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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Initial signs that anabolic steroids are being abused may include rapid weight gain and unusual mood swings. Emotions may include increased aggressiveness. Acne is almost always seen.

The side effects of steroids can be explained by the excess androgen and anabolic drug levels present in the body.

The use of steroids suppresses the naturally occurring testosterone in the body and, in males, may lead to a decrease in testicle size (atrophy), decreased sperm production, infertility, and baldness. As well, the excess steroid can be converted to estrogen in males and may lead to enlarged breasts (known as gynecomastia). In females, the excess testosterone production may lead to a deeper voice, changes in the menstrual cycle, and increased hair production. Baldness may also be seen in women.

These steroids also have direct effects on numerous organs:

• An increased number of sebaceous glands in the skin routinely leads to acne.



• Liver damage may often occur, and liver cancer is a risk.



• The heart is at risk for damage in a various ways. In response to excess steroid in the body, the heart muscle may enlarge just like any other muscle in the body. This enlargement, or hypertrophy, can lead to decreased pumping ability (cardiomyopathy) as well as changes in the electrical conduction system in the heart causing rhythm changes (arrhythmias), palpitations, and potentially sudden cardiac death. As well, steroids may cause high blood pressure, increased cholesterol levels, and elevated blood sugars, all of which are risk factors for heart attack and stroke.



• Psychiatric effects of steroids include excitation and depression. Aggression is common. Manic episodes of aggressive behavior are known as "roid rage," and violence may be the outcome. Depression and suicide may also occur.

In adolescents who have yet to complete growing, the use of steroids may stunt growth and stop bones, joints, and muscles from reaching full maturity. As well, premature sexual development may occur.

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