Anabolic steroids (often referred to as the only anabolic term) are steroids that work similarly to testosterone, the best known of male sex hormones.

Steroids are naturally occurring organic substances, where they play a fundamental role in many physiological processes. There are several substances that are part of the steroid category: sterols (eg phytosterols and zoosterols), hormones produced by the bark of the adrenal glands (for example corticosteroids, aldosterone and adrenocorticotropic hormone), alkaloids steroids (for example, solanidine, tomatidine and tomatillidine), bile acids (e.g., cholic acid), sex hormones (e.g. estrogens and progesterone).

The synthesis of the steroids occurs in the human organism in the following way:

cholesterol -> pregnenolone -> DHEA -> androstenedione -> testosterone.

For more information on this point, see our article Androgen metabolism.

Anabolic steroids derive from testosterone; the anabolic term is due to the fact that these substances are able to accelerate anabolism, one of the two phases in which the metabolism is distinguished (the other phase is catabolism). During the anabolic phase the synthesis reactions of the substances necessary for the organism occur, to the detriment of the energy that is released in the catabolic phase.

Anabolic steroids: uses in medicine

Anabolic steroids are of considerable interest at the pharmacological level; in fact, the pharmaceutical industries have been trying to obtain products that are able to enhance the anabolic characteristics of natural hormones, minimizing as much as possible the side effects related to their intake, effects of no small importance and which we will discuss in detail in the following paragraph .

The main therapeutic use of anabolic steroids is hormone replacement therapy in the case of hypogonadism (a clinical condition that leads to inadequate secretion of sex hormones); there are various conditions that can give rise to hypogonadism; the administration of anabolic steroids allows to compensate for the lack of hormonal secretion.

Anabolic steroids are also given in the case of significant catabolic states caused by serious illness or serious trauma; in this case the anabolic ones, increasing protein synthesis and promoting the growth of muscle mass favor a faster recovery.

Anabolic steroids are also able to effectively stimulate erythropoiesis; they are therefore recommended in particular cases of anemia.

In the past, anabolic steroids were often prescribed to treat osteoporosis (they favor bone mineralization and density); however, this use is increasingly rare because there are drugs with greater efficacy (and with fewer side effects) for the treatment of the pathology in question.

Anabolic steroids are also included in the therapeutic protocols of diseases such as rheumatoid arthritis and lipodermatosclerosis.

The use of anabolic steroids for anti-aging purposes is a point that has been discussed for years; the risk / benefit ratio, however, seems to advise against the use of anabolics for this purpose.

Side effects of anabolic steroids

The side effects resulting from the use of anabolic steroids are mainly due to one of the main characteristics of these substances, androgenicity; these effects mainly concern damage to the liver, the cardiovascular system and the genital apparatus, mood disorders and increased aggression. Taking steroids is tantamount to introducing into the body a “bomb” that is not known when and how it will explode: only an incurable optimist can be so irresponsible as to think that “in his case the bomb will never burst”!

The use of anabolic steroids involves a long series of side effects. Among the most important we point out the following:

growth of sexual tissues; in puberty, an anabolic effect is observed on the external genital organs, after which the most important effect is the one related to the prostatic growth with consequent urinary and ejaculatory disorders; there is also a percentage increase in the risk of tumors.

Atrophy of the testicles; this side effect is due to the fact that by supplying exogenous testosterone, there is an inhibition of the normal endogenous production of this hormone. Generally, with the termination of anabolic steroid intake, the endogenous testosterone production mechanism returns to be active, but if the assumptions have been massive and prolonged it may no longer be possible to return to the normal state.

Abnormal dimensional development of male breasts (gynecomastia); this side effect is due to a compensatory reaction of the organism that reacts to the excess of androgenic hormones, converting them into estrogens (typically female hormones) with consequent hypertrophy of the breast tissue. Gynecomastia can be prevented pharmacologically by taking testolactone and tamoxifen.

Hypertrophy of cardiac muscle and acute myocardial infarction; the anabolic effect caused by the intake of anabolic steroids includes, among others, the heart muscle. Cardiac steroid-induced hypertrophy greatly increases the risk of sudden death due to acute myocardial infarction.

Other side effects that are recorded are acne, excessive hair growth, baldness, increased aggression with homicidal tendencies, sexual aggression and increased anger.

After a medium or long-term administration of anabolic steroids, anxiety, depression and suicidal tendencies are recorded in the case of abstinence.

In the female subjects there are menstrual cycle disorders, atrophy of the mammary glands, hirsutism, breast atrophy, clitoral hypertrophy, lowering of the vocal tone.

One of the major problems of the use of anabolic steroids is linked to the fact that the reversibility of the effects is decidedly slow (in some cases, as mentioned above, it is even impossible) and, in case of suspension of intake, the production levels endogenous testosterone remain undersized over a long period of time. This results in loss of muscle mass, increase in fat mass and sexual and psychological problems. This is the main reason why steroid companies are looking for substances with high anabolic effect and minimal androgenic effect. If we consider that testosterone has an anabolic effect / androgen effect ratio of 1: 1, other substances have much higher ratios (see for example nandrolone, one of the most commonly used anabolic steroids in sports) but they tend to decrease the more they are elevated the doses taken; in fact reached the peak of the anabolic effects, these stabilize, but there is still an increase in androgenic effects with all the consequences of the case.

Anabolic steroids and sports activity

In sports, anabolic steroids are mainly used in bodybuilding and power sports (wrestling, weight lifting, sprinting, etc.) and, although less frequently, in those disciplines that combine strength with resistance (football, rugby, tennis). .

With regard to their use in relation to resistance sports, we invite you to deepen the subject by consulting our article Anabolics and resistance; Here we limit ourselves to observing that the lesser use of anabolic steroids in aerobic disciplines such as running and (partly) cycling is linked to the fact that an excessive increase in muscle mass is to be considered counterproductive for performance. Already this fact should advise against the use of anabolic steroids by an athlete engaged in endurance sports: the increase in muscle mass, which can undeniably be useful in shooting and / or power disciplines, in the stroke of resistance is penalizing: just look at the slender legs of the Kenyan athletes to understand that the bottleneck of performance in a sport is not muscle power. Perhaps some bottom athletes take anabolic steroids by analogy with the effects of growth hormone (see our article Growth Hormone and especially the Growth Hormone and Training Section), which is also responsible for increase in muscle mass. The difference (which is fundamental for a cross-country skipper) is that the growth hormone also decreases fat mass and this is an undoubted advantage.

On the other hand, it is different for women who have a “masculine” musculature, but it is undoubtedly an advantage.

The methods of taking anabolic steroids

The most commonly used methods of intake are oral intake or intramuscular injection. The assumption is carried out following cyclical methods because it is believed that these modalities are those that guarantee a maximization of benefits and, at the same time, a reduction of side effects. The doses are progressively increased and then gradually decreased. At the end of the anabolic steroid cycle, use of human chorionic gonadotropin, the so-called pregnancy hormone; the intake of human chorionic gonadotropin allows the reactivation of endogenous testosterone production, inhibited by the exogenous intake of anabolic steroids.