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Acne

Acne in an athlete is one of the obvious indicators of steroid use. As a teenager acne is very common it will usually appear at the onset of puberty when testosterone levels will peak.

When the body begins producing hormones, the oil glands become over active. The excess oil combine with the normal shedding of dead skin cells cause pores to become clogged. The oil bacteria trapped with a pore are the beginning of a pimple.

A steroid user can also get acne because the androgen’s will stimulate the sebaceous glands which secrete oils in the skin. The more you increase the hormones the higher amount of oil that is secreted which can cause acne to develop on your back, shoulders and face. So there is a proportional relationship between the level of androgen’s and the amount of oil secreted by the skin.

To treat acne the most common way is by washing the skin to remove dirt and oil before pores become clogged. If this fails to work there is a prescription drug called Accutane®, this is a very effective medication that acts on the sebaceous glands reducing the level of oil secreted.

The use of strong androgenic steroids such as Dianabol® and Anadrol® 50 can bring out some of the worse cases of acne including unsightly blemishes all over the skin.

Aggression

One side effect common with steroid use is aggression, it is more noticeable in men as they carry a higher level of testosterone than woman. The aggression is a positive effect for some bodybuilders as it will help them to lift weights more intensely. However if you lack the maturity to control yourself and this aggression and let things get out of hand, you should not use steroids.

Birth Defects

Anabolic/androgenic steroids can greatly effect a developing fetus resulting in fetal retardation which can lead to death. Or Pseudo-hermaphroditism where the child is born with both male and female traits, in both physical and characteristic. Woman who are, or plan to become pregnant, should never consider the use of anabolic steroids, it would be best to stay clear of these drugs. Anabolic/androgenic steroids can reduce a males sperm count and male fertility but are not linked to birth defects.

Blood Clotting Changes

Anabolic/androgenic steroids can increase the prothrombin time, this is the time duration in which it will take the blood to clot. If a user of steroids was to get a regular nasal bleed, they would notice that the blood would seep a little longer that it usually would. If surgery was required or the user was involved in a serious accident the lose could be quite dramatic. The use of medications like Aspirin, Tylenol and especially anticoagulants (stop blood from clotting) can amplify blood clotting changes when using anabolic/androgenic steroids.

Cancer

It is thought that steroids can give you cancer, but this is actually very rare. Since anabolic/androgenic steroids are synthetic versions of a natural hormone that your body can metabolize easy, they only place a low level of stress on the organs. Compounds like Anadrol® 50 that are c17 alpha alkylated, due to their chemical alteration are liver toxic. In a small number of cases this severe liver damage from Anadrol has lead to cancer. It was only patents that were already very ill that got cancer and only from low dosages of it.

One cancer associated with steroid abuse is Wilm’s tumor or nephroblastoma which is cancer of the kidneys.

Assuming an athlete is not abusing methylated oral substances, and visits his doctor during heavy cycles, cancer should not need to be a big concern.

Cardiovascular Disease

Anabolic/androgenic steroids have an effect on the level of LDL, HDL, and total cholesterol values.

What is cholesterol? Cholesterol is a substance in the human body that is required for building and regulating cells. There are two types of cholesterol LDL (low density lipoprotein) which is know as the bad cholesterol and HDL (high density lipoprotein) which is known as the good cholesterol.

What is a lipoprotein? A lipoprotein is a biochemical assembly made up of lipids, which are fats, and protein molecules. Lipoproteins are vital to the body functions because they serve to transport different forms of cholesterol to areas in the body where they are needed.

LDL (Low Density Lipoprotein): Causes buildup of cholesterol in the artery walls, forming plaque and eventual blockages that can lead to heart attack or stroke.

HDL (High Density Lipoprotein): Removes cholesterol deposits from the arteries. Carries cholesterol through the system to the liver, where it can be properly metabolized. HDL seems to protect the cardiovascular system from disease.

From the use of steroids the general pattern seen is that they can decrease the level of HDL cholesterol numbers while simultaneously increasing the level of LDL cholesterol numbers. What is important is the ratio of the HDL and LDL cholesterol numbers not one’s total cholesterol count. Unfavorable changes to the ratio in the long term can be very detrimental to the cardiovascular system which can lead to high blood pressure and disease.

