Anabolic Steroids Have Few Long-Term Side Effects In Bodybuilders
Every bodybuilder, powerlifter, athlete and gym rat who has ever taken anabolic steroids (AAS) worries at one point or another about the risks involved. Even though there are not designated parking spots at gyms for ambulances to make it easier for EMTs to push oversized gurneys to the squat racks, every public statement made by politicians, health agencies and celebrity athletes emphasizes the potential damage to a person’s health in addition to tagging AAS users as cheaters. 

Certainly, AAS use carries risks, as does the use of any drug. Unfortunately, the true scope and degree of that risk is unknown, as AAS research has been stunted due to biases in funding and ethical concerns from traditionally ultra-conservative Institutional Review Boards (IRBs). Clinical research involving humans and animals is approved by an IRB prior to recruiting volunteers to ensure that the subjects will not be exposed to significant or unnecessary risks. At this time, the risk profile for testosterone use appears to be dose-related, with doses that result in plasma (blood) concentrations well outside the normal range (both above and below), leading to side effects that range from temporary and trivial to serious and permanent…potentially fatal in rare cases. Not only do the risks depend upon the concentration achieved; age, gender (sex), AAS used and underlying health conditions (sometimes undiagnosed) in the user need to be considered as well. Extremely young (adolescents or children) and elderly people may not be able to tolerate the sudden or extreme swing in androgen concentrations; women are much more sensitive to changes in androgen levels and may develop features that would go unnoticed or be of little consequence in men; while testosterone is generally well-tolerated, other AAS may affect certain tissues or behaviors negatively; and lastly, the existence of psychiatric or health conditions that may be stimulated or accelerated by fluctuations in androgens are relevant concerns (certain cancers, mania, depression, etc).

Nonetheless, demand for AAS remains high, particularly among adults who wish to improve their appearance, quality of life or health. Why is there such a disparity? Why do adults who are seeking to be healthier and more vital choose to use hormones that are supposed to be so dangerous? Frankly, most users do not perceive AAS to be dangerous and readily accept the side effects they realize in exchange for the tangible benefits of increased muscle mass and strength, not to mention the positive response of peers.1 However, is it perception or reality that is influencing AAS users? After all, the medical literature is replete with cases of liver damage, heart attacks, behavior problems and premature deaths.2-5 Conversely, other papers have noted that in consideration of the assumed prevalence of AAS in the United States, the number of cases of serious adverse events is relatively low, especially when one considers that the majority of users are self-educated or even untrained in AAS use, that the drugs are often of undocumented purity and potency and may be adulterated with other substances and are also commonly distributed through dubious channels.6