Risks and Benefits Associated with Steroids
by ACE Physical Therapy and Sports Medicine Institute

Steroids. The word may immediately bring to mind athletes who have been caught using illegal doping to enhance their performance. While some athletes have used illegal steroids to achieve temporary success, they have also taken risks that could cause permanent harm. Steroids can play a positive part of an overall medical treatment, but they can also be abused for short-term rewards.

Types of Steroids

There are two types of steroids: corticosteroids and anabolic steroids. Healthcare professionals prescribe corticosteroids to control inflammation.  This type of steroid is catabolic and reduces the size of the tissues.  Anabolic steroids enhance the size of the tissues of the body, thus they are sometimes referred to as “performance-enhancing drugs” (PEDs).  They work best on tissues that are high in protein; therefore muscle is affected as much or more than any other type of body tissue.

PEDs are a popular topic in the news, and the effects of the drugs are well documented.  The most commonly referenced PED is an anabolic steroid. If taken without a prescription, these drugs are illegal (though they are readily available in most areas of the world).  PEDs are expensive and when taken without proper medical oversight, they are usually taken in significantly larger doses than a prescription dosage, causing a profound effect on the human body.

Made from synthetic materials, PEDs are designed to simulate the effects of the body’s “natural steroid”: Testosterone.  A potent hormone, testosterone stimulates development of muscle and lean body mass as well as giving the body the male (androgenic) characteristics such as a deep voice and facial hair.

How Anabolic Steroids Increase Strength

Anabolic steroids aid the production of muscle tissues by increasing the rate of protein synthesis within the cells.  Since muscle tissues are primarily protein, this increase in protein synthesis helps to reduce the “break down” of the existing muscle tissue following a hard workout. Muscle development requires the “over-load” principle. This is primarily adding a great deal of resistance to the muscle during a workout. The actual process development is debatable: whether the muscle cells hypertrophy (each individual cell gets larger) or hyperplasia (dividing of muscle cells – creating a larger total number of cells) or both. It is agreed that anabolic steroids stimulate the process of muscle development.  Larger muscle mass and size can usually be correlated to a greater ability to generate force and power.  In other words, anabolic steroids can help increase muscle mass and size and that means more strength.

Medical Use of Anabolic Steroids

Medical use of Anabolic Steroids has been prescribed for the past 50+ years.  Anabolic steroids have proven to be very helpful in the treatment of certain conditions.  They have helped stimulate bone growth and male puberty in patients fighting a chronic disease (cancer and AIDS) with a side effect of muscle wasting. Prescribed dosages usually range from 2mg to 400mg per day.  Very seldom are more than one steroid prescribed to be taken at the same time in the medical world.  Conversely, many athletes and body builders take up to 2000 mg per day and often times take multiple types of steroids at the same time.

Side Effects of Anabolic Steroids

There are some short-term side effects of taking these steroids including acne, excess hair growth, deepening of the patient’s voice, and musculoskeletal injuries (primarily tendon and musculotendinous junction strains/ruptures).  Long-term and more severe side effects include a higher risk of developing certain types of cancer, heart and liver disease, fluid retention, reduction of the HDL (“good cholesterol”), high blood pressure, increased risk of atherosclerosis, and developing sleep apnea.   Men might experience a lower sperm count, testicular atrophy, baldness, infertility, and breast development.  Women might encounter enlargement of the clitoris, changes in body shape, facial hair, deeper voice, infertility and abnormal menstrual cycles.  These long-term changes can be permanent.

Illegal Use of Anabolic Steroids

Using anabolic steroids is illegal if not prescribed by a doctor.  In the world of sports, they are illegal even if prescribed by a doctor due to their performance enhancement capabilities.  Drug testing is done in almost every sport played throughout the world.  Some unethical athletes go to great lengths to hide their use of these drugs.  They feel that the enhanced physical capabilities can increase their performance on the playing field and lead to personal success.  This athletic success can be parlayed into personal gains including large financial gains.  Unfortunately, athletes face physical risks, legal risks, and career-ending reputation risks. Plus for many of these athletes the successes never pan out.

In recent years, adolescents wanting to increase performance have increased their use of Anabolic Steroids.  Although most studies indicate that the use among these children is less than 3 percent, the total usage has doubled in recent years.  Many young athletes want to attempt to maximize their potential and develop their bodies to better prepare themselves for higher-level competition.  Some adolescents use PEDs to improve their body image.  By losing fat and gaining lean body mass, they develop a body that they feel is more appealing.

Illegal PEDs Pose Dangerous Risks for Youth

Unfortunately, the use of steroids in adolescents can be deadly.  Incidents of suicide and attempted suicides are being studied to uncover a link between the use of steroids and suicide.  Psychological effects of steroid use are documented as increased aggression “Roid Rage,” manic behavior and depression when the drug is no longer taken.  Physical side effects in adolescents can be drastic.  These drugs can stunt growth, increase puberty changes, develop severe acne, body and facial hair (devastating to a young girl!), deep voice, disruption of the menstrual cycle, and possibly permanent infertility.

The use of Anabolic Steroids as a PED coupled with taking a protein supplement and performing an aggressive resistance-training program can significantly increase lean body mass.  This regimen is regularly linked to extraordinary sports performances throughout the world of sports.  There are very few sports that have not had some kind of PED scandal.  Fortunately, most people attempt to compete in an honest, legal way, placing competitions on a “level playing field.”  There are and always will be a few dishonest participants who use PEDs in an attempt to gain an illegal personal advantage.  The future of sports will be marred if this is allowed to continue.  More stringent testing criteria and vigilant enforcement of the law will reduce and hopefully eliminate the use of PEDs in the future.