As a natural bodybuilder, I’m often asked why I choose to remain natural. While there are several reasons, the most compelling one for me is health. Despite the performance enhancements steroids can offer, the potential health risks are significant and should not be taken lightly. This article will delve into the scientific literature on the health implications of anabolic steroid use.
It’s important to clarify some terminology. Performance-enhancing drugs (PEDs) encompass a broad range of substances, but androgenic anabolic steroids, particularly testosterone, are the most commonly used by athletes and bodybuilders. While numerous other steroids exist, this article will focus on the general category of androgenic anabolic steroids. Researching the effects of steroids can be challenging, due to ethical considerations regarding high-dose studies. Much of the existing data comes from case studies, retrospective surveys, and animal studies. Controlled trials, when available, often under-represent the actual risks associated with real-world steroid use.
A 2014 position statement by the Endocrine Society detailed a comprehensive list of potential health problems linked to steroid use. Cardiovascular issues were highlighted as particularly serious, alongside testicular dysfunction, mood disorders, and dependence.
Cardiovascular complications are widely recognized as a major concern. A 2015 paper examined 25 case studies involving athletes, primarily bodybuilders, aged 19 to 54, who used high-dose anabolic steroids. These individuals experienced a range of severe cardiac events, including fatal and non-fatal heart attacks and strokes. Unfavorable changes in blood lipid profiles, such as decreased HDL cholesterol and increased LDL cholesterol, were observed just two months after starting steroid use. Long-term use can contribute to atherosclerosis, the hardening and narrowing of arteries, increasing the risk of heart attack and stroke.
Water retention, another side effect of steroid use, is linked to high blood pressure, which can persist for up to a year after stopping steroid use according to a study from the University of Saarland in Germany. Left ventricular myocardial hypertrophy, a thickening of the heart’s main pumping chamber, is also common, reducing the heart’s elasticity and increasing the risk of cardiac events.
A 2006 German dissertation analyzed autopsy data from 10 young bodybuilders (average age 33) who used anabolic steroids. In four cases, the cause of death was acute cardiac dysfunction. All 10 individuals had significantly enlarged hearts, indicative of cardiopathy.
Beyond cardiovascular issues, steroids can also have a direct toxic impact on the liver, particularly with oral steroids. Liver adenomas (benign tumors) have been observed in steroid users. While some tumors disappear after steroid use is discontinued, others can progress to liver carcinomas, potentially leading to liver failure and death.
While the cardiac and liver effects are perhaps the most serious, other health risks exist. Evidence suggests potential for irreversible neuropsychiatric toxicity. Although the “roid rage” stereotype may be exaggerated, studies show that steroids can induce hypomania, characterized by elevated mood, increased self-esteem, and decreased need for sleep. Manic episodes can be associated with aggression and violence. Depression is also common during steroid withdrawal.
Hypogonadism, the suppression of natural testosterone production, is another concern. This can lead to testicular shrinkage, reduced sperm count, and infertility. Gynecomastia, the development of breast tissue in males, can also occur and is often irreversible without surgery. Acne, changes in libido, and, in female users, virilization effects such as deepened voice, enlarged clitoris, and baldness are also possible side effects.
While most research focuses on male bodybuilders, the effects on females can be even more severe and permanent.
It’s important to emphasize that these are primarily the effects of steroid abuse. Individual responses vary based on genetics, family history, and other factors. Some researchers argue that the link between steroid use and some adverse health outcomes is not definitively established. However, consistent physician monitoring is crucial for anyone considering using anabolic steroids.
Testosterone does have benefits for men with clinically low testosterone levels. These benefits include improved libido, bone density, muscle mass, mood, and cognition. However, even testosterone replacement therapy carries risks and should only be undertaken under medical supervision. There are natural ways to boost testosterone levels, such as through lifestyle modifications and optimizing training and diet.
Ultimately, the decision to use steroids is a personal one. However, it’s essential to be fully aware of the potential health consequences before making that choice.
