Why do people do steroids?
The most common reason given by steroid users is that it improves their performance in sports and/or increases their recovery rate from training.
Steroid abuse has been estimated to be very high among bodybuilders especially. Among other athletes, the incidences of abuse vary more depending on the specific sport.
Many steroid abusers also do it to increase their muscle size and/or reduce their body fat. This need to change your body in such a way can occur in sufferers of a behavioural syndrome (muscle dysmorphia) which gives a person a distorted body image.
Men with this condition think that they look small and weak, even if they are large and muscular. Similarly, women with the syndrome think that they look fat and loose, even though they are actually lean and muscular.
Some people who abuse steroids to boost muscle size have experienced physical or sexual abuse. They feel that increasing muscle will put them in a better position to protect themselves.
It was found in one series of interviews with male weightlifters, 25 percent who abused steroids reported memories of childhood physical or sexual abuse, compared with none who did not abuse steroids.
In a study of women weightlifters, twice as many of those who had been raped reported using anabolic steroids and/or another purported muscle-building drug, compared to those who had not been raped.
Almost all of those who had been raped reported that they markedly increased their bodybuilding activities after the attack. They believed that being bigger and stronger would discourage further attacks because men would find them either intimidating or unattractive.
Adolescents that abuse steroids tend to have a pattern of high-risk behaviour. They are most likely to take risks such as drinking and driving, carrying a gun, not wearing a helmet on a motorcycle, and abusing other illicit drugs.
While conditions such as muscle dysmorphia, a history of physical or sexual abuse, or a history of engaging in high-risk behaviours may increase the risk of initiating or continuing steroid abuse, researchers agree that most steroid abusers are psychologically normal when they start abusing the drugs.
How are steroids used?
Some anabolic steroids can be taken orally, by injection or by the use of gels or creams rubbed on the skin. Doses taken by abusers can be 10 to 100 times higher than the doses used for medical conditions.
Steroid abusers typically use a system of 'stacking' drugs. Here they take two or more different anabolic steroids, mixing oral and/or injectable types and sometimes even including compounds that are designed for veterinary use.
Abusers think that mixing steroids has a greater effect on the muscles than taking the drugs individually. However this theory has no scientific backing.
Often, steroid abusers also 'pyramid' their doses in cycles of 6 to 12 weeks. At the beginning of a cycle, the person starts with low doses of the drugs being stacked and then slowly increases the doses. In the second half of the cycle, the doses are slowly decreased to zero.
This is sometimes followed by a second cycle in which the person continues to train but without drugs. Abusers believe that pyramiding allows the body time to adjust to the high doses and the drug-free cycle allows the body's hormonal system time to recuperate. As with stacking, the perceived benefits of pyramiding and cycling have not been substantiated scientifically.
Steroids can be injected directly into the muscle group which the abuser wants to develop; this is often painful and can lead to infection.
Effects of Steroid Abuse
Anabolic steroid abuse can be the cause of a long list of side-effects. These include unattractive physical attributes, such as acne and breast development in men, as well as life threatening conditions such as heart attacks and liver cancer.
Some symptoms appear to be reversible if the abuser stops taking the drugs. However, continuous use may take the course of distortion too far, making the effects permanent. Other side-effects are known to be irreversible.
The normal production of hormones in the body can be disrupted with steroid abuse, causing both reversible and irreversible changes. Changes that can be reversed include reduced sperm production and shrinking of the testicles (testicular atrophy).
Irreversible changes include male-pattern baldness in both sexes and breast development in men (gynaecomastia).
The disruption of normal hormone balance is thought to be the main cause of gynaecomastia. In the female body, anabolic steroids cause masculinization. Breast size and body fat decrease, the skin becomes coarse, the clitoris enlarges, and the voice deepens. Women may experience excessive growth of body hair and lose scalp hair.
Rising levels of testosterone and other sex hormones normally trigger the growth spurt that occurs during puberty and adolescence. Subsequently, when these hormones reach certain levels, they signal the bones to stop growing, locking a person into his or her maximum height.
When a child or adolescent takes anabolic steroids, the artificially high sex hormone levels can signal the bones to stop growing sooner than they normally would have done.
Steroid abuse has been associated with heart attacks and strokes, even in athletes younger than 30. Steroids contribute to the development of Cardio Vascular Disease (CVD), partly by changing the levels of lipoproteins that carry cholesterol in the blood.
Oral steroids in particular can increase the level of low-density lipoprotein (LDL) and decrease the level of high-density lipoprotein (HDL). High LDL and low HDL levels increase the risk of atherosclerosis, a condition in which fatty substances are deposited inside arteries and disrupt blood flow.
If blood is prevented from reaching the heart, the result can be a heart attack. If blood is prevented from reaching the brain, the result can be a stroke.
Steroids also increase the risk of blood clots forming in blood vessels, potentially disrupting blood flow and damaging the heart muscle so that it does not pump blood effectively.
Liver tumours can be caused by steroid abuse. A rare condition called peliosis hepatis, in which blood-filled cysts form in the liver can also result from abuse. Both the tumours and the cysts sometimes rupture, causing internal bleeding.
Steroid abuse can cause acne, cysts, and oily hair and skin infection.
Many abusers who inject anabolic steroids use non sterile injection techniques or share contaminated needles with other abusers. In addition, some steroid preparations are manufactured illegally under non-sterile conditions. This puts abusers at risk for acquiring life-threatening viral infections, such as HIV and Hepatitis B and C.
Abusers also can develop infective endocarditis, a bacterial illness that causes a potentially fatal inflammation of the inner lining of the heart. Bacterial infections can also cause pain and abscess formation at injection sites.