What are steroids?
All sex hormones are technically termed steroids. However, another class of related compounds, glucocorticoids (cortisol, cortisone), is also called steroids. Be sure not to confuse the two; they elicit different physiological effects. Androgens are commonly called ‘male’ hormones. Testosterone and dihydrotestosterone (DHT) are the two most commonly known androgens. Both men and women have testosterone circulating in their bodies, just as both have estrogen. The gender difference is the ratio of these hormones. Women normally have 1/10th the level of testosterone level of men and more estrogen.
The most common androgen, testosterone, is anabolic and androgenic. Simply put, androgenic properties are the differentiation and maintenance of androgen-dependent tissues of the male reproductive system. They are also responsible for secondary male sex characteristics, such as body hair, deep voice, and increased libido. This is commonly called virilization. The anabolic properties facilitate protein synthesis in androgen-sensitive tissues such as bone and muscle. This is the effect that bodybuilders are mainly interested in.
Anabolic/androgenic steroids (AAS) are synthetic derivatives of testosterone. There are more than 25 different compounds in varying forms and with varying effects. Although they were designed to be anabolic they are not without some degree of androgenic effects. Some AAS have significantly greater anabolic actions than androgenic effects; however, an athlete who takes AAS gets the entire package. AAS are therapeutically used in replacement or maintenance therapy in men who have androgen deficiencies. The goal in replacement therapy is to restore normal levels of testosterone.
Bodybuilders generally use much higher levels of AAS than considered safe (by therapeutic standards) to increase muscle mass. Depending on the compounds used, high levels may induce a multitude of physiological effects. Bodybuilders also may use multiple forms of AAS, called ‘stacking’, in varying time lengths (‘cycles’). Although much is known about physiological effects in men at therapeutic dosages, less is known about effects in women. One fact is known for sure: because women have lower baseline levels of testosterone than men, the response to AAS is much greater in women. AAS stimulate greater muscular development in women than men with the same dose. However, there are also several side effects that can accompany AAS use in women.
Depending on the form of AAS, dose and duration, side effects in women may include male baldness pattern, cystic acne, decreased breast tissue, excessive facial hair, and disruption of the menstrual cycle. These are considered reversible and usually disappear not long after discontinued use. Some side effects are permanent, such as deepening of the voice and enlargement of the clitoris.
Another potential risk in men and women is combining use of AAS with cortisone or its derivatives. Recall that cortisone is also called a steroid. However, its actions are considered catabolic. It may actually cause muscle degeneration when used over a long period of time. It is frequently prescribed in sports to reduce inflammation caused by injury. Combining AAS with cortisone may predispose the user to severe connective tissue injuries. Several such sports injuries have been reported due to concomitant AAS and cortisone use.
There are other health risks related to AAS. The C-17 alkyl derivatives of testosterone are orally administered. Liver damage is associated with long term use of this form of AAS even though they are short acting and clear the body quickly. Other derivatives are injected into the muscle and stored in body fat. Thus they are released over a longer period and take several months to clear. Therefore, mixing different forms of AAS may lead to unpredicted side effects.
Burn patients, who experienced severe muscle wasting, were given AAS long term. Side effects, such as increased blood pressure, heart disease and liver cancer, appeared. Although direct extrapolation to similar use by bodybuilders has not been documented, some of these effects have been linked with AAS use in athletes. Several studies show AAS use may lead to premature hardening of the arteries. Salt and water retention is a side effect commonly experienced by AAS users.
Let’s look specifically at women and AAS use. Studies published to date on androgen replacement in women do not indicate detrimental effects on body composition, lipids or vascular function. The key words here are "replacement therapy". Testosterone derivatives have been developed for clinical hormonal replacement therapy in men. Thus, few forms of AAS are approved for women because the pharmacodynamics and efficacy in women have not been well researched. Therefore, less is known about the short-term and long-term effects of AAS in women. Consequently, even less is known regarding the supraphysiological doses that fbbs have been known to use. Women using the typical doses of fbbs to gain their extreme muscle mass are venturing into unknown health risks.
One risk I wish to address here is amenorrhea, which is the cessation of menstrual cycles for several months. Amenorrhea is resultant from a disruption in the body’s normal hormone status and is usually accompanied by a decline in estrogen levels. This may be disconcerting as it can significantly contribute to osteoporosis and osteopenia. These effects were thought to be short-term. On the contrary, an increasing number of studies demonstrate the effects are long-lasting even after resumption of menstruation. Low dose androgen use is now being integrated with estrogen replacement therapy in postmenopausal women to prevent or reduce osteoporosis. However, it is not known if long term AAS use negates the association of osteoporosis with amenorrhea.
Women considering steroid use should first ask themselves if they are willing to take the health risks that may be involved. First, examine your training and nutritional program and optimize that to gain muscle mass. Body fat can be lost later with a sound diet program. If you need assistance in optimizing your regime, consult with a knowledgeable person who has a credible background in physiology, exercise and nutrition. Educate yourself so that you can make informed decisions. If your friendly gym trainer suggests using steroids, he or she obviously doesn’t know how to train and eat correctly.
If you do decide to use steroids, find someone who knows what they are doing. Don’t rely on Big Ben in the gym to guide you. He may be big, but being big doesn’t guarantee a brain. Ideally, someone with a medical background would be able to minimize side effects, but that also can’t be guaranteed. Most of all educate yourself. It’s your body you are tinkering with. Most of all, ask yourself if you really want to take the risks especially if your goal is obtainable by other means.
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