The dangers of steroid use and abuse remain well documented in the health science literature yet the demand for these performance enhancing supplements appears as strong as ever. Adolescents as well as competitive athletes feel intense pressure to perform and to fit a certain physical aesthetic ideal.
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As a result, this pressure to meet short term competitive and social needs tends to supersede the long term health risks involved in steroid use and abuse. This paper examines recent literature that details the numerous and dangerous health complications that can result from steroid use and abuse, including multi-organ damage, depression, immune system impairment, stunted growth, and suicide (Tygart, 2009).
CEO of the United States Anti Doping Agency Travis Tygart (2009) devotes most of his time and energy working with youth sports associations as well as competitive athletes to devise educational curricula which can help eliminate the use and abuse of performance-enhancing steroids in amateur and professional athletics (Tygart, 2009).
Tygart’s report stresses the importance of understanding the drive to take steroids in the first place, especially amongst young athletes. Sometimes this pressure originates in the competitive aspect of sports itself, and other times these youth glean pressure from the media, which tends to be overly focused on the importance of physical attractiveness (Tygart, 2009).
Although some side effects from steroids diminish over time, many are in fact often irreversible (Tygart, 2009). Young people face the highest risk as steroid abuse can have an impact on their growth over the course of puberty, and can lead to long-term physical underdevelopment, not to mention a compromised immune system (Tygart, 2009).
Other physical side effects that may endure over the long term include male pattern baldness, liver damage, testicular atrophy, impotence, decline in sperm production, and breast enlargement in males (Tygart, 2009). In females who abuse steroids, the lasting impact can include hair growth on the face, chest, stomach, and back, interruption or utter termination of the menstrual cycle, enlargement of the clitoris, and deepening of the voice (Tygart, 2009).
Steroids also affect users psychologically. Tygart (2009) highlights the prevalence of extreme violent behavioral episodes and uncontrolled rage, often referred to colloquially as “roid rage,” as well as hyper sexuality, both of which can lead to deviant sexual behavior and criminal conduct. Tygart (2009) details the problems faced by youth and competitive athletes once they stop taking steroids, which can include severe depression.
In some instances, former steroid users and abusers will take their own lives (Tygart, 2009). Tygart (2009) also points to subjective reports from former Eastern block athletes who competed during the 1970s and 1980s and now suffer from heart disease, infertility, breast cancer and testicular cancer. Tygart (2009) feels strongly that the media plays a crucial role in its depiction of performance enhancing drugs.
The media still tends to glorify winning at all costs, and touts examples of professional athletes who abused steroids and were able to successfully camouflage the drugs when it came time to pass the anti doping tests (Tygart, 2009). The media can be a valuable ally for the anti doping movement in providing the whole story about the long term health effects of steroid use, and becoming a force for education and ethical fair play in sports (Tygart, 2009).
Samaha et al’s (2008) journal article details the “diverse array of pathologies” that patients who abuse anabolic steroids and similar performance enhancing drugs manifest in later life once the drug cycle has ended. The article reports on one particular case that concerns the grave physiological, psychiatric and physical health complications experienced by a 24 year old male patient, “resulting from the abuse and uncontrolled use of anabolic steroid supplements, mainly testosterone” (Samaha et al, 2008).
The patient was admitted to hospital with abdominal pain, whereupon he reported that he had been taking testosterone intravenously three times per week for eight weeks (Samaha et al, 2008). Doctors found damage had occurred in numerous vital organs, including the liver and pancreas. The patient was then formally admitted for treatment, with an initial diagnosis of “acute pancreatitis, acute renal failure and hypercalcemia” (Samaha et al, 2008).
Samaha et al (2008) explained the multi-organ damage displayed in the patient as hypercalcemia which had happened as a consequence of the anabolic steroid injections he took, as “anabolic steroids modulate steroid hydroxylase activity thereby precipitating hypercalcemia.” Samaha et al (2008) also detail the psychological effects of uncontrolled anabolic steroid use, which can include acute depression, bipolar disorders, and panic attacks.
