What effects do anabolic steroids have on men?
High doses of anabolic steroids can lead to temporary sterility, testicular atrophy, and the development of female sex characteristics in the normal male.(1-4) One case of prostate cancer has been associated with steroid abuse in an athlete.(5,6) The severity of these effects depends on how much of the steroid has been taken and how long the steroid user has been taking the drug.(1) In the normal male, the testes secrete testosterone and make sperm. The pituitary gland in the brain monitors the amount of testosterone in the male's bloodstream. If the level is too low, it secretes the hormones FSH ("Follicle Stimulating Hormone") and LH ("Luteinizing Hormone") to cause the testes to secrete more testosterone. If there is too much testosterone, the pituitary cuts back on FSH and LH, and the testosterone level drops. In this way, the body controls the amount of testosterone needed to produce sperm and to maintain male sexual characteristics. When a male takes steroids, the pituitary gland detects the sudden high quantity of anabolic steroids and sends chemical signals to shut down testosterone production in the testes. The longer a person takes anabolic steroids, the longer the testes remain inactive. The sperm cells begin to have abnormal shapes, and are fewer in number.(1) If anabolic abuse continues long enough, the male becomes infertile.(1,2) The testes of male athletes who have been stacking and cycling steroids for years decrease in size.(3) If the adult male stops taking anabolic steroids, testicular function will probably return to normal.(2,7) However, it may take four months to a year or more for him to regain normal sperm cell shape and fertility.(1,2) In two cases, long term use of anabolic steroids may have led to lasting sterility and loss of libido with impotence due to a permanent effect on the pituitary.(4) However, more studies need to be done to determine whether steroids caused the pituitary damage or whether each of these men had pre-existing pituitary damage.(4) When there are large amounts of anabolic steroids in the body, part of them are metabolized to form conjugated estradiol and estrone, female hormones.(1,8-11) In some anabolics abusers, this results in breast growth, known medically as "gynecomastia." (7,11) Breast growth is an irreversible side effect of anabolic steroid abuse and may accumulate from one cycle of use to the next.(12) The use of alcohol while taking anabolics increases the likelihood of breast growth.(11) The body changes a portion of the anabolics to conjugated estradiol and estrone, female sex hormones, by a chemical process called "aromatisation."(6) Ordinarily, the liver quickly deactivates most of these female hormones before they can have effects on the body. Alcohol prevents the liver from deactivating them, allowing them to promote breast growth. Bodybuilders are more likely to drink alcohol to excess than others of their age.(13)
1. Knuth UA, Maniera H, Nieschlag E. Anabolic steroids and semen
parameters in bodybuilders. Fertility And Sterility 1989
2. Yesalis CE, Wright JE, Bahrke MS. Epidemiological and policy
issues in the measurement of the long term health effects of
anabolic-androgenic steroids. Sports Medicine 1989
3. Creagh TM, Rubin A, Evans DJ. Hepatic tumours induced by
anabolic steroids in an athlete. J Clin Pathol 1988;41:441-3.
4. Jarow JP, Lipshultz LI. Anabolic steroid-induced
hypogonadotropic hypogonadism. Am J Sports Med 1990 Jul-
5. Roberts JT, Essenhigh DM. Adenocarcinoma of prostate in 40-
year-old body-builder. Lancet 1986 Sep 27;8509:742.
6. Hickson RC, Ball KL, Falduto MT. Adverse effects of anabolic
steroids. Med Toxicol Adv Drug Experience 1989 Jul-
7. Johnson MD. Steroids. Adolescent Med 1991 Feb;2(1):79-93.
8. Wagner JC. Abuse of drugs used to enhance athletic
performance. American Journal Of Hospital Pharmacy 1989
9. Wilson JD. Androgen abuse by athletes. Endocrine Reviews
10. Gluud C. Testosterone and alcoholic cirrhosis. Danish Med Bull
11. Giannini AJ, Miller N, Kocjan DK. Treating steroid abuse - a
psychiatric perspective. Clinical Pediatrics 1991
12. Huang QF, Gebrewold A, Altura BT, Altura BM. Cocaine-induced
cerebral vascular damage can be ameliorated by Mg2+ in rat
brain. Neurosci Let 1990;109:113-6.
13. Brower KJ, Blow FC, Young JP, Hill EM. Symptoms and correlates
of anabolic androgenic steroid dependence. British Journal Of
Addiction 1991 Jun;86(6):759-68.
14. Johnson MD. Anabolic steroid use in adolescent athletes.
Pediatr Clin North Am 1990 Oct;37(5):1111-23.
(c) 1992 University of Maryland Office of Substance Abuse Studies.
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