Steroid use and long-term health risks in former athletes

The paradox is that discussing the topic of anabolic androgenic steroid use and abuse can inspire the idea that they are the sole determinant of high performance in bodybuilders and other athletes.

This encourages the illegal use of oral steroids by naive teens and young adults, gives readers the temptation to choose, and encourages the illegal distribution of steroids to benefit unscrupulous individuals, making it difficult to prescribe controlled use of these drugs. Nevertheless, readers are looking for real benefits achievable only with steroid use – increased exercise performance combined with proper diet and lifestyle. The reward for many AAS users is not only physical development, but also increased social status, financial gain, employment opportunities, increased safety, self-esteem, and even health (if taken wisely).

There are three things that are most in demand among young people who use anabolic steroids: strength, power, and size. Most of these people strive to get all three of these components at once. Strength and power are often used synonymously, but there is a difference between the two. Power is the most significant metric for athletic performance; it refers to the amount of strength a muscle can develop per unit of time. The high jump is a commonly used test to determine power. Strength is the amount of force exerted in a single movement. This is best illustrated by single-repetition maxima in the bench press, squat and deadlift.

Anabolic steroids and growth hormone can greatly increase muscle mass, and thus improve your strength and endurance. These traits are essential in almost all sports, but especially in those where there are high anaerobic (power) loads (weightlifting, wrestling).

The hormone erythropoietin increases the number of red blood cells and speeds up oxygen delivery to the muscles, which may play a key role in tolerance of high aerobic loads (cycling, soccer).

Psychostimulants can help during competitions where extreme concentration and agility are required (shooting, tennis, fencing).

Effects of anabolic steroids (androgens) on sex drive

Sex drive (or libido) is mainly controlled by testosterone. Anabolic steroids can lead to an increase in libido. Increased libido can be a problem, as using androgens in high doses can also increase the likelihood of violent behavior.

A common problem is a situation that occurs already after steroid use, when the body stops producing testosterone for a long time. This is familiar to everyone who uses steroids. In this case, the concentration of testosterone in the bloodstream is insufficient to maintain a normal libido, so such hormonal disorders can lead to a loss of libido. In addition, testosterone deficiency is associated with many other symptoms and health hazards.

A very pronounced decrease in testosterone can also lead to erectile dysfunction and mental disorders.

For example, a significant deterioration in a weightlifter’s performance may be accompanied by an increased risk of a new androgenic cycle.

Other Side Effects of Anabolic Steroids

Other extensive side effects of anabolic steroid doping have recently been identified, at least indirectly affecting reproductive health as well. Some have reported psychiatric symptoms and severe mood disorders: hyperactivity, irritability, aggressiveness, hyperexcitability, impaired concentration, reckless behavior, and other symptoms of a psychotic nature. Suicidal thoughts and actions were also observed. These symptoms have occurred in only a few individuals, and there is no definitive data on what the mental state of these individuals was prior to the use of anabolic steroids. There is strong evidence of negative effects on the heart: those who have used anabolic steroids have been diagnosed with heart muscle pathology that is associated with impaired cardiac function. Some pathological changes in the heart may be reversible if the person stops taking steroids. However, if the use of anabolic steroids has resulted in the destruction of heart muscle cells, the changes are irreversible. Pathological changes in the liver can be fatal or require a liver transplant.

Study effects and therapy

People who use anabolic steroids are somewhat aware of the problems that occur, but they don’t mention the fact that they use steroids, for example, at a doctor’s appointment. Thus, the side effects of steroid use may go unnoticed, and treatment may not be optimal. On the other hand, general practitioners may have rather superficial knowledge of the effects of steroids on the body.
A medical examination may reveal signs of long-term androgen use, such as acne, skin stretch marks, breast enlargement, and possible injection marks. Laboratory tests may show high hemoglobin and low HDL cholesterol (called good cholesterol), as well as abnormal liver function. As a result of prolonged use of androgens, a significant decrease in testicular size may be noted.
The effect of anabolic androgenic steroids on reproductive function greatly depends on the drugs used, the doses and timing of use. According to hormonal studies reflecting testicular function, typical abnormalities can be observed. According to seminal fluid studies, a significant proportion of steroid users may have a complete absence of sperm. You should also remember that the use of anabolic steroids does not exclude

other causes of male infertility. Previously, it was thought that the changes caused by the use of anabolic androgenic steroids were reversible. However, this is obviously not the case for some side effects. Severe side effects, such as effects on the heart and liver, can lead to chronic consequences, such as heart failure, sudden death, and in the case of the liver, transplantation due to severe hepatic impairment. Testosterone: It can take a long time to restore normal sperm production, and even patient waiting does not always pay off. These functions are not restored in everyone. As a rule, the most effective effective method is simple: stop using anabolic androgenic steroids completely. Therapy will be successful as long as the person understands the connection between androgen use and the development of impairment, and also realizes that it will take time to recover.

Maintenance of physiological testosterone concentrations (i.e. testosterone replacement therapy) may be required during the recovery phase if severe and prolonged hypo-function is noted. Nevertheless, the risk of abuse is not excluded. Substitution therapy should be confidential. It should be kept in mind that physiological replacement therapy slows down the recovery process of sperm production. Therefore, during treatment, one has to balance subjectively unpleasant symptoms of testosterone deficiency with positive effects on future health.