ Corticosteroids:

 Used to reduce inflammation and suppress the immune system. Examples include prednisone and cortisone.

▪︎ Sex Hormones:

 Include natural hormones like estrogen, progesterone, and testosterone.
Anabolic Steroids: Synthetic derivatives of testosterone that promote muscle growth and enhance physical performance.

▪︎ Sterol Lipids: 

Such as cholesterol, which are essential components of cell membranes.

Anabolic Steroids

■ Definition: 

Anabolic steroids are synthetic substances similar to the male sex hormone testosterone, specifically designed to promote muscle growth (anabolic effects) and the development of male sexual characteristics (androgenic effects).

■ Uses:

▪︎ Medical: 

Treat conditions like delayed puberty, muscle loss from diseases, and hormone replacement therapy.

▪︎ Non-medical: 

Often misused to enhance athletic performance and physical appearance, leading to potential health risks.

■ Examples: 

Include testosterone, nandrolone, methandrostenolone (Dianabol), stanozolol (Winstrol), and oxandrolone (Anavar).

In summary, while all anabolic steroids are steroids, not all steroids are anabolic steroids. The term "steroids" is broader and includes a variety of hormones and compounds with different functions and uses, whereas anabolic steroids specifically refer to those compounds that mimic the muscle-building effects of testosterone.

What do anabolic steroids treat?

Anabolic steroids are used in medicine to treat a variety of conditions. Here are some of the key uses:

● Delayed Puberty:

 In adolescent boys with delayed puberty, anabolic steroids can help stimulate the development of secondary sexual characteristics.

● Hormone Replacement Therapy:

 For men with low testosterone levels due to conditions such as hypogonadism, anabolic steroids can be used to restore normal hormone levels.

● Muscle Wasting Diseases:

 Conditions like HIV/AIDS and cancer can cause severe muscle wasting. Anabolic steroids can help increase muscle mass and strength in these patients.

● Anemia: 

Certain types of anemia, such as aplastic anemia, can be treated with anabolic steroids, which stimulate the production of red blood cells.

● Chronic Wasting Conditions:

 Patients with chronic conditions that cause significant weight loss and muscle wasting, such as severe chronic obstructive pulmonary disease (COPD) or chronic kidney disease, may benefit from anabolic steroids to help maintain muscle mass.

● Burn Patients:

 In severe burn injuries, anabolic steroids can aid in recovery by promoting muscle growth and reducing protein loss.

● Osteoporosis: 

Anabolic steroids can be used in some cases to help increase bone density and reduce the risk of fractures.

These treatments are typically administered under strict medical supervision due to the potential for significant side effects and complications. Misuse of anabolic steroids outside of these medical indications can lead to serious health risks.

How do anabolic steroids work?

Anabolic steroids work by mimicking the effects of naturally occurring testosterone in the body. Here’s a step-by-step explanation of how they function:

■ Receptor Binding:

 Anabolic steroids enter the bloodstream and bind to androgen receptors in various tissues, such as muscle cells. These receptors are proteins located inside cells that respond to androgens like testosterone.

■ Gene Activation: 

Once bound to the receptor, the steroid-receptor complex enters the cell nucleus and attaches to specific DNA sequences. This interaction activates certain genes that control the synthesis of proteins.

■ Protein Synthesis: 

The activated genes increase the production of proteins, particularly those involved in muscle growth and repair. This process enhances the body's ability to build muscle tissue.

■ Inhibition of Catabolic Processes: 

Anabolic steroids also inhibit the effects of cortisol, a catabolic hormone that breaks down muscle tissue. By reducing the impact of cortisol, anabolic steroids help preserve muscle mass.

■ Increase in Red Blood Cells: 

Anabolic steroids stimulate the production of erythropoietin, a hormone that increases red blood cell production. More red blood cells improve oxygen delivery to muscles, enhancing endurance and performance.

■ Impact on Secondary Sexual Characteristics: 

In addition to anabolic effects, these steroids have androgenic effects, promoting the development of male secondary sexual characteristics such as increased facial hair, deeper voice, and greater muscle mass.

These mechanisms collectively enhance muscle growth, strength, and physical performance, which is why anabolic steroids are sometimes misused by athletes and bodybuilders. However, this can lead to significant health risks, including hormonal imbalances, cardiovascular problems, liver damage, and behavioral changes.

Anabolic steroid misuse

Anabolic steroid misuse refers to the use of these substances without medical supervision, often in doses much higher than those prescribed for medical conditions. This misuse can lead to a range of serious health issues and adverse effects. Here are some key points about anabolic steroid misuse:

Common Reasons for Misuse

● Performance Enhancement:

 Athletes and bodybuilders may use anabolic steroids to increase muscle mass, strength, and endurance.

