Anabolic steroid abuse

Anabolic steroids are substances similar to the male hormone testosterone. They are used to promote masculine features, increase growth, build muscle tissue, and strengthen bones. Common anabolic steroid medications include fluoxymesterone (such as Halotestin), methylprednisolone (such as Medrol), and nandrolone (such as Durabolin). All anabolic steroids available in the United States require a prescription and are used to treat conditions that occur when the body produces abnormally low amounts of testosterone, such as delayed puberty and some types of impotence.

Some dietary supplements contain dehydroepiandrosterone (DHEA) and androstenedione (street name Andro) and are taken to increase muscle growth. Whether these products actually result in muscle growth has not been proven. However, if they are taken in large amounts, the person may develop the same side effects produced by anabolic steroids.

When anabolic steroids are taken without a medical reason, it is usually to improve performance in sports or to increase muscle size and reduce body fat. Some teens abuse steroids along with other drugs.

When these medications are taken to supplement physical development, the dose is 10 to 100 times higher than when they are taken for medical conditions. They may be taken as a pill, an injection into a muscle, or a gel or cream rubbed on the skin. Often more than one of these drugs is used at the same time (stacking), or the drug is taken in a cycle from no drug to a high dose over a period of weeks to months (pyramiding).

Anabolic steroid use can cause a wide range of side effects affecting many systems in the body. Some of these effects can be permanent. Systems affected include the:

  • Hormonal system. In men, anabolic steroids reduce sperm count, shrink testicles, cause male-pattern balding, and enlarge breasts. In women, they cause masculine effects, such as decreased breast size and body fat, enlarged clitoris, and a deeper voice.
  • Musculoskeletal system (muscles and bones). A teen who abuses anabolic steroids may not reach his or her full adult height because these drugs can stop bone growth before it is complete.
  • Cardiovascular system (heart and blood vessels). Some anabolic steroids affect the level of fat (lipids) in the blood and may cause a heart attack or stroke, even in a very young person. Anabolic steroids also increase blood pressure.
  • Liver. Anabolic steroids can cause liver cancer.
  • Skin. Anabolic steroids cause oily skin and acne. Skin infections can develop if the person injects steroids, and these can become severe if the drug was contaminated with a virus or bacteria during its preparation.
  • Brain. Anabolic steroids may cause irritability, homicidal rage, uncontrollable activity level (mania), or false beliefs (delusions).

Signs of use

  • Possession of prescription anabolic steroid medications without a medical reason
  • Behavior changes, such as spending a great deal of the day at the gym or in other forms of exercise
  • Mood changes, such as increased aggressiveness
  • Physical changes that can't be attributed to expected patterns of growth and development
  • Purple or red spots on the body or unexplained darkness of skin
  • Unpleasant breath odor
  • Evidence of injecting medications when no injectable medications have been prescribed, such as possessing syringes or having redness at injection sites


Author: Sabra L. Katz-Wise
Ralph Poore
Last Updated: September 13, 2006
Medical Review: Kathleen Romito, MD - Family Medicine
Michael J. Sexton, MD - Pediatrics
Yifrah Kaminer, MD - Child and Adolescent Psychiatry

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