Possible Negative Effects of Androgenic-Anabolic Steroids (AAS)

Long Term Effects

• Long term effect of AAS in general are unknown
• Specifically, as related to:
  • Type of AAS
  • Dose
  • Frequency of use
  • Age at initiation
  • Concurrent drug use
• Other confounds
  • Varied AAS practices of individuals
    • large dosages for prolonged time
    • therapeutic dosages intermittently
• Investigation has been proposed
  • Study the long term effects of AAS
  • Costing approximately $1 million
  • Approved but never funded

Also see Problems with Current Information.

Physical effects

• All effects fully reversible (adult males)
  • Within several months after cessation
  • Except postulated changes in the myocardium
    • which have not been followed
• Effect vary significantly
  • Types of AAS
  • Dosages of AAS
  • Individuals
  • Other situations
• Best documented effects
  • Liver
  • Serum lipids
  • Reproductive system
• Other effects
  • Psyche and behavior
  • Glucose tolerance and hyperinsulinism
  • Cerebrovascular accidents
  • Prostatic Changes
  • Immune function
  • Altered collagen production possibly effecting tendon integrity
• Cardiovascular risk factor
  • Hyperinsulinism and decreased glucose tolerance
  • Changes in lipoprotein fraction
  • Increased triglyceride levels
  • Increased concentration of several clotting factors
  • Hypertension (via estrogen conversion)
  • Changes in myocardium
• Liver structure and function
  • Cholestatic jaundice
  • Peliosis hepatis
  • Hepatocellular hyperplasia
  • Hepatocellular adenomas
  • Associated with 17 alpha-alkylated (oral) steroids
• Male reproductive system
  • Decreased endogenous testosterone
  • Decreased gonadotrophic hormones
  • Decreased sex hormone-binding globulin (SHBG)
  • Decreased testicle size
  • Sperm
    • decreased count
    • decreased mobility
    • altered morphology
  • Gynecomastia
• Women
  • Some effects not reversible
  • Menstrual abnormalities
  • Deepening of the voice
  • Shrinkage of the breasts
  • Male pattern baldness
  • Increased libido, acne, body hair, clitoris size
  • Greatly increased testosterone levels
  • Decreased sex hormone-binding globulin (SHBG)
  • Decreased follicle-stimulating hormone
  • Decreased thyroid-binding proteins

Also see Physiological Effects of Anabolic/Androgenic Steroids.

Psychological

• Research in the last half century
  • AAS used for mood & mental disorders
  • Generally positive findings
• Self-reported changes
  • Increased self-acknowledged acts of violence
  • Mood
  • Behavior
  • Somatic perceptions
• Case reports noted by steroid users
  • Hypomania
  • Schizophrenic episodes
  • Psychotic episodes
• Transient upon discontinuation
• Seem to be related to type
  • Not dosage
• Unclear factors
  • Previous history
  • Genetic susceptibility
    • addictions or mental disorders
  • Environmental and peer influences
  • Individual expectations

Also see Psychological Effects of Anabolic/Androgenic Steroids.