● Physical Appearance: 

Some individuals use steroids to improve their physique, aiming for increased muscle definition and a more muscular look.

● Competitive Edge:

 In competitive sports, some may use steroids to gain an advantage over opponents.

Health Risks and Side Effects

● Cardiovascular Issues: 

Misuse can lead to high blood pressure, changes in cholesterol levels (increased LDL and decreased HDL), and an increased risk of heart attacks and strokes.

● Liver Damage: 

Oral anabolic steroids can cause liver damage, including liver tumors and a condition known as peliosis hepatis (blood-filled cysts in the liver).

● Hormonal Imbalances:

• Men: 

Reduced sperm production, testicular shrinkage, infertility, development of breasts (gynecomastia), and increased risk of prostate cancer.

• Women: 

Deepened voice, increased body hair, changes in menstrual cycle, and enlargement of the clitoris.

● Psychiatric Effects: 

Mood swings, aggression ("roid rage"), manic behavior, and other mental health issues like depression and anxiety.

● Skin Problems:

 Acne, oily skin, and cysts.

● Musculoskeletal Issues:

 Premature closure of growth plates in adolescents, leading to stunted growth.

● Infections:

 Sharing needles or using non-sterile injection techniques can lead to infections such as HIV/AIDS and hepatitis.

Legal and Ethical Concerns

● Legal Status:

 Anabolic steroids are controlled substances in many countries. Possession, distribution, or use without a prescription is illegal.

● Sports Regulations:

 Many sports organizations have banned the use of anabolic steroids and conduct regular drug testing to enforce these bans.

Signs of Misuse

● Rapid muscle growth or physical changes.

● Behavioral changes such as increased aggression or irritability.

● Physical signs like severe acne, rapid weight gain, and needle marks.

Prevention and Treatment

● Education:

 Increasing awareness about the risks and legal issues associated with steroid misuse.

● Support Services:

 Counseling, support groups, and medical interventions for those struggling with steroid misuse.

● Testing and Enforcement:

 Drug testing in sports and legal enforcement of steroid regulations.

Anabolic steroid misuse poses significant health risks and legal consequences, highlighting the importance of using these substances only under medical supervision and for legitimate medical purposes.

What are the side effects of anabolic steroids?

The side effects of anabolic steroids can be extensive and affect various bodily systems. These effects vary based on dosage, duration of use, and individual susceptibility. Here are the major side effects:

Cardiovascular System

■ Hypertension:

 Increased blood pressure.

■ Lipid Imbalances: 

Elevated LDL (bad cholesterol) and decreased HDL (good cholesterol), increasing the risk of atherosclerosis.

■ Heart Disease:

 Increased risk of heart attacks and strokes.
Cardiomyopathy: Damage to the heart muscle, leading to heart failure.

Liver

■ Hepatotoxicity:

 Liver damage, particularly with oral steroids.

■ Liver Tumors:

 Increased risk of benign and malignant liver tumors.

■ Peliosis Hepatis:

 Formation of blood-filled cysts in the liver.

Endocrine System

■ Hormonal Imbalances:

 Disruption of natural hormone production.

■ Men: 

Testicular atrophy, reduced sperm production, infertility, gynecomastia (development of breast tissue), and increased risk of prostate cancer.

■ Women:

 Menstrual irregularities, deepening of the voice, increased body and facial hair, and clitoral enlargement.

■ Adolescents: 

Premature closure of growth plates, leading to stunted growth.

Skin and Hair

■ Acne and Oily Skin:

 Increased sebaceous gland activity.

■ Hair Loss:

 Accelerated male pattern baldness.

■ Skin Infections:

 Risk of infections from injection sites.

Musculoskeletal System

■ Tendon Damage: 

Increased risk of tendon ruptures due to disproportionate muscle growth.

■ Stunted Growth: 

In adolescents, premature closure of growth plates can permanently stunt growth.

Psychiatric Effects

■ Mood Swings:

 Increased aggression, irritability, and "roid rage."

■ Mental Health Issues:

 Depression, anxiety, and manic behavior.

■ Addiction: 

Psychological dependence and withdrawal symptoms.

Reproductive System

■ Reduced Fertility:

 In both men and women, due to hormonal imbalances.

■ Sexual Dysfunction: 

Decreased libido and erectile dysfunction in men.

Immune System

■ Infections:

 Increased risk of infections due to suppressed immune function and non-sterile injection practices.

General Side Effects

■ Fluid Retention: 

Leading to edema and hypertension.

■ Insomnia: 

Difficulty sleeping.

■ Fatigue:

 General tiredness and lack of energy.

The severity and reversibility of these side effects can depend on the duration of steroid use and the doses taken. In many cases, discontinuing steroid use can lead to the resolution of some side effects, but others may be permanent or require medical treatment.

