The risks of anabolic steroids

November 1, 2021

Dr Deborah Lee, Dr Fox Online Pharmacy, explores the risks associated with anabolic steroids and how to get help if you have an addiction

Anabolic steroids are prescription-only drugs that are often taken illegally. But why do men want to take them? What are the risks? Are they safe? What can men do if they become addicted? Read on and find out.

What are they?

Anabolic steroids are the most common Appearance and Performance Enhancing Drugs (APEDs). Often, they are just referred to as ‘steroids.’

They are synthetic hormones, similar to testosterone, which have anabolic (bodybuilding) effects due to the fact they stimulate the growth of skeletal muscle. They also have androgenic (male) effects which enhance typical male characteristics. When you see a male bodybuilder, many will have been using steroids in order to create this appearance.

Anabolic steroids have serious side effects and risks. Young men should be firmly discouraged from turning to these drugs despite any pressure they feel from the excessive media hype about unrealistic body image. Men need to be fully aware of the dangers of using these drugs.

Don’t confuse anabolic steroids with ordinary steroids (prednisolone) which are powerful anti-inflammatories and sometimes prescribed by the doctor.

Who uses them?

Around 1 million UK adults, mostly men, are currently taking anabolic steroids, according to a 2016 IPED survey – this equates to about 3% of the male population. 56% of those surveyed said that they were taking them for cosmetic reasons or to improve their appearance. The typical anabolic steroid user will be a male, non-athlete, in their 20’s or 30’s. Usage is rare in females, and in teenagers.

Anabolic steroids are class C drugs under the Misuse of Drugs Act 1971. Possession is not an offence. However, it is illegal to manufacture, supply/possess/import/export anabolic steroids with the intent to supply unless you have the correct license. If found guilty you could face up to 14 years in prison and/or a hefty fine.

Why do men use them?

Most men who use anabolic steroids are suffering from body dysmorphic syndrome, a psychological condition arising from or exacerbated by, watching unrealistic portrayal and exaggerated male physiques on film, television, in magazines, and other media. Men with this condition, look in the mirror and see a man who is puny and weak, even though this is far from the case. Although women also suffer from body dysmorphia, very few take steroids as being large and muscley is not usually attractive to females.

In fact, men who use anabolic steroids are also more likely to be experiencing psychological symptoms, such as depression and low self-esteem. They may have had previous suicide attempts. They also tend to have poor knowledge of health, have been brought up in families with a greater fixation on body weight, and have participated in more sport in their youth in an effort to change their size and shape. There is also a link between the use of anabolic steroids with eating disorders and substance abuse.

What do anabolic steroids do?

Using anabolic steroids results in muscular growth and development above and beyond what is possible solely from good nutrition and weight training. Users often say they take them to help improve their confidence.

Their main objective is to take them in order to achieve their ideal body. Increased muscle mass also improves their performance at certain sports – such as weightlifting or shotput throwing. Anabolic steroids are not so good at improving performance in sports that require agility.

How do you take them?

Anabolic steroids can be taken by mouth or injected into the muscle. Most men start with tablets but may progress to injections which are less likely to cause liver damage.

Commonly used steroids

Oral

Stanozolol
Oxandrolone
Anadrol

Injectable

Testosterone
Nandrolone

Other Performance Enhancing Drugs (PEDs)

Erythropoietin (EPO)
Human growth hormone
Corticosteroids
Amphetamines

When taking anabolic steroids, users often take them in cycles of 6 -12 weeks, mix two or more different types, or may taper off the doses slowly. These regimens are known as cycling, stacking and pyramiding.

Are they safe?

In short – No. There is a range of serious and unpleasant side effects listed below.

Abuse of anabolic steroids has also been linked to sudden cardiac deaths. In a 2015 literature review, 19 sudden deaths were identified in those taking anabolic steroids between 1990-2012.

The authors stated that they wished to strengthen the warning against the use/abuse of anabolic steroids in both athletes and nonathletes. This is because steroids cause abnormal lipid profiles (raised cholesterol), and result in thickening of the heart muscle, causing left ventricular hypertrophy (enlargement of the left ventricular wall), cardiac hypertrophy (an enlarged heart), and increases the risk of cardiac arrhythmias (abnormal heart rhythms) and myocardial infarction (heart attacks.)

The NHS cautions against the use and misuse of anabolic steroids, highlighting the range of serious side effects including addiction.

What are the side effects?

Cardiovascular

High blood pressure
Deep vein thrombosis (blood clots)
Abnormal lipids – raised LDL ‘bad’ cholesterol, lowered HDL ’good’ cholesterol
Atherosclerosis (fatty deposits in the arteries)
Myocardial infarction (heart attack)
Stroke

Male reproductive system

Reduced sperm production
Infertility
Gynecomastia (male breast enlargement)
Testicular atrophy (shrunken testes)
Hair loss – male pattern baldness
Testicular cancer
Prostate cancer

Increased risk of serious infections

Many men who use anabolic steroids inject themselves, often in unsterile circumstances, and may share needles. This increases the risk of acquiring HIV and hepatitis B and C.
Anabolic steroids suppress immune function

Liver

Liver damage
Liver cysts
Peliosis hepatis – blood-filled cysts in the liver. These can rupture and be fatal.
Liver failure

Skin

Acne
Increased sebum, resulting in greasy skin and hair
Hair loss – male pattern baldness
Skin infections – abscesses – at the injection site
Ulcers at injections sites
Liver disease can result in jaundice with yellowing of the skin and eyes

Psychiatric

Anger – sometimes called ‘roid rage’
Anxiety
Major depression
Mania
Delusions and hallucinations

Growth and development

Short stature – if taken as a young adult, high doses of steroids cause bones to stop growing
Tendon stiffening

Other

A greater than average number of men addicted to heroin or cocaine have used anabolic steroids.

What about addiction?

Around 32% of men using anabolic steroids are likely to become dependent on these drugs. Dependency means they find they need to take higher and higher doses to achieve the same effect. They will also experience withdrawal symptoms if they try to stop. These are very unpleasant symptoms such as fatigue, restlessness, insomnia, loss of appetite, loss of libido, trouble concentrating, and craving for the steroids. Dependency can lead to depression and suicide.

What to do about addiction

If you think you might be addicted to anabolic steroids, why not do one of the following –

See your GP.
Find your local addiction services at Frank. Follow the link and type in your postcode to find your nearest services.
Phone the Frank Drugs Helpline – 0300 123 6600
See the Adfam website for a list of charitable and other organisations that can help you.

Treatments may involve Cognitive Behavioural Therapy (CBT), and medical treatment to help with withdrawal symptoms. You may be treated at home or need to be admitted to hospital.

Final thoughts

The numbers of men with concerns about their body image has tripled in recent years – in one study the incidence was 45%. Men who suffer from body dysmorphic syndrome will often be obsessively checking their appearance in the mirror, comparing themselves with others, excessively grooming and working out in the gym. There is a serious risk of severe depression and risk of suicide.

Men need to recognise this body obsession as a medical disorder and ask for help, instead of embarking on potentially dangerous anabolic steroids. These drugs can be so dangerous these drugs can be for their health and have a severe negative impact on their quality of life.

There are other ways of treating body dysmorphic syndrome. There has been some success for example, with the use of serotonin reuptake inhibitors (SSRIs).

If you are reading this, do you need help? Are you taking anabolic steroids and need help to stop? If this applies to you, don’t suffer in silence. Why not seek professional help? See your doctor without delay and discuss things in confidence, or contact Frank (see above). Don’t leave things too late. Whatever you feel about your body size and shape, anabolic steroids are not the solution.

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