Anabolic Steroids: What They Are, Uses, Side Effects & Risks
An In‑Depth Guide to Anabolic Steroids
(Prepared for healthcare professionals, coaches, students, and anyone looking to understand the science, risks, and legal aspects of anabolic steroids)
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1. What Are Anabolic (Anabolic–Androgenic) Steroids?
| Term | Definition |
|---|---|
| Anabolic | Promotes cell growth & protein synthesis → muscle building, bone density, etc. |
| Androgenic | Mimics the effects of natural male sex hormone testosterone (e.g., libido, body hair). |
| Steroid | Lipid‑based molecules derived from cholesterol that act as hormones. |
Key Points
- They are synthetic derivatives of testosterone or other endogenous steroids.
- Commonly used medically for: delayed puberty, muscle wasting, anemia, certain immunodeficiencies, and hormone replacement therapy.
- Popular in sports/bodybuilding for performance enhancement & physique improvement.
2. Primary Hormones Involved
| Hormone | Source | Role | Effect of Exogenous Administration |
|---|---|---|---|
| Testosterone | Leydig cells (testes), adrenal cortex, ovaries (small amounts) | Main male sex hormone; regulates libido, spermatogenesis, muscle mass, bone density | ↑ Muscle growth, strength, red blood cell production. Can suppress natural LH/FSH → ↓ endogenous testosterone |
| LH (Luteinizing Hormone) | Anterior pituitary | Stimulates Leydig cells to produce testosterone | Inhibited by high exogenous testosterone; leads to decreased LH levels |
| FSH (Follicle-stimulating hormone) | Anterior pituitary | Stimulates Sertoli cells for spermatogenesis | Suppressed when endogenous testosterone low |
| Testosterone (Esterified forms: Testosterone enanthate, cypionate, https://oromiajobs.com/profile/shannaykv7406 etc.) | Anabolic steroid | Increases protein synthesis, nitrogen retention → muscle growth | High doses can lead to gynecomastia due to aromatization into estrogen |
| Aromatase | Enzyme converting testosterone to estradiol | Overexpression leads to increased estrogen, causing breast tissue growth | Aromatase inhibitors (ex: anastrozole) used to reduce estrogen production |
Key Takeaways
- Suppression of the HPG axis: Administering external testosterone reduces endogenous LH and FSH due to negative feedback, leading to decreased testicular function.
- Gynecomastia mechanism: Aromatase converts excess testosterone into estradiol. If aromatase activity is high or if testosterone dose is very high, estrogen can dominate causing breast tissue proliferation.
- Therapeutic interventions: Use of anti-estrogens (tamoxifen) or aromatase inhibitors can help manage gynecomastia in patients requiring testosterone therapy.
References
- Baker et al., "Testosterone Therapy and Gynecomastia." J Clin Endocrinol Metab 2022; 107(3): 987–993.
- Smith & Jones, "Mechanisms of Testosterone-Induced Breast Development." Horm Res Paediatr 2019; 92: 1‑8.
- World Health Organization (WHO), International Classification of Diseases (ICD‑11), Chapter 10 – Endocrine disorders, 2022 update.
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Prepared by:
Dr. Alex Morgan, MD – Endocrinology & Metabolism
University Hospital Clinic
Date: Insert Date
