Anabolic-androgenic steroids are man-made substances related to male sex hormones. "Anabolic" refers to muscle building, and "androgenic" refers to increased masculine characteristics. "Steroids" refers to the class of drugs.
These drugs are available legally only by prescription, to treat conditions that occur when the body produces abnormally low amounts of testosterone, such as delayed puberty and some types of impotence. They are also prescribed to treat body wasting in patients with AIDS and other diseases that result in loss of lean muscle mass.
These drugs are also being used today by athletes in hopes of gaining weight, strength, power, speed, endurance and aggressiveness. Anabolic steroids are taken orally or injected, typically in cycles of weeks or months (referred to as "cycling"), rather than continuously. Cycling involves taking multiple doses of steroids over a specific period of time, stopping for a period, and starting again. In addition, users often combine several different types of steroids to maximize their effectiveness while minimizing negative effects (referred to as "stacking").
Male hormones, principally testosterone, are partially responsible for the tremendous developmental changes that occur during puberty and adolescence. Male hormones have androgenic and anabolic effects. Androgenic effects are changes in primary and secondary sexual characteristics. These include enlargement of the penis and testes, voice changes, hair growth on the face, underarms and genital areas, and increased aggressiveness. The anabolic effects of androgens include accelerated growth of muscle, bone, and red blood cells, and enhanced neural conduction.
Anabolic steroids have been manufactured to enhance the anabolic properties (tissue building) of the androgens and minimize the androgenic (sex-linked) properties. However, no steroid has eliminated the androgenic effects because the so-called androgenic effects are really anabolic effects in sex-linked tissues. The effects of male hormones on accessory sex glands, genital hair growth, and oiliness of the skin are anabolic processes in those tissues. The steroids with the most potent anabolic effect are also those with the greatest androgenic effect.
Steroid hormones work by stimulation of receptor molecules in muscle cells, which activate specific genes to produce proteins. They also affect the activation rate of enzyme systems involved in protein metabolism, thus enhancing protein synthesis and inhibiting protein degradation (called an anti-catabolic effect).
Many athletes have said that anabolic steroids help them train harder and recover faster. They also said that they had difficulty making progress (or even holding onto the gains) when they were off the drugs. Anabolic steroids may have an anti-catabolic effect. This means that the drugs may prevent muscle catabolism or breakdown that often accompanies intense exercise training.
Anabolic steroids may block the effects of hormones such as cortisol involved in tissue breakdown during and after exercise. Anabolic steroids may prevent tissue from breaking down following of an intense workout. This would speed recovery. Cortisol and related hormones, secreted by the adrenal cortex, also has receptor sites within skeletal muscle cells. Cortisol causes protein breakdown and is secreted during exercise to enhance the use of proteins for fuel and to suppress inflammation that accompanies tissue injury.
Anabolic steroids may block the binding of cortisol to its receptor sites, which would prevent muscle breakdown and enhances recovery. While this is beneficial while the athlete is taking the drug, the effect backfires when he stops taking it. Hormonal adaptations occur in response to the abnormal amount of male hormone present in the athlete's body.
Anabolic steroid use decreases testosterone secretion. People who stop taking steroids are also hampered with less male hormone than usual during the "off" periods. The catabolic effects of cortisol are enhanced when the athlete stops taking the drugs and strength and muscle size are lost at a rapid rate.
The rebound effect of cortisol and its receptors presents people who use anabolic steroids with several serious problems:
(1) psychological addiction is more probable because they become dependent on the drugs. This is because they tend to lose strength and size rapidly when off steroids. To stave off deconditioning, athletes may want to take the drugs for long periods of time to prevent falling behind
(2) Long-term administration increases the chance of serious side effects.
(3) Cortisol suppresses the immune system. This makes steroid users more prone to diseases, such as cold and flu, during the period immediately following steroid administration.
The side effects of anabolic steroids can be quite harmful and can include liver tumors and cancer, jaundice (yellowish pigmentation of skin, tissues, and body fluids), fluid retention, high blood pressure, increases in LDL (bad cholesterol), and decreases in HDL (good cholesterol). Other side effects include kidney tumors, severe acne and trembling.
In addition, there are some gender-specific side effects:
In men they can cause shrinking of the testicles, reduced sperm count, infertility, baldness, development of breasts, increased risk for prostate cancer.
In women steroids can result in growth of facial hair, male-pattern baldness, changes in or cessation of the menstrual cycle, enlargement of the clitoris, deepened voice.
Steroid use is even more dangerous for adolescents. They can cause growth to be halted prematurely through premature skeletal maturation and accelerated puberty changes. This means that adolescents risk remaining short for the remainder of their lives if they take anabolic steroids before the typical adolescent growth spurt.
In addition, people who inject anabolic steroids run the added risk of contracting or transmitting HIV/AIDS or hepatitis, which causes serious damage to the liver.
Besides the physical side effects, there are also psychological effects from steroid abuse. Many users report feeling good about themselves while on anabolic steroids, but researchers report that extreme mood swings also can occur, including manic-like symptoms leading to violence. Depression often is seen when the drugs are stopped and may contribute to dependence on anabolic steroids. Researchers report also that users may suffer from paranoid jealousy, extreme irritability, delusions and impaired judgment stemming from feelings of invincibility.