What are anabolic steroids?

Health Hazards

• For men — shrinking of the testicles, reduced sperm count, infertility, baldness, development of breasts, increased risk for prostate cancer.
  
• For women — growth of facial hair, male-pattern baldness, changes in or cessation of the menstrual cycle, enlargement of the clitoris, deepened voice.
  
• For adolescents — growth halted prematurely through premature skeletal maturation and accelerated puberty changes. This means that adolescents risk remaining short for the remainder of their lives if they take anabolic steroids before the typical adolescent growth spurt.

In addition, people who inject anabolic steroids run the added risk of contracting or transmitting HIV/AIDS or hepatitis, which causes serious damage to the liver.

Scientific research also shows that aggression and other psychiatric side effects may result from abuse of anabolic steroids. Many users report feeling good about themselves while on anabolic steroids, but researchers report that extreme mood swings also can occur, including manic-like symptoms leading to violence. Depression often is seen when the drugs are stopped and may contribute to dependence on anabolic steroids. Researchers report also that users may suffer from paranoid jealousy, extreme irritability, delusions, and impaired judgment stemming from feelings of invincibility. 1

Research also indicates that some users might turn to other drugs to alleviate some of the negative effects of anabolic steroids. For example, a study of 227 men admitted in 1999 to a private treatment center for dependence on heroin or other opioids found that 9.3 percent had abused anabolic steroids before trying any other illicit drug. Of these 9.3 percent, 86 percent first used opioids to counteract insomnia and irritability resulting from the anabolic steroids.

How Anabolic Steroids Work

Male hormones, principally testosterone, are partially responsible for the tremendous developmental changes that occur during puberty and adolescence. Male hormones have androgenic and anabolic effects. Androgenic effects are changes in primary and secondary sexual characteristics. These include enlargement of the penis and testes, voice changes, hair growth on the face, axilla, and genital areas, and increased aggressiveness. The anabolic effects of androgens include accelerated growth of muscle, bone, and red blood cells, and enhanced neural conduction.

Anabolic steroids have been manufactured to enhance the anabolic properties (tissue building) of the androgens and minimize the androgenic (sex-linked) properties. However, no steroid has eliminated the androgenic effects because the so-called androgenic effects are really anabolic effects in sex-linked tissues. The effects of male hormones on accessory sex glands, genital hair growth, and oiliness of the skin are anabolic processes in those tissues. The steroids with the most potent anabolic effect are also those with the greatest androgenic effect.

Steroid Receptors

Steroid hormones work by stimulation of receptor molecules in muscle cells, which activate specific genes to produce proteins (see Figure 1). They also affect the activation rate of enzyme systems involved in protein metabolism, thus enhancing protein synthesis and inhibiting protein degradation (called an anti-catabolic effect).

Heavy resistance training seems to be necessary for anabolic steroids to exert any beneficial effect on physical performance. Most research studies that have demonstrated improved performance with anabolic steroids used experienced weight lifters who were capable of training with heavier weights and producing relatively greater muscle tension during exercise than novice subjects. The effectiveness of anabolic steroids is dependent upon unbound receptor sites in muscle. Intense strength training may increase the number of unbound receptor sites. This would increase the effectiveness of anabolic steroids.

Anti-Catabolic Effects Of Anabolic Steroids

Many athletes have said that anabolic steroids help them train harder and recover faster. They also said that they had difficulty making progress (or even holding onto the gains) when they were off the drugs. Anabolic steroids may have an anti-catabolic effect. This means that the drugs may prevent muscle catabolism that often accompanies intense exercise training. Presently, this hypothesis has not been fully proven.

Anabolic steroids may block the effects of hormones such as cortisol involved in tissue breakdown during and after exercise. Anabolic steroids may prevent tissue from breaking down following of an intense work-out. This would speed recovery. Cortisol and related hormones, secreted by the adrenal cortex, also has receptor sites within skeletal muscle cells. Cortisol causes protein breakdown and is secreted during exercise to enhance the use of proteins for fuel and to suppress inflammation that accompanies tissue injury.

Anabolic steroids may block the binding of cortisol to its receptor sites, which would prevent muscle breakdown and enhances recovery. While this is beneficial while the athlete is taking the drug, the effect backfires when he stops taking it. Hormonal adaptations occur in response to the abnormal amount of male hormone present in the athlete's body. Cortisol receptor sites and cortisol secretion from the adrenal cortex increase.

Anabolic steroid use decreases testosterone secretion. People who stop taking steroids are also hampered with less male hormone than usual during the "off" periods. The catabolic effects of cortisol are enhanced when the athlete stops taking the drugs and strength and muscle size are lost at a rapid rate.

The rebound effect of cortisol and its receptors presents people who use anabolic steroids with several serious problems: (1) psychological addiction is more probable because they become dependent on the drugs. This is because they tend to lose strength and size rapidly when off steroids. To stave off deconditioning, athletes may want to take the drugs for long periods of time to prevent falling behind. (2) Long-term administration increases the chance of serious side-effects. (3) Cortisol suppresses the immune system. This makes steroid users more prone to diseases, such as cold and flu, during the period immediately following steroid administration.

Anabolic Steroids and Performance

The effects of anabolic steroids on physical performance are unclear. Well controlled, double blind studies have rendered conflicting results. In studies showing beneficial effects, body weight increased by an average of about four pounds, lean body weight by about six pounds (fat loss accounts for the discrepancy between gains in lean mass and body weight), bench press increased by about 15 pounds, and squats by about 30 pounds (these values represent the average gains for all studies showing a beneficial effect). Almost all studies have failed to demonstrate a beneficial effect on maximal oxygen consumption or endurance capacity. Anabolic steroid studies have typically lasted six to eight weeks and have usually used relatively untrained subjects.

Most changes in strength during the early part of training are neural: increased strength is mainly due to an improved ability to recruit motor units. Anabolic steroids affect processes associated with protein synthesis in muscle. Studies lasting six weeks (typical study length) would largely reflect neural changes and could easily miss the cellular effects of the drugs.

The gains made by athletes in uncontrolled observations have been much more impressive. Weight gains of thirty or forty pounds, coupled with thirty percent increases in strength, are not unusual. Such case studies lack credibility because of the absence of scientific controls. However, it would be foolish to completely disregard such observations because the "subjects" have been highly trained and motivated athletes.

Source: http://www.nida.nih.gov, http://sportsci.org