Steroids Conclusions

The literature also shows no evidence of any endurance benefits to be had with ASS use. Early studies by Win May and Mya Tu (1975) and Johnson et.,al (1975) found no improvements in endurance performance. Alén (1985) found significant increases in RBC but its possible these increases are negated by the cardiovascular side effects.  A review by Herbert et.,al (1984) appears to agree with the findings in this review. They found that out of 11 studies on endurance performance, 10 found no significant changes in either performance times or maximal oxygen uptake. This is seconded by Strauss and Yesalis (1991), although anabolic steroids may help to increase haemoglobin concentration, there is no clear evidence that they enhance aerobic capacity or endurance.

Furthermore it is yet to be fully established if ASS can aid recovery time. The theory that inhibition of glucocoricoid action can prevent atrophy is yet to be proved (Hickson et.,al 1990). The perceived enhanced recovery could be caused by athletes increased aggression or competitiveness while on ASS.  There is yet to be any conclusive physiological evidence on shorter recovery time in athletes thus mitigating reason of it’s abused for such gains.

Similarly, fat metabolism remains a grey area when talking about the pro’s and con’s of ASS. Few if any respectable scientific studies have reached a definitive conclusion on the role of ASS on fat metabolism. Bhasin et al. (1996) attributed all changes in mass to an increase in lean mass. They found no reason to believe a reduction in fat occurred, as did Hartgens and Kuipers (2004). Overall there are few conclusions that can be drawn from investigating all the potential benefits for athletes. An increase in strength and lean mass can be assumed to result from ASS use which in theory should help certain athletes in performance. Athletes who seek a more competitive aggressive edge in their respective sport might benefit from changes in their psyche but changes in behaviour are negated by the possible social problems out with a competitive environment.  It therefore should be said that no athletes other than those wanting to increase strength and muscle mass have any reason to take AAS.

The consequences have to be made aware to athletes before use. Several sudden deaths have been attributed to the action of AAS (Di Paolo et.,al 2007). The deaths reported have all been a result of heart problems. Although there is still a high level of ambiguity it appears that LV hypertrophy, impaired diastolic function and a higher systolic strain can be a consequence of AAS (Hussan et al. 2009).  Furthermore, there appears to be an increase risk of myocardial infarction due to the increased pro-thrombotic state caused by AAS (Vanberg and Atar 2010). Small vessel disease can also appear in some cases which may contribute to possible heart implications. Once again the role of AAS in various heart problems requires further study. With the evidence available athletes should be made aware that heart problems may occur as a consequence of their AAS use, especially if athletes have any pre-existing heart problems. It should be noted that there is little evidence to disprove that - although unlikely - AAS could not cause severe heart trauma and therefore sudden death.

Lipoprotein metabolism is affected in a negative manner following AAS use. There is clear and concise literature on rising LDL-cholesterol and lowering HDL-cholesterol concentrations during periods of AAS use. It appears more prevalent the higher the dose and the longer the duration of use. Changes in these concentrations can pose a further serious cardiovascular risk to users. The true risk to athletes of these changes warrants further study as it is a clear consequence of AAS use. The evidence also indicates that decreased serum lp (a) levels are also likely to indicate a change in lipoprotein concentrations.

The effect on the male reproductive system is an important risk factor when on Anabolic-androgenic steroids. It’s known that AAS suppresses the hypo-thalamic-pituitary-gonadal axis, which in turn affects the rate of testosterone production (Hartgens and Kuipers 2004).  AAS can further reduce sperm production and semen quality therefore directly affecting male fertility. More noticeably testicular atrophy can occur during the ‘on’ period of AAS use whilst evidence suggests that infertility can stay after cessation of AAS (Kicman and Gower 2003). Long term problems could therefore be an issue and requires more in-depth analysis as evidence mainly highlights the effects whilst on AAS.

In females the reproductive affects are just as serious. They can develop masculine traits which lead to menstrual irregularities, clitoral enlargement and breast atrophy (Kam and Yarrow 2005). All the reproductive side-effects described in the literature are very serious and require athletes to be fully aware of these proven consequences. The consequences are so that the risk to benefit ration for athletes attempting to improve performance sizeably increases.