It should be noted that most oral steroids with 17alpha alkaylated structure have a much stronger negative effect on the HDL cholesterol numbers than injectable steroids.

A study was carried out comparing the effect of a weekly injection of 200mg testosterone enanthate and a 6mg daily oral dose of Winstrol®. After only six weeks, stanozolol was shown to reduce HDL and HDL-2 (good) cholesterol by an average or 33% and 71% respectively. While the HDL reduction (HDL-3 subfraction) with the testosterone group was only an average of 9%. Stanozolol LDL (bad) cholesterol rose by 29%, while with the use of testosterone is actually dropped by 16%.

It should be noted that estrogen also has an impact on cholesterol profiles, for example, estrogen replacement therapy in postmenopausal woman is commonly linked to a rise in HDL cholesterol and a reduction in LDL values.Likewise the aromatization of testosterone to estradiol may be beneficial in preventing a more dramatic change in serum cholesterol due to the presence of the hormone.

A recent study was conducted comparing the effects of testosterone alone (280mg testosterone enanthate weekly), vs the same dose combined with an aromatase inhibitor (250mg testolactone 4 times daily). Methyltestosterone was also tested in a third group, at a dose of 20mg daily. The group using only testosterone enanthate showed no significant decrease in HDL cholesterol values over the course of the 12-week study. After only four weeks, the group using testosterone plus an aromatase inhibitor displayed a reduction on average of 25%. The methyltestosterone group noted an HDL reduction of 35% by this point, and also noted an unfavorable rise in LDL cholesterol.

So from the results of the study we should think a little more carefully about the estrogen maintenance through a steroid cycle. For instance Nolvadex® doesn’t exhibit anti-estrogenic effects on cholesterol values, it can actually raise HDL values. So using Nolvadex® instead of using a aromatase inhibitor like Arimidex®, may be the better choice, especially for those who will use steroids for longer periods of use.

Depression

Since anabolic steroids affect hormone levels in the body this may result in a change in one’s general disposition or mood. We might see either very aggressive behavior or possibly extreme depression. This will usually occur to users who are psychologically sensitive to an imbalance in androgen and estrogen levels.

The most common time for this to occur for male bodybuilders is when the anabolic/androgen steroids are discontinued. At this time endogenous testosterone levels are suppressed, and it may take a while before one’s normal hormonal balance will return. During this period, estrogen levels may be more stable than testosterone, as our bodies can produce it from adrenal hormones. The result may be a protracted window of time in which estrogen seems to be the more dominant sex hormone. For some, individuals this window can be filled with feelings of emotional sensitivity, sadness, and lack of motivation which are all symptoms of depression.

Depression can also occur during the course of a steroid cycle, particularly with the sole use of anabolics. Although these compounds are mild in comparison to androgens, many can still suppress the endogenous production of testosterone. If the testosterone level drops significantly during treatment, the administered anabolics may not provide enough of an androgen level to compensate, and a marked loss of motivation and sense of well-being may result. The best advice when looking to avoid cycle or post-cycle depression is to closely monitor drug intake and withdrawal. The use of a small weekly testosterone dose might prove very effective if added to a mild dieting/anabolic cycle, warding off feelings of boredom and apathy to training. Of course a strong steroid cycle should always be discontinued with the proper use of ancillary drugs (Nolvadex, Arimidex, HCG, Clomid, etc.). Although tapering schedules are very common, they are not an effective way to restore endogenous testosterone levels.

Gynecomastia

Gynecomastia is the medical term for the development of female breast tissues in the male body. This occurs when the male is presented with an unusually high level of estrogen, particularly with the use of of strong armatizing androgens such as testosterone or Dianabol. The excess estrogen can act upon receptors in the breast and stimulate the growth of mammary tissues. If left unchecked, this can lead to an actual obvious and unsightly tissue growth under the nipple area, in many cases taking on a very feminine appearance.

