Steroid Side EffectsSteroids, as we all are well aware of, are drugs that help bring about desired effects in the body, altering and at times reciprocating certain body functions, though temporarily. They generally have anabolic impact on the body and are thus termed as anabolic steroids, technically called anabolic – androgen steroids. Their main function lies in increasing the synthesis of protein within cells, resulting in the buildup of cellular tissue (anabolism), particularly in he muscles. Therapeutically, they mimic the effects of the hormones testosterone and dihydrotestosterone in the body. Anabolic steroids possess androgenic and virilizing properties, including the development and maintenance of masculine properties. As far as administering steroids by sportspersons is concerned, their usage is controversial mainly because of their adverse effects and also gaining triumph through unfair means. This is commonly referred to as ‘doping’.

The side effects of steroids may be numerous and ranging in severity. Depending upon the length of their use, these side effects may be irreversible and adverse, leading to jeopardy of health. Other factors affecting the frequency and severity of side effects are the type of drug, dosage, duration of use and individual sensitivity and response.

1. ANABOLIC EFFECTS

(i) Enhanced protein synthesis

(ii) Increased appetite

(iii) Increased remodeling and growth of bone tissues

(iv) Stimulation of muscle cell formation

(v) Stimulation of bone marrow

2. VIRILIZING EFFECTS

(i) Enlargement of the clitoris in females and that of penis in male children

(ii) Enhanced growth of androgenic-sensitive hair

(iii) Increased of vocal cord

(iv) Deepening of voice

(v) Increased libido

(vi) Impaired production of sperm

(vii) Suppression of natural sex hormones

3. SHORT TERM SIDE EFFECTS

A veritable buffet of problems may be experienced by both men and women. Men may face problems such as:

(i) Testicular Atrophy ( or shrunken testicles)

(ii) Gynecomastia (enlarged breasts)

(iii) High blood pressure

(iv) Acne

(v) Reduced sperm count

(vi) Fluid retention

(vii) Abnormal liver function ( peliosis hepatis)

(viii) Prostate enlargement etc

Women may experience:

(i) High blood pressure

(ii) High cholesterol

(iii) Liver damage

(iv) Balding

(v) Deepening of the voice

(vi) Facial and body hair growth

(vii) Coarsening of the skin

However, both sexes experience increased aggressiveness commonly called ‘roid rage’. Also, acne is seen owing to increased sebum production due to enlarged sebaceous glands in the skin.

Other side effects experienced commonly include:

(i) Insomnia

(ii) Behavioural changes

(iii) Increase in appetite

(iv) Facial flushing

(v) Temporary weight gain

4. LONG TERM SIDE EFFECTS

More serious side effects are seen when steroids are used for a longer period of time, or taken on multiple occasions. Some side effects can be decreased by replacing the daily doses by alternate days. In some cases, many side effects can be reversed by stopping the drugs.

Long-term side effects of steroids are:

(i) Cardiovascular malfunctions

(ii) Osteoporosis

(iii) Diabetes mellitus

(iv) Glaucoma

(v) Obesity

(vi) High blood pressure

(vii) Cataract

(viii) Myopathy

A. EFFECTS ON THE LIVER

Adverse effects on the liver are particularly true for orally administered steroids. Some of these are:

(i) Lesions of the liver

(ii) Anemia

(iii) Decrease in hepatic excretory function

(iv) Intra hepatic cholestasis

(v) Jaundice

(vi) Hepatic peliosis (formation of blood filled cysts)

(vii) Fibrosis

(viii) Portal hypertension

(ix) Adenoma

(x) Hepatocellular carcinoma

(xi) Increase in plasma activity of liver enzymes

B. EFFECTS ON THE MALE REPRODUCTIVE SYSTEM

Anabolic steroids are generally derivatives of testosterone, effects on the reproductive system are quite obvious.

(i) Hypogonadotrophic hypogonadism

(ii) Decrease in sperm cell production

(iii) Decreased fertility

(iv) Gynecomastia

(v) Increased libido (resulting in greater risk of involvement in sexual assault

C. EFFECTS ON THE FEMALE REPRODUCTIVE SYSTEM

(i) Adverse effect on hypothalamic-pituitary-gonadal axis

(ii) Inhibition of follicle formation

(iii) Irregularities of menstrual cycle and ovulation

(iv) Hypertrophy of the clitoris

(v) Increased libido

(vi) Fetal death (in case of pregnant women)

(vii) Breast atrophy

D. CARDIOVASCULAR DYSFUNCTION

(i) Increase in cholesterol level

(ii) Increase in diastolic blood pressure (due to salt and water retention)

(iii) Decrease in ischemic tolerance

(iv) Hypertrophy of left ventricle

(v) Cardiomyopathy

(vi) Greater risk of heartd attack and stroke

E. PSYCHOLOGICAL EFFECTS

(i) Behavioural differences

(ii) Increased aggressiveness

(iii) Euphoria

(iv) Sleeping disorders

(v) Confusion

(vi) Paranoia

(vii) Hallucinations

(viii) Pathological anxiety

(ix) Mental depression

(x) Suicidal behaviour

(xi) Psychosis

(xii) Withdrawal effect

F. ADDITIONAL SIDE EFFECTS

(i) Hypertrophy of sebaceous glands

(ii) Hair loss

(iii) Increased tallow excretion

(iv) Alopecia

(v) Adverse effect on immune system

(vi) Decrease in glucose tolerance

(vii) Increased insulin resistance

(viii) Thrombosis

(ix) Adverse effect on thyroid function

(x) Multiple drug abuse

G. HIV

Though scoffed at by many abusers, HIV is one of the deadliest side effects of steroids. A hazardous combination is attained by the mergence of a heightened sex drive and libido along with sharing of intravenous needle. This is notable among adolescents and youth who possess weaker skills of decision-making. They are also influenced by high susceptibility to peer pressure.

H. RETARDED GROWTH

Research studies have proved that adolescents involved in steroid abuse are at a risk of being short unto death. The pubescent period is crucial for development and growth. On sensing a certain level of hormones in the body, the adolescent brain signals the bones to stop growing, barring the growth in the long bones. This makes the youngsters permanently short.

I. NEUROLOGICAL ISSUES

Studies reveal that steroids have a long term effect on neurological pathways of the brain. The serotonin enzyme is tampered with, thereby heightening aggression and depression.

J.WEIGHT ISSUES

Persons who are accustomed to steroids often develop atrophied muscle mass which converts to fat. Many people face problems of weight gain or losing excess flab. In the long run, weight gain contributes a great deal to various cardiovascular and other maladies.

K. SKELAT AL ISSUES

As mentioned earlier, steroids increase muscle mass, but deal quite unfairly with ligaments and joints. Consequently, the weak ligaments fail to anchor the new muscle strength, increasing the possibility of severe injury and thereafter surgery.

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