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Steroids Questions and Answers

Harrison G. Pope, JR, Medical Doctor

Harvard Medical School


Q.  What are steroids?

A.  Steroids are hormones that include testosterone and more than 100 synthetically developed testosterone relatives.  They posses muscle building and masculinizing properties.  They are widely used in a harmful way, especially by boys and young men seeking to gain increased muscle mass and strength either for athletic purposes or to improve personal appearance.  Steroids were first reportedly used in the 1940's by Adolf Hitler's troops in World War 2 to increase aggressiveness, although this claim has never been verified.


Q.  What aspects of steroid use are least understood?


A.  Most of the general public and even most physicians are surprisingly unfamiliar with the effects of steroids and the extent of their use.  In particular, most people are unaware that, without massive doses, it is virtually impossible to achieve the combination of low body fat and high muscularity exhibited by many body builders and professional athletes.  Because athletes and their promoters have large personal and financial motivations to deny such drug use, the public has been hoodwinked for decades about the magnitude of the steroid problem.


Q.  How common is steroid use?


A.  Surveys of U.S. High School students over the past 15 years suggest that approx. 3-11% of boys have used anabolic-androgenic steroids.


Q.  Describe what steroids can do to the mind of the user?


A.  During a cycle of steroid use, a typical user will experience hypomanic symptoms like euphoria, prominent irritability, increased libido, decreased need for sleep and a feeling of invincibility.  Aggressive outbursts worsen with increasing steroid doses; one user described his girlfriend as "she's scared of me when I'm on the juice."


Q.  Describe what it's like to stop using steroids?


A.  During the withdrawal phase after stopping each cycle, one will feel prominent depression, loss of libido, hypersomnia, and suicidal ideation.  "I almost jumped off a bridge after my fourth cycle" admitted one user.  "I couldn't wait to get on my next cycle to feel good again."  Depression is often characterized by body image obsessions.  These guys will spend at least 1 hour a day examining themselves in a mirror and sometimes refuse to go out in public because they feel that they are 'getting too small'.


Q.  Is there a comparison between male steroid users and female's who are anorexic?


A.  Oddly enough there is, neither group voluntarily seeks help to stop their drug use.  We are unaware of any rehabilitation centers, clinics, 12 step programs, or the like for steroid users-there is no demand for them.  Usually a steroid user will feel worse about their body image during their steroid cycles then they felt before taking them.  This is another way that steroid users are tied with those who are anorexic...


Q. Can you hide your steroid use to friends and family?


A.  The signs of use are so obvious that they can't be covered up.  As a doctor, I can actually calculate the maximum amount of muscularity a person can achieve without the use of drugs; it is called the fat-free mass index.  If you score >26 on this calculation of muscle size than we know you are using drugs. That calculation is not the only indicator of use, a gain of >8 pounds in a month along with acne, gynecomastia, and testicular atrophy are other obvious signs of use.


Q.  Does the media do a good job of educating young people about the dangers of steroid use?


A.  I think that American culture is partly to blame for the problem that we are now facing.  Americans pay to watch 300 pound football linemen, muscle bound baseball players, and steroid using movie stars.  Makers of cars, computers, and electronics advertise their products as 'on steroids' but they would never claim their products to be 'on cocaine'.


Q.  Can steroid use become addictive?


A.  Yes.  Users often report body-image disorders where the individual becomes preoccupied with the belief that they are not adequately muscular.  This often leads to continued use and it also will lead the user into major psychiatric treatment to overcome the disorder.  Steroids play nasty tricks on your mind.


Q.  What are the long term consequences of steroid use?


A.  A recent 12 year follow up of 62 power lifters in Finland who used steroids showed that 13% had died, a rate 4.6 higher than in a matched population.  They showed increased cholesterol, increased blood pressure and coronary artery disease.  They found higher than expected numbers of tumor in the livers, blood-filled cysts that could rupture and cause death, and a case of prostate cancer.


Q.  Who is a typical steroid user?


A.  The general traits of someone who will use steroids are those with antisocial traits, a greater use of other illicit drugs before taking steroids, and users generally had poorer relationships with their fathers than did non-users.


Q.  Can you give us some hard statistics regarding steroid use?


A.  Among users 51% said that they took more steroids than they first intended, 16% reported difficulty in controlling their doses, 37% continued to use despite adverse consequences, and 84% experienced withdrawal symptoms.  The withdrawal statistics are 20% had severe headaches, 43% fatigue, 41% depressed, 29% restlessness, 24% anorexia, 20% insomnia, and 20% decreased libido.


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