The authors lament the discrepancy of medical data and dearth of accurate information on these “widely abused drugs,” coupled with the rampant and unrestrained proliferation among amateur and professional athletes and body builders, and highlight the need for a “worldwide collective endeavor to educate both the public and physicians about this issue” (Samaha et al, 2008).
The authors understand that if the trend in steroid abuse continues at its current rate of spread, “medically-supervised withdrawal and…psychiatric support” for those coming off steroids will become a medical imperative (Samaha et al, 2008).
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Graham et al.’s (2008) article in the Sports Medicine journal details the widespread use of anabolic-androgenic steroids, or AAS, as a means to achieve hypertrophy and increase muscle strength in males, both athletes and non-athletes. A particular focus of these researchers was the sport of body building, wherein athletes “are using [anabolic-androgenic steroids] to improve size and cosmetic appearance” (Graham et al, 2008). However, the authors also caution that AAS use is not limited to the bodybuilding sector.
Rather, “the prevalence of AAS use has risen dramatically over the last two decades and filtered into all aspects of society” (Graham et al., 2008). One key issue facing anabolic-androgenic steroid abusers is lack of support once they decide to withdraw from the drugs. The authors note that while support for steroid abusers has increased somewhat, it remains hamstrung by the fact that the “medical profession…will not accept that AAS use dependency is a psychiatric condition” (Graham et al., 2008).
Other problems the researchers detail in anabolic-androgenic steroid abuse, particularly in the body building culture, remains the unbridled practice of self prescription, often by those with little or no pharmaceutical or scientific knowledge of the long term effects of the drugs they self prescribe.
Graham et al. (2008) point to the fact that “polypharmacy by self-prescription is prevalent in this sector …used in sport by individuals who have acquired knowledge of the half-lives of specific drugs and the dosages and cycles required to avoid detection” (Graham et al., 2008).
Given that bodybuilders use anabolic-androgenic steroids in massive doses to gain muscle mass and size, often these athletes are results focused, and have “little or no regard for the consequences” (Graham et al., 2008). Graham et al. (2008) list the numerous dangers implicit in uncontrolled use and abuse of anabolic-androgenic steroids, including reproductive issues such as infertility, testicular degeneration in males, and secondary interference with the menstrual cycle in females.
Adverse side effects will manifest on the basis of dosage, the particular cocktail of steroid or combination of anabolic-androgenic steroids the user ingests, as well as the duration of the abuse itself (Graham et al., 2008). The authors categorize the negative side effects according to the afflicted organ.
The study found affects in all major organs: the brain, the skin, in the form of cystic acne, the liver, which suffers “adenoma, carcinoma, peliosis hepatis, [and] cholestatic jaundice”, the cardiovascular system, which manifests “atrial fibrillation and alteration in lipid profile and arterial structure and function,” and finally the “gonadal systems, including the prostate and testes in males and the ovaries in females” (Graham et al., 2008).
The widespread use of steroids in many sports has become the elephant in the room in recent years. The long term negative health effects of these drugs rarely find the light of day in the media, however, and the medical establishment, according to much of the research covered in this paper, remains ill equipped to effectively treat the physical and psychological impact of steroid abuse (Graham et al., 2008).
Also, the demand for the drugs themselves often stem from a pervasive sense of inadequacy amongst youth and athletes alike. Until the health sciences discover a means to successfully communicative worth and value independent of winning at all costs in sports, young athletes will continue to seek the competitive edge, and cause irreparable harm to their bodies in the interim.
Graham, M.R., et al. (2008). Anabolic steroid use: patterns of use and detection of doping. Sports Medicine 38 (6), 505-525.
Samaha, A. A., et al. (2008). Multi-organ damage induced by anabolic steroid supplements: a case report and literature review. Journal of Medical Case Reports 2 (340), 1-6.
Tygart, T. (2009). Steroids, the media, and youth: a Q&A with Travis Tygart. The Prevention Researcher, 16(S1), 7-9.