Anabolic steroids, technically called anabolic-androgenic steroids, are a group of drugs first made in the 1930s. They have similar effects to testosterone in the body. Widely associated with body building and cheating in sports, they have other uses, as well as a number of harmful side effects.
Steroids can be taken in the form of pills, injections, creams or patches. While oral consumption of pills is the most convenient, it is not always the most effective, as large proportions of some steroids will not make it into the body when taken this way.
Injected steroids usually go into the muscle rather than straight into the bloodstream as with many other drugs. This is to avoid sudden changes in the amount of the drug in the bloodstream, and to remove a risk of blood clotting.
Patches and gels can deliver a steady does into the bloodstream, but absorption can be inefficient. If the person using the steroid gets a lot of exercise or washes often then much of the steroid may be washed off before it is absorbed. These also create a risk of transferring the steroid to other people.
Steroids increase the protein in cells, especially in skeletal muscles – the muscles attached to our bones which we voluntarily control. Protein allows the human body to repair and grow, and so is central to the beneficial effects of steroids.
Steroids are used in many ways in medicine – to encourage appetite, bone growth, facilitate puberty in boys and treat cancer and AIDS. They can support weight gain and muscular strength if used together with intensive exercise and a proper diet, and so may help build up body mass and prevent bone loss in lean elderly men, as well as countering growth failure in the young.
Steroids are famous for the health risks they can bring through long-term use or excessively large doses.
Some side effects are primarily cosmetic. Stimulation of the sebaceous glands makes acne common, and the masculinising effects of steroids can accelerate male pattern baldness as well as causing baldness in women.
Other effects include changes in cholesterol levels, with good HDL cholesterol being replaced by bad LDL cholesterol. Liver damage, high blood pressure and changes in the structure of the heart are also possible.
In men, steroids can impede sexual function, reduce fertility and cause the testicles to shrink, while in women effects can include a deeper voice, more body hair, and decreases in menstrual cycles.
While the evidence on the psychiatric effects of steroids is less definitive, there are indications that they can cause aggression, depression and suicide. The potential for physical addiction is currently unclear.
Sports and body building
Steroids are strongly disapproved of in sports, due to their harmful side effects and their image as a way of cheating, gaining an advantage over others that could not have been gained through hard work and skill alone. They are therefore banned by all major sporting bodies. Professional athletes are regularly tested for drug use, and may be banned from their sports if caught with steroids in their system.
As a result, steroid use is mostly limited to non-competitive athletes and body builders, or those concerned with changing their physical appearance. Between one and three million people in the USA are thought to have misused steroids. They are more likely to research the drugs than other drug users, but are unlikely to use reliable sources such as doctors.
Steroid use, and its side effects, are increasingly common. What is less common is awareness of their real impact.
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