It is still yet to proven with AAS have a significant effect on the liver. The evidence shows that the liver enzymes ALT and AST will increase indicating liver cell damage especially with supraphysiologic doses of AAS (Stimac et.,al 2002). However, leaking of AST from the muscle to serum may contribute to the rise in concentration. Overall no consistency has been found in the other hepatic side-affects on the liver that are blamed on AAS. The literature describes a large variation of diseases, few of which can conclusively be attributed to AAS. Also most hepatic consequences described may be reversed by drug cessation. Liver disease therefore can not be described as a side-effect of AAS use until more definitive conclusions are reached.

It is equally as difficult to make conclusions regarding the psychological implications of AAS use. Upon questioning users, the results vary from feelings of euphoria to those of aggression and hostility. It is likely AAS will affect psyche and mood but it is uncertain to what degree. Athletes might see this as a benefit as they are mentally able to push themselves harder in training and competition. Major mood disturbances associated with anabolic-androgenic steroids may represent an important public health problem for athletes using steroids and sometimes for the victims of their irritability and aggression (Pope and Katz 1994). However, all evidence thus far is a still anecdotal so negative change in behaviour cannot be declared as a side affect of AAS when advising athletes.

Other more minor effects such as Acne vulgaris and gyneocomastia can happen in some users. These can coincide with oily skin and thinning hair. Both consequences are likely dose and steroid dependent although the reason for it occurring in some and not others needs further study. It should be concluded that any athletes indicative of these physical conditions may be considered to be on AAS. These side-effects are unlikely however to act as deterrents but they still represent a risk factor for athletes tempted by AAS use.
The consequences of AAS on woman are the same as those in men. However they do pose several other problems. They will increase noticeably in lean mass which could act as a tell-tale sign on the competitive stage. This masculinization can lead to reproductive problems for females. Anabolic-androgenic steroids (AAS) are synthetic derivatives of testosterone originally designed to provide enhanced anabolic (tissue-building) potency with negligible androgenic (masculinizing) effects (Clark 2003). The androgenic effects are still prominent however, even after attempts to limit its effects in modern AAS.

Rhabdomyolysis is yet another condition that has been identified in literature. Once again there are no clear-cut conclusions that Rhabdomyolysis occurs as a result of AAS use. Case reports indicate the possibility of a connection between the two but other causes such as intense weight-training could be the more realistic determinant.

It can be concluded that the true consequences of AAS still remain unclear. The possible affects are still a significant concern. The effects on lipid metabolism and the reproductive system are clear and serious side-effects of supraphysiologic doses in-particular. These should be identified and explained to anyone thinking of taking steroids. Behaviour and psyche may be affected by AAS and athletes with previous mental-problems should avoid their use. The increase in strength and muscle mass are the sole benefits for an athlete taking steroids. There is no evidence to suggest that AAS aids fat loss or endurance. On the contrary it’s likely that cardiac structure and function are negatively affected by AAS.

To conclude it can be acknowledged the benefits of AAS are unlikely to be worth the risks involved for performance enhancement. Although improvements in strength happen with supraphysiologic doses of AAS, improvements in performance in certain sports are unsubstantiated. This is the case for sprinters in-particular as there is no evidence suggesting that type II (fast twitch) fibre CSA in the leg muscles are increased more than type I (slow twitch) CSA with AAS use. Furthermore the added ‘bulk’ of lean mass may in-fact negatively affect performance. Added strength could be beneficial for field athletics throwing events such as shot-put, javelin, discuss and hammer throwing. This appears more prevalent in female athletes (Franke and Berendonk 1997). In addition, sports such as American football and Rugby that requires increased strength and lean body mass that may be partially achieved by AAS use. An increase in strength may not occur in therapeutic doses or lower. No athletes will achieve improvements in aerobic endurance or fat reduction. Athletes should not be mis-lead into believing they will gain any physiological benefits other than an increase in strength and muscle mass. Rather they should be made aware of the substantial associated risks. There still remains too much ambiguity in the other possible physiological implications that may occur. The ‘risks’ are not worth the ‘rewards’ regardless of it use; whether it simply be for recreational purposes or a under the intentions of a competitive athlete.

End of steroids summary and conclusions