II. Mechanism
- Anabolic Steroids are Testosterone derivatives
- Performance enhancing drugs that that increase muscle Protein synthesis
- Short term effects: Increased strength and increased Lean Body Mass
III. Epidemiology
- Banned by most athletic organizations (NCAA, IOC)
- DEA Controlled Substance (Schedule III)
- Black market sales: $2 Million per year in U.S.
-
Prevalence of Anabolic Steroid use
- Buckley (1988) 6.6% High School (38% before age 15)
- Tennant (1986): 75% of NFL lineman
- Rumor (1996) 95% of NFL Lineman
IV. Indications: Medical
- Anemia
- Burn victims
- Growth Hormone Replacement
V. Efficacy
- Athletes dose 10 to 40 times higher than medical dose
- Effective in strength gain (short-term)
- Rapid strength and anaerobic power gain
- Rapid gain in lean Muscle mass and weight
- Maintenance of competitive edge
- Benefit only with Resistance Training program
VI. Adverse Effects: General
- Associated with premature death (esp. from Suicide, Myocardial Infarction)
- Tendon ruptures from dysplastic Collagen changes
- Adolescents
- Early closing of bone Growth Plates
- Decreased adult height
- Cardiovascular changes
- Hypertension
- Acute Cardiovascular events (Platelet aggregation)
- Stroke
- Myocardial Infarction
- Hypercholesterolemia with marked HDL drop (<10)
-
Liver disease
- Increased liver Aminotransferases
- Hepatic failure
- Peliosis (rare hemorrhagic Liver Cysts)
- Hepatocellular Carcinoma
- Hepatic Adenoma
- Hepatic cholangiocarcinoma
- Psychiatric: Steroid Psychosis ('Steroid Rage')
VII. Adverse Effects: Sexual Effects
- Libido changes
- Severe Cystic Acne
- Specific changes in men (may be irreversible)
- Decreased sperm production
- Testicular atrophy
- Scrotal Pain
- Gynecomastia (potentially irreversible)
- Prostate Cancer increased risk
- Specific changes in women
- Voice deepening (irreversible)
- Hirsutism (potentially irreversible)
- Acne Vulgaris
- Clitoral hypertrophy (potentially irreversible)
- Amenorrhea
- Male-pattern baldness
- Coarsening of skin (potentially irreversible)