Steroid Symptoms and Signs
Anabolic-androgenic steroids (AASs) do not trigger rapid increases in the brain chemical dopamine, which causes the “high” that drives people to abuse other substances. Yet long-term steroid abuse can act on some of the same brain pathways and chemicals such as dopamine, serotonin and opioid systems, thereby impacting moods and behaviors. The androgenic effects include masculinizing effects such as increased facial hair, deepening of voice and enlargement of some male sex glands. Anabolic effects include an increase in muscle mass and calcium in the bones and some internal organs. It is believed years of AAS cycling enable athletes to train abnormally hard, resulting in increased capillary and mitochondrial density and improved oxygen delivery, all of which may be permanent.1,2,3
Short-Term Side Effects
Aggressive behavior known as “roid rage” can lead to severe outbursts of anger and violence. Several other physical and behavioral side effects are associated with short-term use.1,3
- Severe acne
- Fluid retention
- Increased blood pressure and cholesterol
- Reduced sexual functioning
- Increase in muscle size
- Swelling of feet and ankles
- Rapid weight gain
- Improved appetite
- Improved healing
Behavioral Side Effects
- Paranoia (e.g. excessive or unreasonable jealousy)
- Delusions (false beliefs or ideas)
- Impaired judgment
- Manic or hypomanic symptoms (e.g. extreme mood swings)
- Extreme irritability
- Suicidal tendencies
Some detrimental steroids signs do not appear until years after drug use began. People who inject steroids are at greater risk of transmitting or contracting diseases like hepatitis, HIV, cellulitis, abscesses and other bacterial infections. Prolonged, high doses may result in human neuronal cell death, increasing the possibility of early onset dementia. Many other potentially serious side effects are linked to long-term use, most notably the negative impact on the cardiovascular system.1,3,4
- Liver damage (e.g. liver tumors and cysts)
- Kidney disease
- High blood pressure
- Changes in cholesterol and other blood lipids
- Enlarged heart
- Heart attack
- Blood clotting issues
- Musculoskeletal injuries (especially tendon ruptures)
Gender and Age-Based Side Effects
The use of AASs can alter the normal hormonal production in the body, causing different side effects in men and women, as well as in adolescents, whose bodies are not fully grown. There is limited scientific data regarding the connection between AASs and an increased risk of prostate cancer in men, with some AAS proponents citing a study published in Lancet in 1986 as insufficient evidence. A more recent mouse model study showed structural changes in weight, volume and epithelium height of the ventral lobe and a predominance of collagen fibers in the prostates of mice injected with steroids. These alterations appeared to be more severe in adult mice.5
- Men: Gynecomastia (development of breasts), shrinking testicles, decreased sperm count, baldness, heart damage, difficulty or pain while urinating, impotence and increased risk of liver cancer.1,3,6
- Women: Menstrual irregularities, growth of facial hair or excessive body hair, male-pattern baldness, enlarged clitoris, reduced breast size, deepened voice and infertility.1,3,6
- Teens: Stunted growth (when high hormone levels from steroids signal the body to stop bone growth too early) and stunted height (if teens use steroids before their growth spurt).1,3,6
Signs of Steroid Abuse
There are several physical and emotional signs of possible AAS use, the first of which is weight gain or rapid muscle development. Swelling of the feet and lower legs is also common, as are shaking and tremors. Although most teens develop acne, parents should be on the lookout for sudden increases in acne and oily skin. Steroid users can also develop purple or red spots on the body, as well as jaundice. Extreme mood swings, increased aggression or irritability and paranoia are possible indications of steroid abuse.1
An unknown number of steroid abusers may become addicted, as evidenced by continued use despite negative health repercussions and strained personal relationships. Moreover, steroid abusers typically spend a good deal of time and money obtaining these drugs, another indication of possible addiction.7
A steroid study involving 4,746 middle and high school students in Minneapolis revealed a high incidence of co-occurring problems. In males, steroid use was associated with poor self-esteem, higher rates of depressed mood and attempted suicide, poor knowledge and attitudes about health, greater participation in sports emphasizing weight and shape, greater parental concern about weight and higher rates of eating disorders and substance abuse.8
- Drug Facts – Anabolic Steroids. National Institute on Drug Abuse website. https://www.drugabuse.gov/publications/drugfacts/anabolic-steroids Updated March 2016. Accessed February 19, 2017.
- An analysis of the long-term effects of performance-enhancing drugs. Velo News website. http://www.velonews.com/2014/02/training-center/an-analysis-of-the-long-term-effects-of-performance-enhancing-drugs_317590#G73QzUEAXov0Tf2u.99 Published February 20, 2014. Accessed February 19, 2017.
- Confirm Biosciences website. http://www.confirmbiosciences.com/knowledge/drug-facts/steroids/ Accessed February 19, 2017.
- Pope HG, Khalsa JH, Bhasin S. Body Image Disorders and Abuse of Anabolic-Androgenic Steroids Among Men. JAMA. Published online December 08, 2016. doi:10.1001/jama.2016.17441
- Vargas RA, Oliveira LP, Frankenfeld S, et al. The prostate after administration of anabolic androgenic steroids: a morphometrical study in rats. Int Braz J Urol. 2013 Sep-Oct;39(5):675-82. doi: 10.1590/S1677-5538.IBJU.2013.05.10.
- What are Anabolic Steroids? Drugs website. https://www.drugs.com/article/anabolic-steroids.html Updated May 4, 2014. Accessed February 19, 2017.
- Anabolic Steroid Abuse. National Institute on Drug Abuse website. https://www.drugabuse.gov/publications/research-reports/anabolic-steroid-abuse/are-anabolic-steroids-addictive Updated August 2006. Accessed February 19, 2017.
- Mhillaj E, Morgese MG, Tucci P, Bove M, Schiavone S, Trabace L. Effects of anabolic-androgens on brain reward function. Front Neurosci. 2015;9:295. doi:10.3389/fnins.2015.00295.