What are the side effects and complications of anabolic steroid misuse?

Anabolic steroid misuse can lead to a wide range of side effects and complications, some of which can be severe and long-lasting. Here is an overview of the primary side effects and potential complications:

Cardiovascular System

● Hypertension:

 Increased blood pressure can lead to heart disease and strokes.

● Lipid Imbalances:

 Elevated LDL (bad cholesterol) and reduced HDL (good cholesterol) increase the risk of atherosclerosis, which can lead to heart attacks and strokes.

● Cardiomyopathy:

 Damage to the heart muscle, potentially resulting in heart failure.

● Thrombosis:

 Increased risk of blood clots, which can cause deep vein thrombosis (DVT) or pulmonary embolism.

Liver

● Hepatotoxicity:

 Liver damage is particularly common with oral anabolic steroids.

● Liver Tumors:

 Increased risk of benign and malignant liver tumors.

● Peliosis Hepatis:

 Formation of blood-filled cysts in the liver, which can rupture and cause internal bleeding.

Endocrine System

● Hormonal Imbalances: 

Disruption of normal hormone production.

● Men:

 Testicular atrophy, reduced sperm production, infertility, gynecomastia (development of breast tissue), and increased risk of prostate cancer.

● Women:

 Menstrual irregularities, deepening of the voice, increased body and facial hair, clitoral enlargement, and breast shrinkage.

● Adolescents: 

Premature closure of growth plates, leading to stunted growth.

Skin and Hair

● Acne and Oily Skin:

 Increased activity of sebaceous glands.

● Hair Loss: 

Accelerated male pattern baldness.

● Skin Infections: 

Risk of infections from injection sites, including abscesses and cellulitis.

Musculoskeletal System

● Tendon Damage:

 Increased risk of tendon ruptures due to disproportionate muscle growth.

● Stunted Growth:

 In adolescents, premature closure of growth plates can permanently stunt growth.

Psychiatric Effects

● Mood Swings:

 Increased aggression, irritability, and "roid rage."

● Mental Health Issues:

 Depression, anxiety, paranoia, and manic behavior.

● Addiction: 

Psychological dependence and withdrawal symptoms.

Reproductive System

● Reduced Fertility: 

Due to hormonal imbalances in both men and women.

● Sexual Dysfunction: 

Decreased libido and erectile dysfunction in men.

Immune System

● Infections:

 Increased risk of infections due to suppressed immune function and non-sterile injection practices.

● HIV/AIDS and Hepatitis: 

Risk of transmission through shared needles.

General Side Effects

● Fluid Retention:

 Leading to edema and hypertension.

● Insomnia: 

Difficulty sleeping.

● Fatigue:

 General tiredness and lack of energy.

● Metabolic Disturbances:

 Such as insulin resistance and increased risk of type 2 diabetes.

Long-term Complications

● Chronic Heart Disease:

 Ongoing cardiovascular problems due to prolonged misuse.

● Liver Disease:

 Including chronic liver damage and liver cancer.

● Psychiatric Disorders:

 Long-lasting mental health issues, including depression and anxiety.

● Reproductive System Disorders: 

Long-term infertility and sexual dysfunction.

The severity and reversibility of these side effects can vary depending on the duration and dosage of steroid use, as well as the individual's overall health. In some cases, discontinuing steroid use can lead to a resolution of some side effects, but others may be permanent or require medical treatment. Misuse of anabolic steroids is a serious health risk and should be avoided.

Can anabolic steroids be used safely?

Anabolic steroids can be used safely when prescribed and monitored by a healthcare professional for legitimate medical conditions. Here are some guidelines and considerations for the safe use of anabolic steroids:

Medical Supervision

■ Prescription:

 Anabolic steroids should only be used when prescribed by a doctor for specific medical conditions, such as hormone deficiencies, certain types of anemia, severe muscle wasting diseases, and delayed puberty.

■ Monitoring: 

Regular medical monitoring is crucial to check for any adverse effects. This includes blood tests to monitor liver function, cholesterol levels, and hormone levels, as well as regular check-ups to assess overall health.

Appropriate Dosage

■ Dosage: 

Adhering to the prescribed dosage is essential. Misusing or taking higher doses increases the risk of side effects.

■ Duration: 

Steroids should be used for the shortest duration necessary to treat the condition. Prolonged use can lead to more severe side effects.

Understanding Risks

■ Awareness:

 Patients should be informed about the potential side effects and risks associated with anabolic steroids.

■ Side Effect Management:

 Strategies should be in place to manage side effects, such as using medications to counteract specific adverse effects or adjusting the steroid dose.

