The performance-enhancing drugs gym-goers talk about are mostly anabolic-androgenic steroids, hormones derived from the male hormone testosterone and sold to people as a shortcut to bigger muscles and a stronger body. In reality they have legitimate medical uses in those suffering from hormonal deficiency or muscle wasting due to illness, but using them to beautify the body without medical supervision opens a door to harms that touch the heart, liver, fertility and mood. In this article we explain the harms of steroids, why some gym-goers get drawn into them until they depend on them, and how doctors treat this.
What is meant by performance-enhancing drugs?
The word “steroid” is used for two completely different types, and they are often confused. The first type is corticosteroids, medicines prescribed to treat inflammation, allergies and immune diseases, and they have nothing to do with building muscle. The second type is the anabolic-androgenic steroids we mean here, which mimic the male hormone and increase protein building in muscles.
Alongside them, other substances some athletes use for performance or appearance enter the list of “enhancers”, such as growth hormone, diuretics and fat burners. All carry risks, and any product sold to you without a prescription and tests remains of unknown composition, as advertised supplements sometimes contain substances not mentioned on the pack.
Why is their use widespread in gyms?
Social pressure is the first driver. The young man who trains for months with slow results sees bodies around him changing quickly, and assumes everyone relies on talent and training only. Then a colleague or “coach” comes and offers him a ready solution. Edited and exaggerated social media images add to this feeling of inadequacy. Some start for an official competition, and others because their opinion of their bodies doesn’t change however much they train, which comes close to body dysmorphic disorder, which we explained in the article on body dysmorphic disorder, in which a man sees himself as small and skinny despite his obvious muscles.
Harms of steroids to the heart and vessels
The heart is among the most affected organs. Prolonged use is linked to enlargement of the heart muscle and weakness in its contraction, high blood pressure, a lipid disturbance that raises bad cholesterol and lowers good cholesterol, and an increased risk of clots and strokes even in young people. The problem is that these changes develop silently, so the person feels nothing until an attack happens. Some think their fitness protects them, but in reality a normal athlete’s heart differs from a heart enlarged because of hormones.
The liver, kidneys and skin
Some types of steroids, especially those taken by mouth, strain the liver and may raise its enzymes, and with long use tumors or serious damage may appear. The kidneys are affected in some users with heavy diets. On the skin severe acne appears, increased oiliness, hair loss in those genetically predisposed, and skin stretch marks from rapid growth. On the other hand, the quick appearance of muscles tempts continuation, so these signs are hidden in the crowd of satisfaction with appearance.
Fertility and hormones: what the advertisement doesn’t say
The body monitors the level of the male hormone, and if it comes from outside it stops its own production. The result in men is shrinkage of the testicles and a drop in sperm count that may reach temporary or long-term infertility, breast enlargement, and reduced desire and erection after stopping. Hormones may need months and sometimes more than a year to return, and may not return fully in some. In women, an irreversible deepening of the voice occurs, increased facial and body hair, and menstrual disturbance. And teenagers face a particular harm, the possibility of growth in height stopping early, because the hormones close the growth areas in the bones.
Anger and mood: the psychological side
Steroids affect the brain too. Some users describe excessive irritability, quick anger and mood swings, which may reach aggressive behavior, and in fewer cases psychotic symptoms occur. On stopping, many face a drop in mood, exhaustion and anxiety, and depression may reach thoughts of self-harm, which is among the most dangerous things linked to sudden stopping. Someone suffering from chronic irritability can read treating excessive irritability, but if the irritability is linked to enhancers, medical assessment comes first.
Do they cause addiction?
Steroids don’t give an immediate high like classic drugs, which is why many think they aren’t addictive. However, a proportion of users develop real dependence: they continue despite clear harm, fear losing their muscle size, suffer psychological and physical symptoms on stopping, and increase amounts and combine types. The fear of “shrinking” plays a big role, especially for those with a distorted view of their body. A cycle forms: stopping followed by exhaustion, sadness and sexual weakness, then a quick return to ease the feeling. That is why their course resembles the depression-linked dependence covered in the article on depression and addiction.
Competition, law and supplements
International and local sports bodies ban anabolic steroids in competitions and carry out tests to detect them, which is why a player who is caught faces suspension and loss of results. In Egypt, trading in these substances is subject to drug and narcotics laws depending on the type, and accurate legal information is taken from a specialist.
As for “natural supplements” sold with a promise of building muscle, not all are safe; tests of different products around the world have revealed stimulant substances not declared on their labels, and the consumer can’t know that. The best precaution is for the trainee to ask their doctor about any product before buying it, and to know that sustainable results are built by years of training, sleep and nutrition.
Signs that call for attention in someone who trains
- A rapid, disproportionate increase in size and weight within a few months.
- Severe acne on the back and shoulders and a change in voice or hair.
- Quick agitation and anger out of proportion to the situation and striking mood swings.
- Declining desire, erection or fertility, and breast enlargement in men.
- Hiding what they take, spending high amounts on “supplements”, and obsession with the mirror and weight.
Treatment: how does the doctor deal with dependence?
Treatment begins with a comprehensive assessment: which substances are used? Since when? What is the condition of the heart, liver, blood pressure and lipids? What is the hormone level? What is the psychological state? Then a plan is set that includes stopping the substances under medical supervision, because sudden stopping may cause a sharp drop in mood. An endocrinologist may add a program to restore natural hormones, with fertility follow-up.
Psychotherapy comes to treat depression, anxiety or distorted body image, and training in a healthy relationship with exercise and food. There is no single medicine suitable for everyone, and any medicine or hormone to restore balance is determined by the doctor alone after tests and isn’t taken on advice from the gym. The article on when the body returns to normal after quitting drugs helps in understanding that recovery takes time.
Call an ambulance on 123 immediately if there appear
With steroid use or after stopping them, these signs need urgent intervention.
- Chest pain, sudden shortness of breath or fainting
- Sudden weakness on one side of the body or difficulty speaking
- Yellowing of the eyes or skin with dark urine and severe tiredness
- Thoughts of self-harm or acute depression, and also call the mental health hotline 16328
- Severe agitation, aggressive behavior or psychotic thoughts
How does Riviera Life help you?
Someone who depends on steroids usually needs a psychiatrist and physical follow-up together. Riviera Life, licensed by the Ministry of Health with fourteen years of experience, offers an assessment by consultants in psychiatry and addiction, round-the-clock medical supervision, complete confidentiality, and a program for the family and follow-up after treatment. The first consultation is free on +201507999722 in Sheikh Zayed, Giza.
More from the enhancers guide
- Body dysmorphic disorder
- Treating excessive irritability
- Depression and addiction
- When does the body return to normal after quitting drugs?
Questions many people ask
Cortisone is an anti-inflammatory and immune medicine, while anabolic steroids mimic the male hormone and increase muscle building, and their harms are different.
They stop the production of the natural hormone, so the testicles shrink, sperm decreases and temporary or long-term infertility may occur, and hormones may need months or more to return.
A proportion of users may develop psychological and physical dependence, continuing despite harm, fearing loss of size and having symptoms on stopping.
It is better for stopping to be under medical supervision, because the sharp drop in mood after stopping may be dangerous in some people.
Not all of them; tests of products around the world have revealed stimulant substances not declared on their labels, which is why it is advisable to ask the doctor before any product.
