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Steroids were once viewed as a substance only being used by body builders, fitness fanatics and professional athletes, however, in the society of today, steroid use is becoming more commonplace. While the short term effects of steroid use are well known.

Steroids were once viewed as a substance only being used by body builders, fitness fanatics and professional athletes, however, in the society of today, steroid use is becoming more commonplace. 

While the short term effects of steroid use are well known, it is the long term adverse effects that are unknown and to date, have not been studied.

What is a Testosterone?

Testosterone is an anabolic steroid secreted by the testicles in a male, in the ovaries of women and in small amounts by the adrenal glands in both sexes.  In males, testosterone plays an integral role in overall health and accounts for the physical differences between genders. 

How Testosterone Effects the Body of Males and Females

For males, testosterone is responsible for virilization and androgenic qualities.  The anabolic effects of testosterone include muscle growth and strength, increase in bone density and stimulating linear growth and bone maturation.  The virilizing effects of testosterone in males includes maturation of the sex organs, deepening of the voice, the growth of facial hair and male secondary sexual characteristics.

How testosterone effects the female body is best witnessed in adulthood.  The hormone is responsible for clitoral enlargement, sex drive, mental and physical energy and plays a role in the fight-or-flight hormonal response regulation. 

Testosterone can be labeled as the “impulse” hormone, and how it effects the body of a male versus a female differs dramatically.  Having a normal level of testosterone in the body is very important for the health, development and well-being of both males and females.

How Testosterone Builds Muscle

There are many hormones that play an important part of how the body responds to exercise, increases strength and builds muscle tissue.  Testosterone is an anabolic steroidal hormone, the word “anabolic,” refers to the building up of body tissues. 

Testosterone is the number one hormone used in the development of muscle and strength and through regular exercise, fine motor skills, fitness, muscle and bone strength and joint function increase.  The mechanism of action by which testosterone increases muscle mass is not well documented and further studies are ongoing.

Statistics About Testosterone

Steroid use is most rapidly growing in males between the ages of 12-17, with the average age of use being 15 years old.  In males attending high school, approximately 6.6% reported using steroids, and out of that percentage some 40% , report heavy usage.

According to statistics, around 1,084,000 adults in the United States have reportedly used steroids.  The use of steroids is more popular among males than females, though in 1997, some 175,000 teenage females admittedly used steroids at least one time within the previous year.

On March 13th, 2006, Bud Selig, Major League Baseball Commissioner, announced that there would be an in-depth investigation regarding the use of anabolic steroids in Major League Baseball.  The use of performance enhancing drugs (anabolic steroids) was banned across the league as part of a collective bargaining agreement in 2002.

On December 13th, 2007, the Mitchell Report on performance enhancing drug use in baseball was released.  The Mitchell Report consisted of statistical information concerning the use of anabolic steroids at all levels of Major League Baseball.

As a result of the report, the following information was obtained:

  • 47 players were linked to steroids and human growth hormone (HGH)
  • 17 players admitted to using performance enhancement drugs
  • 33 players were implicated 
  • 22 players tested positive for using performance enhancement drugs
  • 4 players either tested positive for use or were suspected of using a performance enhancement drugs

There has been an ongoing debate as to whether or not the use of certain performance enhancing drugs should be allowed in the arena of professional sports.  Statistics have found there is widespread use of steroids in all types of sports, from Major League Baseball to the Tour De France. 

The use of androgenic steroids in the world of elite sports is strongly monitored by the World Anti-Doping Agency (WADA), which sets the standards for sports doping tests on an international level.  The effectiveness of the screening process is witnessed by the extremely low level of positive tests, <2% per 170,000 tests performed by 32 independent laboratories during 2004.  The random drug testing took place at the Olympics and other major international sporting events.

Over 80% of positive androgen steroid tests detected three main drugs, testosterone, nandrolone and stanozolol.  There have been many types of “designer steroids” produced by independent laboratories, however once the offending chemicals have been identified, new tests are rapidly added, as a result, only one tetrahydrogestrinone (THG) was evidenced in international competition.

The WADA jurisdiction does not pertain to the United States baseball and football leagues.  Without the institution of randomized drug testing, the likelihood of anabolic steroid abuse remains quite high.

The Effects of Testosterone on the Body

All types of medications have the ability to cause side effects, but the long term use of anabolic steroids remains shrouded in mystery.  The following is a list of side effects that can be experienced with the different types of testosterone:

Testosterone:

  • Acne
  • Bitter or strange taste in the mouth
  • Decrease or increase in libido
  • Fatigue
  • Nausea
  • Vomiting
  • Mouth and irritation, pain or tenderness in the gums
  • Headaches
  • Hair Loss
  • Severe anaphylactic reaction (difficulty breathing, rash, hives, chest tightening, swelling of mouth, gums, face, lips or tongue)
  • Breast growth and/or pain
  • Change in the size and/or shape of the testicles
  • Dark urine, light colored stools
  • Depression and/or mood swings
  • Sleep apnea
  • Dizziness
  • Edema in legs and/or ankles
  • Stomach pain
  • Jaundice
  • Difficulty urinating
  • Weight gain
  • Appetite loss
  • Birth defects (mental retardation, pseudohermaphroditism, etc.)
  • Painful or prolonged erection
  • Infertility