Avoiding Non-Medical Use

■ Non-Medical Use: 

Using anabolic steroids for bodybuilding, performance enhancement, or cosmetic purposes without medical supervision is unsafe and illegal.

■ Alternatives: 

For those seeking muscle growth or enhanced performance, safer alternatives like proper diet, exercise, and legal supplements should be considered.

Legal Considerations

■ Legality:

 In many countries, anabolic steroids are controlled substances. Possession, distribution, or use without a prescription is illegal.

■ Sports Regulations:

 Athletes should be aware of the regulations of their sport regarding anabolic steroid use.

 Many sports organizations ban these substances and conduct regular drug testing.

Special Populations

■ Adolescents:

 Anabolic steroids should not be used in adolescents for non-medical reasons due to the risk of stunted growth and other developmental issues.

■ Women: 

Special caution is needed due to the risk of virilization (development of male characteristics).

Harm Reduction

■ Injection Safety: 

If steroids are administered via injection, safe and sterile techniques should be used to prevent infections.

■ Medical Advice:

 Users should seek medical advice immediately if they experience any adverse effects or unusual symptoms.

In summary, while anabolic steroids can be used safely under medical supervision for specific health conditions, misuse and non-medical use carry significant risks and should be avoided. Safe use involves adhering to prescribed dosages, regular medical monitoring, and being fully informed about potential side effects.

When should I call my healthcare provider?

You should call your healthcare provider if you are using anabolic steroids and experience any of the following symptoms or side effects:

Cardiovascular Symptoms

● Chest Pain:

 Any pain, pressure, or discomfort in your chest.

● Shortness of Breath: 

Difficulty breathing or feeling breathless.

● Severe Headache: 

A sudden, intense headache, which could indicate high blood pressure or a stroke.

● Palpitations: 

Irregular or rapid heartbeats.

Liver Symptoms

● Jaundice:

 Yellowing of the skin or eyes, indicating liver issues.

● Dark Urine:

 Dark-colored urine or pale stools.

● Abdominal Pain: 

Pain or tenderness in the upper right side of the abdomen.

Endocrine and Reproductive Symptoms

● Testicular Pain or Swelling:

 Pain or noticeable shrinkage of the testicles.

● Menstrual Irregularities: 

Unusual changes in menstrual cycles or severe cramping.

● Sexual Dysfunction:

 Decreased libido, erectile dysfunction, or other sexual issues.

Skin and Hair Symptoms

● Severe Acne:

 Unmanageable or widespread acne, cysts, or skin infections.
Hair Loss: Rapid or excessive hair loss.

● Skin Lesions: 

Unusual lumps, bumps, or sores on the skin.

Musculoskeletal Symptoms

● Joint or Muscle Pain:

 Severe or persistent pain in muscles or joints.

● Tendon Ruptures: 

Sudden pain or a popping sensation in tendons.

Psychiatric Symptoms

● Mood Changes:

 Severe mood swings, increased aggression, irritability, or "roid rage."

● Depression or Anxiety: 

Persistent feelings of sadness, hopelessness, or severe anxiety.

● Paranoia or Delusions:

 Unusual or irrational thoughts and fears.

General Symptoms

● Unexplained Fatigue:

 Persistent tiredness or weakness.

● Swelling:

 Unusual swelling in the legs, feet, or hands (edema).

● Weight Changes: 

Sudden, unexplained weight gain or loss.

Signs of Infection

● Fever:

 High fever or chills, especially if related to injection sites.

● Injection Site Issues: 

Redness, swelling, or pus at the injection site.

Other Concerns

● Persistent Symptoms: 

Any other symptoms that are severe, persistent, or causing concern.

● Withdrawal Symptoms:

 If you have stopped using steroids and are experiencing withdrawal symptoms like fatigue, mood swings, or depression.

It is essential to communicate openly with your healthcare provider about any anabolic steroid use, prescribed or otherwise, so they can provide appropriate care and guidance. Regular check-ups and honest discussions about your health and any substances you are using are crucial for your safety.

Conclusion:

In conclusion, anabolic steroids can be effective medications when used appropriately under medical supervision for treating specific conditions. However, their misuse for non-medical purposes can lead to severe side effects and complications. It's essential to understand the potential risks associated with anabolic steroid use and to prioritize safety.

If you are considering using anabolic steroids, it's crucial to consult with a healthcare professional to discuss the risks and benefits, as well as safer alternatives. Misuse of anabolic steroids is not only illegal but also poses significant health risks, including cardiovascular issues, liver damage, hormonal imbalances, and psychiatric effects.

Remember to always adhere to prescribed dosages, undergo regular medical monitoring, and seek immediate medical attention if you experience any concerning symptoms or side effects. Prioritizing your health and well-being should be the top priority when considering any medication, including anabolic steroids.