Anabolic steroid abuse has been associated with a wide range of adverse side effects ranging from the physically unattractive to others that are life threatening, Some of these effects range from acne and breast development in men to heart attacks and liver cancer. Many are reversible if the abuser stops taking drugs, but some are permanent, for example voice deepening in female abusers.
Most data on the long term effects of anabolic steroids in humans come from case reports rather than formal epidemiological studies. From the case reports, the incidence of life threatening effects appears to be low, but serious adverse effects may be under recognized and underreported, especially since they may occur years later. Data from animal studies seems to support this possibility. One study determined that exposing male mice to steroid doses, comparable to those taken by human athletes, for one-fifth of their lifespan caused a high rate of early deaths.
Long term consequences of anabolic steroid use include, but are not limited to, the following indicators; by gender and systems:
Hormonal: Men
- Infertility
- Breast Development
- Shrinking of the Testicles
- Male-Pattern Baldness
Hormonal: Women
- Enlargement of the Clitoris
- Excessive Growth of Body Hair
- Male-Pattern Baldness
Steroid abuse disrupts the normal reduction of hormones in the body, causing both reversible and irreversible changes. Changes that can be reversed include reduced sperm production and shrinking of the testicles, known as testicular atrophy. Irreversible changes include male-pattern baldness and breast development in men, known as gynecommastia.
In the female body, anabolic steroids cause masculininization. Breast size and body fat decrease, the skin becomes coarse, the clitoris enlarges, and the voice deepens. Women may also experience excessive growth of body hair or loss of scalp hair. With continued administration of steroids, these effects become irreversible.
Musculoskeletal:
- Short Stature (if taken by adolescents)
- Tendon Rupture
Cardiovascular System:
- Increases in LDL
- Decreases in HDL
- High Blood Pressure
- Heart Attacks
- Enlargement of the heart’s left ventricle
Rising levels of testosterone and other sex hormones normally trigger the growth spurt that occurs during puberty and adolescences and provide the signal to stop growth as well. When a child or adolescent takes anabolic steroids, the resulting artificially high sex hormone levels can prematurely signal the bones to stop growing.
Steroid abuse has been associated with cardiovascular diseases (CVD) including heart attacks and strokes, even in athletes younger than 30 years of age. Steroids contribute to the development of CVD by changing the levels of lipoproteins that carry cholesterol in the blood. Steroids, particularly those taken orally, increase the level of low-density lipoprotein (LDL). High LDL and low HDL levels increase the risk of atherosclerosis, a condition in which fatty substances are deposited inside arteries and disrupt blood flow. This can result in a heart attack by compromising the blood flow to the heart. If blood is prevented from reaching the brain, the result can be a stroke. In addition, steroids can also increase the risk that blood clots will form in blood vessels, potentially disrupting blood flow and damaging heart muscles reducing its efficiency.
Liver:
- Cancer
- Peliosis hepatitis
- Tumors
Skin:
- Severe acne and cysts
- Jaundice and oily scalp
- Fluid Rentention
Steroid abuse has been associated with liver tumors and a rare condition called Peliosis Hepatitis. This condition causes blood-filled cysts to form in the liver. Both the tumors and the cysts can rupture causing internal bleeding.
Steroid abuse can cause acne, cysts and oily hair in addition to jaundice.
Infection:
Abusers who inject anabolic steroids may use nonsterile injection techniques or share contaminated needles with other abusers. In addition, some steroid preparations are manufactured illegally under non-sterile conditions. These factors put abusers at risk for acquiring life threatening viral infections, such as HIV and Hepatitis B and C. Abusers can also develop endocarditis which is a bacterial infection that causes a potentially fatal inflammation of the inner lining of the hearts. Bacterial infections are also known to cause pain and abscess formation at injection sites.
Psychiatric Effects:
- Rage, Aggression
- Mania
- Depression
There are case reports and small studies that indicate that anabolic steroids, when used in high doses, increase irritability and aggression. Some steroid abusers report that they have committed aggressive acts, such as physical fighting or armed robbery, theft, vandalism, or burglary under the effects of steroids. Abusers who have committed aggressive acts or property crimes generally report that they engage in these behaviors more often when they take steroids than when they are drug free. A recent study suggests that the mood and behavioral effects seen during anabolic-androgenic steroid abuse may result from secondary hormonal changes.
Scientists have attempted to test the association between anabolic steroids and aggression by administering high steroid doses or placebos for several days or weeks to human volunteers and then asking people to report on their behavioral symptoms. To date, four such studies have been conducted. In three, high doses did produce greater feelings of irritability and aggression than did the placebo, although the effects appear to be highly variable.
One possible explanation for the varying results is that some, but not all, steroids increase irritability and aggression. In a few controlled studies, aggression or adverse, overt behaviors resulting form the use of anabolic steroids has been reported.
The extent to which steroid abuse contributes to violence and behavioral disorders is unknown, As with health complications of steroid use, the prevalence of extreme cases of violence and behavioral disorders seems to be low, but simply may not be recognized or reported. There is also some indication that abusers may turn to other types of drugs to alleviate some of the negative symptoms of anabolic steroids.
