Anabolic steroids are a class of natural and synthetic steroid hormones that promote cell growth and division, resulting in growth of muscle tissue and sometimes bone size and strength. Testosterone is the best known natural anabolic steroid, as well as the best known natural androgen.
Most anabolic steroids work by activation of androgen receptors, producing anabolic and virilizing effects.
Examples of anabolic effects:
Examples of virilizing effects:
Many androgens are metabolized to compounds which also cross-react with estrogen receptors, producing additional (usually) unwanted effects:
A hormone with purely anabolic effects would have many uses, but in many cases the usefulness is limited by unwanted virilizing effects. Many of the synthetic anabolic steroids were devised in an attempt to find molecules that produced a higher degree of anabolic rather than virilizing effects.
Other side effects (some the opposite of intended effects) include elevated blood pressure and cholesterol levels, severe acne, premature baldness, reduced sexual function, and testicular atrophy. In males, abnormal breast development (gynecomastia) can occur. In females, anabolic steroids have a masculinizing effect, resulting in more body hair, a deeper voice, smaller breasts, masculinized or enlarged clitoris (clitoral hypertrophy), and fewer menstrual cycles. Several of these effects are irreversible. In adolescents, abuse of these agents may prematurely stop the lengthening of bones (premature epiphyseal fusion through increased estrogen), resulting in stunted growth. Serious medical illness can result from extreme hormone use. Enlargement of the heart (the heart is a muscle and thus affected by the muscle-building qualities of the hormones) is a risk which increases the chance of an adverse cardiac event occurring in later life. Another health risk is long-term liver damage, particularly if the anabolic steroid compound is 17-alpha-alkylated in order to not be destroyed by the digestive system when taken orally.
Anabolic steroids were tried by physicians for many purposes in the 1940s and 1950s with varying success. Disadvantages outweighed benefits for most purposes, and in recent decades medical use in North America and Europe has been restricted to a few conditions.
- Bone marrow stimulation: For decades, anabolic steroids were the mainstay of therapy for hypoplastic anemias not due to nutrient deficiency, especially aplastic anemia. Anabolic steroids are slowly being replaced by synthetic protein hormones that selectively stimulate growth of blood cell precursors.
- Growth stimulation: Anabolic steroids were used heavily by pediatric endocrinologists for children with growth failure from the 1960s through the 1980s. Availability of synthetic growth hormone and increasing social stigmatization of anabolic steroids led to discontinuation of this use.
- Stimulation of appetite and preservation of muscle mass: Anabolic steroids have been given to people with chronic wasting conditions such as cancer and AIDS.
- Induction of male puberty: Androgens are given to many boys distressed about extreme delay of puberty. Testosterone is now nearly the only androgen used for this purpose but synthetic anabolic steroids were often used prior to the 1980s.
Anabolic steroids have been marketed to doctors for stimulation of children's appetite in developing countries, long after developed countries have abandoned this practice because of side effects.
Use and abuse in athletics and bodybuilding
During the 1990s, anabolic steroid use became a national concern in the competitive sports. These drugs are used by track and field athletes, weight lifters, bodybuilders, shot putters, cyclists, professional baseball players and others to give them a competitive advantage, and improve their physical appearance or to allow them to better compete with others who have a physical advantage, perhaps from a more fortunate natural endowment of endogenous steroids or from steroid use as well. Steroid use for these purposes is a violation of the laws of the United States (since anabolic steroids are "controlled substances") and other countries. Steroid use to obtain competitive advantage is prohibited by the rules of the governing bodies of many sports, and officially condoned by none.
According to the 1999 Monitoring the Future study, the percentage of eighth, tenth, and twelfth graders in the United States who reported using steroids at least once in their lives increased steadily over the preceding four years (an average of 1.8 percent in 1996, 2.1 percent in 1997, 2.3 percent in 1998, and 2.8 percent in 1999). In addition, steroid use to enhance athletic performance is no longer limited to high school males: a 1998 Pennsylvania State University study found that 175,000 high school girls nationwide reported taking steroids at least once in their lifetime.
Minimising the side-effects
Typically bodybuilders, athletes and sportsmen who use anabolics steroids try to minimise the negative side-effects. For example increasing the amount of cardiovascular exercise to help negate the effects of left ventricle hypertrophy. Also many bodybuilders take a Selective Estrogen Receptor Modulator (SERM), such as tamoxifen (brand name: Nolvadex). The prescription drug tamoxifen binds to the estrogen receptor in the breast, thus significantly reducing the risk of gynocomastia caused by increased estrogen.
Furthermore to combat natural testosterone supression (and testicular atrophy) caused by introducing exogenous hormones; what is known as 'post cycle therapy' or PCT is self prescribed. This PCT takes place after the course of anabolic steroids. It typically consists of combining a SERM such as clomiphene citrate or tamoxifen (or both) with an Aromatase Inhibitor (AI) such as anastrazole (brand name: Arimidex) or femara. The aim of PCT is to return the bodies' endogenous hormonal balance to its original state within a short space of time.
Those prone to premature hairloss due to steroid use/abuse have been known to take the prescription drug finasteride for prolonged periods of time.
It must be noted that often this self-medication takes place outside of the supervision of a doctor.
Anabolic steroids are believed to have been inadvertently discovered by German scientists in the early 1930s, but at the time the discovery was not considered significant enough to warrant further study. In the 1950s, however, scientific interest was rekindled, and methandrostenolone (Dianabol) was approved for use in the United States by the federal Food and Drug Administration in 1958 after promising trials had been conducted in other countries.
Concerns over the growing illicit market and the prevalence of abuse, combined with the possibility of harmful longterm effects of steroid, use led the U.S. Congress in 1991 to place anabolic steroids into Schedule III of the Controlled Substances Act (CSA). The CSA defines anabolic steroids as any drug or hormonal substance chemically and pharmacologically related to testosterone (other than estrogens, progestins, and corticosteroids) that promotes muscle growth. Most illicit anabolic steroids are sold at gyms, competitions, and through the mail. For the most part, these substances are smuggled into the United States. In addition, a number of counterfeit products are sold as anabolic steroids.
On January 20, 2005, the Anabolic Steroid Control Act of 2004 took effect, amending the Controlled Substance Act to place both anabolic steroids and prohormones on a list of controlled substances, making possession of the banned substances a federal crime.
List of Anabolic Compounds Commonly used as Ergogenic Aids
- Testosterone (attached to various esters enanthate, cypionate, propinate or suspended in oil or water)
- Methandrostenolone / methandienone (Dianabol)
- Nandrolone / Nor-testosterone (Deca-durabolin)
- Boldenone (Equipoise)
- Stanozolol (Winstrol)
- Oxymetholone (Anadrol)
- Oxandrolone (Anavar)
- Fluxymesterone (Halotestin)
- Trenbolone (Fina)