When you ask the average consumer what they think of anabolic steroids, words like “death,” “liver problems,” “juiced-up musclemen,” and “roid rage” come to mind. The same thing happens when you ask the average scientist, physician, or allied health professional. It’s as if time has stood still on the political correctness clock, while science has actually moved forward beyond the “steroids are always bad for you” mentality.

Why is that? Who knows? Intellectual laziness, perhaps. Or maybe it’s that images of extremely muscular physiques, whether they’re men or women, still “scare” the average person. Also, there’s the subtle, but important, cultural difference between those who grew up being “gym rats” and those who think spending all that time moving iron is a somewhat odd obsession.

Of course, these folks usually talk about how “odd” recreational bodybuilders are, while at the same time they are smoking cigarettes and patting their ever-expanding waistlines that have already exceeded their hip circumference. 

      The list of positive things anabolic steroids or androgens can do is growing by the minute. Thanks to the work of Dr. S. Bhasin in 1996, we’ve now got a plethora of new work published each month on the effects of androgen use. 

Roughed Up Rotator Cuffs
For example, recent work showed that you can enhance remodeling, and improve the biomechanical properties, of bioartificially engineered human supraspinatus tendons. The supraspinatus is a muscle that sits deep in your shoulder and is involved in shoulder joint abduction (i.e., raising the arm laterally from the side). Keep in mind that this study was in vitro (test tube). In this investigation, bioartificial tendons were treated with nandrolone decanoate, loading, or both, with a control group getting no treatment (non-load, non-steroid). Guess what happened? Do you think the steroid-taking group messed up their tendons even more? Certainly, that’s what many in the mainstream press would say.

To the contrary, the load/steroid group showed the greatest remodeling and the best organized actin cytoskeleton. Also, matrix metallo-proteinase-3 levels in the load/steroid group were greater than those of the non-load, non-steroid group. Ultimate stress and ultimate strain in the load/steroid group were greater than those of the non-load/non-steroid and non-load/steroid groups. Basically, providing nandrolone and a load (which is basically resistance) causes the two to act in combination to increase matrix remodeling and biomechanical properties of bioartificial tendons. For real world applications, this suggests that anabolic steroids may enhance production of bioartificial tendons and the healing of the rotator cuff tendon. Perhaps, instead of heading straight for the corticosteroid injection, the proper application of an androgen would be a better way to promote musculotendinous healing.1

Post-Steroid ‘Nad Function
You know that prolonged use of androgens can shut down your sperm production as effectively as a bunch of fire ants can ruin a Sunday afternoon picnic. Some individuals might actually like that side effect, though having atrophied testicles may not be the best way to attract Mrs. Right (or Ms. Right Now). In order to avoid or ameliorate this condition, the use of human chorionic gonadotrophin (HCG) and/or antiestrogens are tried concurrent with and/or post-steroid use. In a recent investigation, 18 healthy male power athletes using massive doses of androgens were recruited for the study. Semen samples were collected during androgen use and 1.5 and six months after cessation of use. Subjects were also asked about their reproductive activity six years after the study. What was found in this group of strongmen? 

At the end of the cycle, the sperm count was 33 million per milliliter and only one subject had azoospermia (the absence of sperm in semen). The lower normal limit is 20 million per milliliter with a range of 20–150 million sperm per milliliter as normal. Thus, most of the subjects were actually above the lower normal limit for sperm count. This by itself is interesting. Past work by the World Health Organization showed that 200 milligrams weekly of testosterone enanthate could effectively suppress spermatogenesis in healthy males; in fact, it was a more effective birth control method than oral contraception used by women. Thus, for the men in this current study, it’s likely that issues of dosage and treatment duration, as well as the type of androgen used, could affect the reproductive function of men. 

At 1.5 months after cessation of androgen use, the mean sperm concentration was 30 million per milliliter and after six months, 77 million per milliliter. There were significant differences between the sample drawn six months after cessation of androgen use and both samples drawn during and 1.5 months after the abuse. There was a significant positive correlation between HCG dose during the cycle and the relative amount of morphologically abnormal spermatozoa. This means the more HCG administered, the greater the number of abnormal sperm. Whether that’s a cause-and-effect relationship is unknown. So, in conclusion, the combination of HCG and supraphysiological androgens cause temporary impairment on semen quality in males; nonetheless, spermatogenesis is maintained with this regimen despite prolonged androgen use.2

Legit Steroid Use for Women
A growing category in androgen use relates to its benefits in treatment of wasting diseases. In a recent investigation, a total of 57 HIV-infected women with free testosterone levels less than the median of the reference range and with weight less than 90 percent of ideal bodyweight or weight loss greater than 10 percent, were randomly assigned to receive transdermal testosterone (four-milligram patch) twice weekly, or placebo, for six months. Testosterone treatment resulted in significant increases in testosterone and free testosterone, and was well tolerated without adverse effects on immune function, lipid and glucose levels, liver function, body composition or the adverse effect of hirsutism (excessive hairiness) when compared to the placebo condition. Translation: Low dose androgen administration in HIV-infected women may be of clinical benefit.

Additionally, muscle mass and strength increased in the testosterone-treated women compared with the placebo-treated subjects. According to the authors, “Testosterone administration is well tolerated and increases muscle strength in low-weight HIV-infected women. Testosterone administration may be a useful adjunctive therapy to maintain muscle function in symptomatic HIV-infected women.”3  Wow, imagine that! Testosterone administration may be good for women who are potentially dying. Think about it. 

References
1.    Triantafillopoulos IK, Banes AJ, Bowman KF, Jr., Maloney M, Garrett WE, Jr., Karas SG. Nandrolone Decanoate and Load Increase Remodeling and Strength in Human Supraspinatus Bioartificial Tendons. Am J Sports Med, Jun-Jul 2004;32(4):934-943.
2.    Karila T, Hovatta O, Seppala T. Concomitant abuse of anabolic androgenic steroids and human chorionic gonadotrophin impairs spermatogenesis in power athletes. Int J Sports Med, May 2004;25(4):257-263.
3.    Dolan S, Wilkie S, Aliabadi N, et al. Effects of testosterone administration in human immunodeficiency virus-infected women with low weight: a randomized placebo-controlled study. Arch Intern Med, Apr 26 2004;164(8):897-904.