Anabolic-androgenic steroids (AAS) are synthetic variations of the male sex hormone testosterone. These substances are distinct from corticosteroids, such as prednisone, which healthcare providers prescribe to manage inflammation. This article explores the significant negative health consequences associated with the non-medical use or misuse of anabolic-androgenic steroids.
Understanding Steroid Misuse
Anabolic-androgenic steroids are synthetic compounds that mimic the effects of testosterone, promoting muscle growth and the development of male characteristics. While some AAS have legitimate medical applications, their misuse involves taking them without a prescription or in doses far exceeding medical recommendations. People often misuse these substances to enhance muscle mass, improve athletic performance, or for cosmetic reasons.
Misuse typically occurs through oral administration, injection, or topical application. Users might also engage in “cycling,” where they take multiple doses over a specific period, stop for a time, and then restart. Another pattern, “stacking,” involves combining several types of steroids.
Impact on Physical Health
Misusing anabolic-androgenic steroids can lead to a wide array of adverse physical effects throughout the body. Many of these effects can be severe, and some may become permanent. The severity often relates to the dose and duration of use, with nonprescription doses frequently being 10 to 100 times higher than medically prescribed amounts.
The cardiovascular system is particularly vulnerable to damage. Misuse can cause high blood pressure and unhealthy cholesterol levels, specifically decreasing beneficial high-density lipoprotein (HDL) and increasing harmful low-density lipoprotein (LDL). This imbalance can contribute to heart damage, including ventricular hypertrophy (enlargement of heart ventricles) and cardiomyopathy, raising the risk of blood clots, stroke, and heart attack.
The liver can also suffer significant harm from AAS misuse. This includes liver damage, the formation of tumors such as hepatic adenomas, and peliosis hepatis, a condition characterized by blood-filled cysts.
The reproductive system experiences distinct negative impacts for both sexes. In males, common effects include testicular atrophy (shrinking of the testicles), reduced sperm count, and infertility. Males may also develop gynecomastia, which is breast tissue enlargement, and experience prostate enlargement. For females, AAS misuse can lead to menstrual irregularities and infertility. Other masculinizing effects include clitoral enlargement, a deepening of the voice, increased body hair, and male-pattern baldness.
Skin and hair changes are also commonly observed. Users may develop severe acne, cysts, and experience oily skin and hair. Male-pattern baldness can occur in both males and females due to the hormonal changes induced by these substances.
Musculoskeletal development can be negatively affected, especially in adolescents. Premature fusion of growth plates can lead to stunted growth, preventing individuals from reaching their full adult height. Additionally, AAS misuse may increase the risk of tendon injuries, potentially due to rapid muscle growth outpacing tendon strength.
Other physical concerns include kidney damage and an increased risk of infections from unsterile injection practices. Such practices can transmit bloodborne diseases like hepatitis B, hepatitis C, and HIV.
Effects on Mental Health and Behavior
Beyond physical changes, anabolic-androgenic steroid misuse profoundly affects mental health and behavior. Users often experience significant psychological and emotional shifts, which can be unpredictable and intense. These effects can severely impact daily life.
Mood disturbances are common, including severe mood swings, heightened irritability, and aggressive outbursts often referred to as “roid rage.” Anxiety is also frequently reported, and individuals may experience severe depression, particularly during periods of withdrawal. Some users may develop psychotic symptoms, such as paranoia and delusions, leading to distorted perceptions of reality. Cognitive impairments can also manifest, making it difficult for individuals to concentrate or recall information. A distorted body image, known as body dysmorphia, can be exacerbated by AAS misuse, leading individuals to continue using the drugs despite experiencing negative physical and psychological consequences.
The Risk of Dependence
Despite common misconceptions, anabolic-androgenic steroids can lead to dependence. This dependence is characterized by a compulsive need to continue using the drugs, often despite adverse physical or psychological effects. Users may develop a tolerance, requiring higher doses to achieve the desired effects, which further escalates risks.
When misuse is stopped, individuals can experience a range of withdrawal symptoms, which may be severe and prolonged. Physical symptoms include fatigue, insomnia, muscle and joint pain, and headaches. Psychological withdrawal symptoms are particularly challenging, encompassing severe depression, anxiety, loss of appetite, decreased libido, and intense cravings for the drug. These difficult withdrawal symptoms often compel individuals to resume misuse as a way to alleviate discomfort, perpetuating a cycle of dependence.
Pathways to Support and Recovery
Individuals struggling with anabolic-androgenic steroid misuse, or those concerned about someone else, can find help through various support pathways. Seeking professional assistance from healthcare providers, addiction specialists, or mental health professionals is an important first step. These professionals can provide guidance and create a tailored recovery plan.
Support options often include medical supervision to manage withdrawal symptoms safely and effectively. Therapy, available in individual or group settings, can help address the underlying psychological factors contributing to misuse and develop coping strategies. Participation in support groups also offers a community where individuals can share experiences and receive encouragement. Recovery from AAS misuse is possible with appropriate and consistent support.