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The Sport Digest - ISSN: 1558-6448

Physical, Psycological and Performance Effects on Anabolic Androgenic Steriods

Athletics are about competition and being the best one can be. When that desire is taken too far, athletes may feel the need to use performance enhancers to get the added edge. This abuse has dated back for centuries, and was not prohibited until 1974. A diverse group of individuals, both athletes and non-athletes, have abused anabolic-androgenic steroids (AAS). In the challenge to alter their bodies and improve their performances, men and women experience a number of physical and psychological effects, along with varying effects on body systems of the two sexes.

AAS, most simply put, are a synthetic version of the natural male hormone testosterone. These man-made versions are very powerful, and have been shown to improve the abilities of the abusing athletes. They are mostly known for their muscle building qualities which occur due to the increased rate of protein synthesis with in cells (“Anabolic Steroids”, n.d.). While huge gains may be achieved, the number and intensity of side effects increases greatly with AAS abuse (Graham, Evans, Davies, & Baker, 2008). Physical and mental side effects plague chronic users. It has been reported from random surveying that 99% of AAS users have experienced side effects (Fitch, 2008). This disturbing statistic makes it difficult to understand why one would want to guarantee themselves a problem or side effect with their body. The answer lies in the determination to change oneself and the reckless abandonment people will go through to achieve their ideal body image. A profile of AAS abusers, physical and psychological effects of use will be discussed.

AAS Abusers

It seems that no social group is stranger to AAS abuse. Most striking is that anabolic steroids are not just for adult males anymore. Male or female, adolescent or adult, any race, all of these groups have members abusing AAS. In the past the media has thrown male AAS use, especially among elite athletes, into the public spotlight. Media attention has recently turned to AAS use by a new, more disturbing group junior high and high school aged children (Clark et al., 2006). In the past, accurate numbers of users were hard to obtain because no one wanted to admit to using, but with the help of systematic and anonymous surveys, more accurate data has been collected (Yesalis & Bahrke, 1995). More specifically Clark et al estimated that 0.5 to 0.8 million teenagers are AAS abusers and teenage girls represented the fastest growing group of AAS abusers. Where many abusers see the increases in their body’s size and decrease in fat as a positive, they often look over the negative physical things happening to their bodies. The adolescent users, many of which are not athletes, disregard the physiological and psychological effects in hopes to correct what they see as a problem or flaw with their bodies.

Generally there seems to be two reasons that individuals abuse AAS. One is to change one’s body and the other is to improve performance levels. In any sense men and women abuse AAS to reach either of these desired goals. It seems that even with the threat of side effects, even fatal effects, nothing will stop these users. Although the occurrence of serious side effects is low, they are still prevalent (Yesalis & Bahrke, 1995). AAS drug use is sometimes downplayed when its side effects are compared to those more socially accepted drugs of alcohol and tobacco (Graham et al., 2008). With advances in studies, there is a great deal of information detailing the short term effect of taking these powerful steroids. Where the void lies is information pertaining to long term effects.

Physical Effects of AAS Abuse

The Drug Enforcement Agency has named 21 parent compounds and at least 60 chemically distinct AAS. This identification of chemical differences allows the different AAS to affect humans differently in terms of metabolism and physiology (Clark et al., 2006). The synthetic testosterones purpose to be used pharmacologically as a tissue builder with negligible masculinity effects, has been abused so that even without the burden of exercise, individuals can increase their physical size with the help of AAS. This cosmetic effect has been sought after for athletes and non athletes alike. As for the athletic side, this proves to be a huge advantage in many competitions despite the side effects. Fitch (2008) showed that a user can achieve increased muscle size and strength without exercise, although exercise along with AAS increases the amount of arm and leg strength as compared with no exercise. This same study also showed an increase in lean body mass and a reduction in fat mass on the athlete’s body (Fitch). While on AAS a competitor can train harder and more aggressively and is able to recover more quickly from hard training sessions than those athletes not on steroids. Along with that, there is also a decrease in recovery time after a hard competition (Fitch, 2008).

The desire to be the biggest and strongest is an obsession with many athletes. This is especially seen in male athletes, but the trend for females is ever increasing. Graham et al. (2008) reported that the gains in muscle mass from resistance training alone are less than the increase in mass and strength with the aid of AAS. These potential benefits come at a high risk. It has been stated that negative side effects and their severity are directly related to the dosage, duration of use, and the type of steroid taken (Sutton, n.d.). There are generally a list of side effects that affect both men and women. This general list includes increase in weight, oiliness of the hair and skin, cysts, high cholesterol and blood pressure, heightened sex drive, acne, shaking, stretch marks, water retentions, liver damage, cancer, depression, kidney disease, HIV/AIDS, and heart complications (“San Diego County Rehabilitation Center”, 2007).

The cardiovascular system is greatly affected for both men and women. AAS use causes many problems for the cardiovascular system, such as heart disease, hypertension or high blood pressure, changes in the myocardium which is a layer of the hearts wall, arterial blockages, blood clots, heart attacks, and in general just damage to the heart (Sutton, n.d.). With muscles rapidly growing, it is hard for the body’s connective tissues to keep up. This can result in the tearing of ligaments and tendons. When speaking in more specific side effects as they relate to the genders there are some differences. Women experience many of the same physical changes in muscle mass and loss of body fat as men, yet they experience some key physical side effects specific to women. The first can be seen in reproductive changes. There have been few studies involving women but it is accepted that AAS effects on sexual and reproductive behaviors are proposed to be greater in women than in men. When on steroids, women’s’ bodies will start to become more masculine. This is called virilization. When this occurs, women will lose their curves, their voice deepens, breasts shrink, large amounts of acne develop, and an excess amount of hair can grow on the face, chest or the back. Chances are that some of these new male traits are irreversible. The irreversibility is also dependent on how much and for how long AAS were used. Some additional negative side effects include insomnia, nose bleeds, bad breath, achy joints, enlarged clitoris, and muscle cramps (Sutton, n.d.). Along with the increase in effects, the damage and changes made to adolescents, especially young girls, may be permanent (Clark et al., 2006). Without any hard backed evidence it is only proposed that the effects of AAS differ with sex and age in terms of effects on the brain. There have been some studies that used rats to research the effects of AAS on the female reproductive and central nervous system (Clark et al.). In a study using rats, it was found that AAS causes early pubertal onset and sexual receptivity, along with chronic and acute effects on the brains neural signaling receptors (Clark et al.).