To fight this side effect during steroid therapy, many find it necessary to use some form of estrogen maintenance medication. This includes an estrogen antagonist such as Clomidor Nolvadex, which blocks estrogen from attaching to and activating receptors in the breast and other tissues, or an aromatse inhibitor such as Arimidex, which blocks the enzyme responsible for the conversion of androgens to estrogens. Aromatase inhibitors like this are currently the most effective options, but also the most costly.

It is worth noting, however, that many believe a slightly elevated estrogen level may help the athlete achieve a more pronounced muscle mass gain during a cycle. With this in mind many athletes decide to use anti-estrogens only when it is necessary to block gynecomastia. It is of course still a good idea to always keep an anti-estrogen on-hand when admininstering an aromatizable steroid, so that is readily accessible should trouble become evident. Puffiness or swelling under the nipple is one of the first signs of pending gynecomastia, often accompanied by pain or soreness in this region (an effect termed gynecodynea). This is a clear indicator that some type of anti-estrogen is needed. If the selling progresses into small marble-like lumps, action absolutely must be taken immediately to treat it. Otherwise, if the steroids are continued at this point without ancillary drug use, the user will likely be stuck with unsightly tissue growth that can only be removed with a surgical procedure.

It is also important to mention that progestins seem to augment the stimulatory effect of estrogens on mammary tissue growth. There appears to be a strong synergy between these two hormones here, such that gynecomastia might even be able to occur with the help of progestins, without excessive estrogen levels being necessary. Since many anabolic steroids, particularly derived from nandrolone, are known to have progestational activity, we must not be lulled into a false sense of security. Even a low estrogen producer like Deca can potentially cause gyno in certain cases, again fostering the need to keep anti-estrogens close at hand if you are very sensitive to this side effect.

Hair Loss

The use of highly androgenic steroids can negatively impact the growth of scalp hair. In fact, the most common form of male pattern hair loss is directly linked to the levels of androgens in such tissues, most specifically the stronger DHT metabolite of testosterone. The technical term for this type of hair loss is androgenic alopecia, which refers to the interplay of both the male androgenic hormones and a genetic predisposition in bringing about this condition. Those who suffer from this disorder are shown to posses finer hair follicles and higher levels of DHT in comparison to a normal, hairy scalp. But since there is a genetic factor involved, many individuals will not see signs of this side-effect, even with heavy steroid use. Clearly those individuals who are suffering from (or have a familial predisposition for) this type of hair loss should be very cautious when using the stronger drugs like testostereone, Anadrol 50, and Dianabol.

In many instances, the renewal of lost hair can be very difficult, so avoiding this side-effect before it occurs is the best advice. For those who need to worry , the decision should probably be made to either stick with milder substances (Deca Durabolin most favored), or use the ancillary drug Propecia/Proscar (finasteride) when taking testosterone. Finasteride is a very effective hair loss medication, which inhibits the 5-alpha reductase enzyme specifically in the hair follicles and prostate. However, it offers us little benefit with drugs that are highly androgenic without 5-alpha reduction, the most notable offenders being Anadrol 50 and Dianabol. We must also remember that all anabolic/androgenic steroids activate the androgen receptor, and can, likewise, all promote hair loss given the right dosage and conditions.

Headaches

Athletes sometimes report an increased frequency of headaches when using anabolic/androgenic steroids. This seems to be most common during heavier bulking cycles, when an individual is utilizing strongly estrogenic compounds.

One should not simply take aspirin and ignore the problem, as it may indicate a more troubling side effect of steroid use, high blood pressure. Since high blood pressure invites a number of unwanted health risks, monitoring it on a regular schedule is important during heavy steroid use, especially if the individual is experiencing headaches. Some athletes choose to lower their blood pressure in such cases with a prescription medication like Catapres, but most find this an appropriate time to discontinue steroid use. Milder anabolics, which generally display little or no ability to convert to estrogen, are also more acceptable options for individuals sensitive to blood pressure increases. Less seriously, many headaches are due to simple strain on the neck and scalp muscles. The athlete may be lifting with much more intensity during a steroid cycle, and as a result may place added strain on these muscles. In this case, a short break from training, and some general rest, will often take care of the problem. Of course if anyone is experiencing a very serious or persistent headache, a visit to the doctor may be in order.