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An Unvarnished Look at Steroids

Testosterone boosters have a place, but it's not on the playing fields

Taking steroids to build muscle and improve athletic performance is a dangerous habit for hundreds of thousands of young people. Charles Yesalis, Professor of Exercise and Sport Science at Penn State University and one of the nation's leading experts on the subject, explains the risks.

What are steroids?

They are synthetic derivatives of the primary male sex hormone, testosterone. Correctly called anabolic-androgenic steroids, they have both an anabolic (tissue-building) effect and an androgenic (masculinizing) effect. The primary use of steroids is in replacement therapy for men whose testes are not producing normal levels of testosterone and for kids who suffer delayed onset of puberty. Some physicians are giving them to AIDS patients to help maintain body weight and appetite. Other uses currently under evaluation include treatment for men over 50 to maintain strength, and as a male contraceptive.

Why do athletes take steroids?

To increase muscle mass and to increase strength - and to train longer, more frequently, and with more intensity. Although no study has demonstrated this last purported effect, most athletes who have used or are using steroids have reported this.

So what's wrong with taking steroids?

First of all, it's cheating. When you go into a contest, there is a commitment to play by the rules; every sport federation prohibits the use of these drugs. It's against federal law, and every state bars using them for nonmedical purposes. Distributing is a felony and possession can get you into jail.

In addition, tests show that if you administer testosterone to mice, it increases their aggressive behavior. Aggression among steroid users is not consistently demonstrated in all studies, but 90 percent of the steroid users I have interviewed report feelings of increased aggression. Whether steroids cause fits of rage, known as 'roid rage,' is yet to be determined.

What about physical dangers?

The long-term effects aren't clear. A handful of cases associate steroids with cardiomyopathy, which is when the heart muscle stops functioning and requires a heart transplant. Steroids have also been found to have a deleterious, but temporary, effect on liver function; when you go off the drug, the liver returns to normal. Anabolic steroids, taken orally, have also been associated with nonmalignant liver tumors.

Steroid use affects the reproductive tract as well. When the hypothalamus gland detects high levels of testosterone, it shuts off the portion of the endocrine system that produces testosterone and sperm. In males that have a predisposition to baldness, balding will be accelerated. Some users may have scarring acne, and males can grow fibrous tissue under the nipple, causing the appearance of small breasts.

In addition, the drugs have been tentatively linked to an increased risk of strokes or heart attacks during use, not later. And finally, based on clinical experience, it is believed that young adolescents taking these drugs could permanently and prematurely close their growth plates.

How are women affected by steroids?

About 55,000 women have used steroids in the past year. Among high school seniors, between a 1/2 and 2 percent of girls have reported using steroids at some time. Small amounts will have a profound effect on women. Use will shrink the breast tissue, cause male-pattern hair growth and baldness, deepening of the voice, clitoral enlargement, and cessation of the menses. Many of these effects are irreversible.


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