In addition to the central nervous system issues, other internal systems may be affected by AAS. Women’s immune systems are also at risk when hormone levels are constantly fluctuating as they are when on AAS (Sutton, n.d.). When immune systems are low, it is very easy to become infected with infectious diseases. A study was conducted and it was reported that the use of anabolic steroids might inhibit the immunomodulatory and antiviral activities of androgens in the body, or they may cause the prevention of antibodies when an individual is sick (Sutton). Women’s reproductive cycle is also greatly affected. Due to the decline in estrogen and progesterone, the menstrual cycle can become irregular or disappear all together. The condition in which it disappears is called amenorrhea. This can also lead to infertility or cervical cancer in particular. In Sutton’s paper, when referring to the effects on women, she stated, “In summary, taking anabolic steroids increases a woman’s risk of cardiovascular disease, liver disease and cancer, kidney disease and cancer, a weakened immune system, osteoporosis, and positive HIV and Hepatitis B and or C from contaminated needles” (p. 5).

Side effects more specific to men include: shrinking of the testicles, reduced sperm count which can lead to infertility, baldness (which also has also been shown to occur in some women who use ASS), and development of breasts (“Steroids”, n.d.). It has also been noted some side effects for males include prostate cancer risk and painful urination. The breast development males encountered was only reversible by cosmetic surgery (San Diego County Rehabilitation Center, 2007).

Psychological Causes and Effects AAS

There are many psychological causes of AAS use. One such example is psychological trauma. Of the 75 female weightlifters studied (Graham et al., 2008), 13% reported taking AAS so that they were able to defend themselves against a male attacker. These women also reported sexual assault in their lives and used AAS abuse as a response and a possible self esteem builder.

There is also a mental disregard for one’s body; especially in regards to the side effects an individual will endure taking AAS (Fitch, 2008). Many people suffer from a condition referred to as “reverse anorexia.” Individuals that have this condition see themselves as weak and small even though they may be very large and muscular (Graham et al., 2008). This distorted body image is a concern that needs professional counseling and should be taken as seriously as anorexia itself. Individuals with reverse anorexia are not only suffering mentally but the physical damage they are doing to their bodies is just as disturbing and detrimental as anorexia itself.

The real root of disorders like anorexia and reverse anorexia are individuals having low self esteem and an unhealthy view of how their body should be. These unrealistic body ideals put those at risk for having a variety of issues such as negative body image, unhealthy eating habits and unhealthy exercise habits. What follows these issues are the resorting of AAS use to counter act their altered body image (Graham et al., 2008).

Studies were done on dedicated women athletes who found that those with substance dependence also displayed co-morbidity or the possession of other disorders (Graham et al., 2008). Fifty six percent of these women, while administering the substance experienced hypomania, and another forty percent had a problem with depression while going through the withdrawal of the substance (Graham et al.). Hypomania, is a mood state characterized by persistent and pervasive elevated or irritable mood, and thoughts and behaviors that are consistent with such a mood state. Many people, especially the media, have described this as “roid rage.” There is also a wide range of disorders that these women displayed that were not so defined before the use of steroids. Some examples are obsessive compulsive disorder, strict dietary routines, nontraditional gender roles, and preoccupation with and an overall dislike of their physique (Graham et al.).

Muscle dysmorphia is a psychiatric disorder in which the affected person is excessively concerned about and preoccupied by an imagined or minor defect in their physical features. This may be one or more things. The psychological stress that an individual may have from this disorder may cause them to have problems at work and problems in their social life to the point where it affects their ability to function properly. A study was done which included the use of 320 individuals, half AAS abusers and the others were controls. This study resulted in the finding that as abuse intensifies and increases so does the severity of the psychiatric side effects (Graham et al., 2008). More specifically in terms of emotions, users of AAS will have a heightened sense of self esteem, feel invincible, suffer from paranoid jealousy, extreme irritability, delusions, altered mental state with impaired judgment branching from their feelings of invincibility (“Steroids”, n.d.).


Improved efforts in prevention and education seem to be the key in combating AAS abuse (Yesalis & Bahrke, 1995). Another important factor is the role pharmacists play in prevention and rehabilitation. They have an obligation to help athletes avoid banned substances and can play a key role in doping control programs to help these athletes (Ambrose, 2004). Also, extensive research needs to be done not only on the long term effects, but the role AAS plays in women’s bodies. It seems that there is a general consensus with most of the literature that the long term effects of steroid use are unknown, although there are some predictions as to what some of those effects may be. Without the statistical data to back these hypotheses up, it is hard to know what is in store for chronic AAS users. Some researchers consider depression, liver damages and cancer as long term effects (“San Diego County Rehabilitation Center”, 2007). The most important aspect though is that these individuals need help and medical attention. The root seems to be the psychological disorders. In conclusion, whether its pressure from society to be the best or one’s own competitive drive to be the best, AAS users are continuing to use at any cost, and experience many positive and negative effects.


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