Anabolic-androgenic steroids (AAS) are synthetic substances related to testosterone, the naturally occurring male sex hormone. The term “anabolic” denotes their ability to promote tissue building, primarily muscle growth, while “androgenic” refers to their role in developing and maintaining male characteristics. AAS are distinct from other types of steroids and have both legitimate medical applications and significant potential for misuse.
Understanding Anabolic Androgenic Steroids
It is important to differentiate anabolic-androgenic steroids from other steroid types, particularly corticosteroids. Corticosteroids, like prednisone, are manufactured drugs that resemble cortisol, a hormone produced by the adrenal glands. Their primary medical application involves reducing inflammation and suppressing immune system activity, which is useful for conditions such as asthma or autoimmune diseases. Unlike AAS, corticosteroids do not promote muscle growth; instead, they bind to glucocorticoid receptors, leading to different physiological responses.
How AAS Affect the Body
Anabolic-androgenic steroids exert their effects by interacting with androgen receptors located within cells throughout the body, including muscle and bone tissues. Once an AAS molecule binds to an androgen receptor, this complex then moves into the cell nucleus. Inside the nucleus, it influences gene expression, leading to increased protein synthesis and, consequently, enhanced muscle growth.
AAS also contribute to androgenic effects. While the anabolic effects are often sought by individuals for physical enhancement, the androgenic effects are an inherent part of their action. Those who misuse AAS typically do so to achieve rapid increases in muscle mass and strength. They also aim for reduced recovery times after intense physical exertion, which allows for more frequent and strenuous training sessions.
Health Risks Associated with AAS Use
The non-medical use of anabolic-androgenic steroids carries a wide array of adverse health consequences, affecting multiple bodily systems. Cardiovascular issues are a significant concern, encompassing potential heart damage, elevated blood pressure, and harmful alterations in cholesterol levels, specifically increasing low-density lipoprotein (LDL) and decreasing high-density lipoprotein (HDL). These changes can heighten the risk of serious events like myocardial infarction and strokes.
Liver damage is another recognized risk, particularly with oral forms of AAS. This can manifest as peliosis hepatis, a condition characterized by blood-filled cysts in the liver, or even the development of liver tumors. Hormonal imbalances are common, leading to conditions such as testicular atrophy and gynecomastia (breast tissue development) in men. In women, AAS use can induce virilization, presenting as increased body hair, a deepened voice, and menstrual irregularities, some of which may be irreversible.
Dermatological problems frequently arise, including severe acne and oily skin. Psychological effects are also a concern, ranging from increased aggression and mood swings to episodes of depression.
Legal Status and Misuse
Anabolic-androgenic steroids are classified as controlled substances in many countries due to their potential for abuse and associated health risks. In the United States, for instance, AAS are designated as Schedule III controlled substances under the Anabolic Steroids Control Act of 1990, which was further revised in 2004. This classification signifies that non-medical possession, distribution, and use of these compounds are illegal.
The legal framework aims to prevent the widespread misuse of AAS, distinguishing it from legitimate medical prescriptions for conditions like hypogonadism or muscle wasting diseases. Despite legal restrictions, a significant black market exists for acquiring these substances outside of medical channels. Individuals often obtain AAS through illicit means, circumventing prescription requirements and medical oversight.