Testosterone Cypionate

  • Acne
  • Bitter or strange taste in mouth
  • Change in sexual desire
  • Gum/mouth irritation
  • Hair loss
  • Headache
  • Fatigue
  • Allergic reaction (hives, breathing problems, itching, swelling of tongue, face, lips or mouth, chest tightness)
  • Jaundice
  • Appetite loss
  • Hair loss
  • Edema in extremities
  • Depression and/or mood swings
  • Urination difficulties
  • Sleep apnea
  • Gynecomastia in males
  • Pain in the breasts
  • Testicular changes
  • Dark colored urine, light colored stools
  • Loss of appetite
  • Dizziness
  • Gingivitis
  • Sustained and/or painful erection

Testosterone Enanthate

  • Allergic reaction (hives, itching, scratching, breathing difficulties, swelling in mouth, tongue, lips or face, tight chest)
  • Hair growth on face (in females)
  • Voice changes
  • Weight gain
  • Dizziness
  • Fatigue
  • Breast pain or growth
  • Change of size or shape in testicles
  • Sleep apnea
  • Jaundice
  • Swelling in legs or ankles
  • Sustained/painful erection
  • Acne
  • Increase or decrease in sex drive
  • Gum or mouth irritation
  • Fits of coughing
  • Headaches
  • Stomach pain
  • Depression, mood swings
  • Appetite loss
  • Changes in menstrual cycles in women

The following side effects have occurred in males who use anabolic steroids for a long period of time:

  • Gynecomastia (breast development)
  • Excessive and sustained penile erections.
  • Oligospermia (low sperm volume) can occur at high dosage.
  • Hirsutism (overgrowth of hair on the face or body), male pattern baldness, seborrhea (dandruff) and acne.
  • Fluid and electrolyte imbalances: retention of water, sodium, chloride, calcium, potassium and inorganic phosphates.
  • Gastrointestinal disturbances: nausea, vomiting, jaundice, decrease in liver function, hepatocellular neoplasms ( newly formed cancerous growths) and peliosis hepatis (random blood filled cavities in the liver).
  • Hematological issues:  suppression of clotting factors in the blood, bleeding in users with combined use of anabolic steroids with anticoagulant therapy and polycythemia (abnormal increase of red blood cells).
  • Effects on the nervous system:  decrease or increase in sex drive, headaches, increased anxiety, depression and general paresthesia (numbing in parts of the body).
  • Allergic reactions:  hypersensitivity, skin manifestations and anaphylactic reactions (hives, rash, itching, etc.)
  • Miscellaneous effects:  pain and inflammation at the injection site.

If any of the above side effects are experienced while taking testosterone, it is important to contact a physician immediately.  Those who have an allergy to testosterone or have had an allergic reaction to hormone therapy, should never use testosterone without prior consultation with a physician, doing so could result in irreversible health damage.

Testosterone Use in Medicine

Testosterone is clinically used in two distinct ways, as androgen replacement therapy (ART) and as pharmacological androgen therapy (PAT).  With the use of testosterone for ART purposes, the aim is to replicate the endogenous androgen exposure of all tissues using measure doses.  PAT uses androgens like any other medication.

In androgen replacement therapy the goal is to correct an androgen deficiency and improve quality of life through increasing energy levels, motivation and endurance, and restore structural or functional deficiencies in muscle, bone marrow and psychosexual activity.

In males, ART can also be used to treat delayed puberty and as a hormonal male contraception.  The  impact of ART has produced numerous benefits in males, such as reduced bone fractures, decreased death rate from prostate cancer, bone fractures and cancers and lowered hospitalization rates.

PAT is used to achieve androgenic effects in males with chronic illness.  The objective of PAT, is limited to improvement of quality of life and morbidity benefits have been seen in the following situations:

  • Anemia due to renal or marrow failure
  • Chronic respiratory failure or cardiac failure
  • Steroid-dependent autoimmune disorders
  • AIDS wasting
  • Prevention of attacks of hereditary angioedema or urticaria
  • Palliating end-stage breast cancer

Further controlled studies are necessary to assess the safety, efficacy, and cost-effectiveness of PAT.  Testosterone can also be used to treat andropause (male menopause), decreased libido, erectile dysfunction and other hormonal imbalances experienced in aging men.

There is no definite consensus among physicians as to the benefits of using testosterone therapy for women in menopause.  As women age, the level of testosterone produced by the body will diminish.  Though natural menopause will not cause a sudden change in testosterone levels, surgical menopause can.

If a menopausal woman experiences a low sex drive, depression and fatigue after the surgical removal of the ovaries, estrogen therapy is the recommended treatment.  However, if estrogen therapy is not an option or is unsuccessful, testosterone therapy at a low-dosage can be another option.

There have also been studies that show testosterone therapy can be used in prepubescent males to induce height increase, help in patients who suffer from multiple sclerosis, and testosterone therapy has also been linked to improved muscle coordination in those suffering from Amyotrophic Lateral Sclerosis.

Overview

Prior to beginning a testosterone therapy regimen, it is important for a person to have a complete medical history, check-up and hormonal screening done.  People receiving any type of anabolic steroid treatment will need to be under the close watch of a physician to note any changes in clinical signs or symptoms or to treat any of the adverse side effects that can occur.

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