The term “roid” is a common, informal name for Anabolic-Androgenic Steroids (AAS), which are synthetic substances derived from the male sex hormone testosterone. Public interest often stems from their association with athletic performance and physical enhancement. Understanding these drugs requires examining their chemistry, biological mechanisms, and the distinction between their limited medical applications and the significant health risks associated with unauthorized use.
The Scientific Definition of Anabolic Steroids
Anabolic-Androgenic Steroids (AAS) are a class of synthetic drugs structurally related to testosterone, the primary androgen produced naturally in the human body. The name describes the two main effects: “anabolic” refers to the promotion of tissue growth, particularly muscle, while “androgenic” refers to the development of male characteristics. These compounds are manufactured to mimic the physiological actions of natural androgens.
AAS must be distinguished from other steroids, such as corticosteroids (e.g., prednisone), which are prescribed to reduce inflammation. Corticosteroids resemble the hormone cortisol and do not share the muscle-building or masculinizing properties of AAS. The unique molecular structure of AAS allows them to bind to and activate androgen receptors in target cells throughout the body.
Scientists modify the testosterone molecule to maximize the anabolic effect while minimizing the androgenic effects. Despite these efforts, all AAS retain both properties because they are fundamentally based on the same steroidal nucleus found in testosterone. They are classified as controlled substances in many countries due to their potential for abuse and dependence, even though they possess legitimate medical uses.
How Anabolic Steroids Impact the Body
AAS exert their primary influence by binding to androgen receptors (AR) located inside cells, including those in skeletal muscle. Once the steroid binds to the AR in the cell’s cytoplasm, the complex moves into the nucleus. There, it interacts with specific DNA sequences, moderating gene transcription and turning on the machinery responsible for building proteins.
The resulting enhancement of muscle protein synthesis (MPS) is the mechanism behind the anabolic effects, leading to increased muscle fiber size and lean body mass. AAS also possess anti-catabolic properties, helping prevent the breakdown of muscle tissue during intense training or caloric restriction. This dual action accelerates muscle growth beyond what is naturally possible.
Medically, these properties treat muscle wasting conditions, such as severe burns, HIV/AIDS, or specific types of anemia. They are also prescribed for men with hypogonadism (low testosterone levels) to restore hormone levels to a healthy physiological range. Therapeutic doses are carefully controlled to achieve a physiological effect, often around 100 milligrams of testosterone per week, or its equivalent.
When AAS are used for performance enhancement, the dosage often enters the “supra-physiologic” range, far exceeding what the body naturally produces. Non-medical users frequently administer doses ten to one hundred times higher than those prescribed for medical treatment. This high-dose, non-therapeutic use drives the severe health consequences associated with the substances.
The Dangers of Non-Medical Steroid Use
The most significant health risks of AAS use are tied to the high doses and uncontrolled cycles common in non-medical settings. A serious concern is the cardiovascular system, where misuse causes harmful changes in lipid levels. Steroid use decreases high-density lipoprotein (HDL, “good cholesterol”) while increasing low-density lipoprotein (LDL, “bad cholesterol”).
This dyslipidemia, combined with high blood pressure, accelerates atherosclerosis (hardening and narrowing of the arteries). Chronic AAS use can also induce left ventricular hypertrophy, causing the heart’s main pumping chamber to enlarge and become less efficient. This significantly increases the risk of heart attack, stroke, and sudden cardiac death.
AAS misuse places a severe strain on the liver, especially with oral formulations, potentially leading to liver damage, peliosis hepatis, or liver tumors. The introduction of external hormones disrupts the body’s natural hormonal balance, signaling it to stop its own testosterone production.
This suppression of the hypothalamic–pituitary–gonadal (HPG) axis can result in hypogonadism, causing testicular atrophy, decreased sperm production, and infertility in men. The body attempts to balance excess androgens by converting some into estrogen, which can lead to gynecomastia (development of male breast tissue).
Beyond physical effects, high doses of AAS provoke psychiatric symptoms, including severe mood swings, increased aggression (“roid rage”), and periods of mania. When users stop taking the drugs, they can experience withdrawal symptoms like severe depression and persistent low testosterone, potentially leading to continued dependence.