What are anabolic steroids and how do they work?

23 January 2012

Many prominent athletes in both professional and amateur sports have been caught “doping” and the accusation alone can sidetrack a promising career. However, winning an Olympic medal can have huge potential payoffs. The lure is obviously big, so what exactly are anabolic steroids and why do they have such a bad rap?

Steroids, or “Roids”, are mainly taken for one of 3 reasons: 1) Body builders take them to increase muscle mass and create a more lean physique with less body fat. In fact, the word anabolic means “to build up”; 2) Endurance athletes such as cross-country skiers take them to increase the amount of high intensity work that their body can withstand; and 3) Others simply take them to “look good”. According to the most reliable estimates, up to 3% of high school students admit to having tried performance enhancing steroids at least once!

So, what exactly are steroids? If you remember your human biology lessons, there area actually many types, but not all of them are important for physique. Androgens are the main male hormones and are important for the development of muscle mass, secondary sex characteristics (sexual development, facial and pubic hair, etc.), male fertility and behaviour.

In the body, testosterone is made primarily by the testes. However, testosterone itself is very weak and must be converted by the prostate to its active form, dihydrotestosterone (DHT). Over 95% of DHT comes from this source. The adrenal gland also secretes weak androgens called androstenedione (ANDRO) and dehydroepiandrosterone (DHEA), which also must be modified by the body to become active. You may remember that several prominent baseball players, including home run king Mark McGuire, have been accused of taking androstenedione. Interestingly, when taken in very large amounts, these hormones overpower the body’s ability to convert them to DHT. This results in the production of female hormones, or estrogens. More on this later...

Steroids exert their effect on many different tissues. They start by penetrating the cell itself and binding receptor proteins that alter our DNA. During puberty, androgens help with muscle development and is one of the main reasons why men have almost twice the muscle mass of women. Androgens also lead to growth of axillary, chest and pubic hair. They promote growth of the penis as well as the larynx and vocal cords, which results in deepening of the voice during puberty. Unfortunately, sebaceous glands on the skin are also activated, leading to acne. In adults, androgens are important for physical vitality as well as sexual desire. Talk about your raging hormones!

So if steroids are so great, why doesn’t everyone take them? The health effects depend on the type of steroid, the dose and duration used, the age at which you start and how it is taken. Athletes who abuse steroids often take them at much greater levels than those found naturally in the body. At these high amounts, the body’s own production of testosterone, as well as other hormones that regulate the testes, drops dramatically (a process known as feedback inhibition). In men, this can lead to testicular shrinkage and infertility. Not only are the sperm reduced in number, but they are also unable to swim properly! Because excessive androgens can also lead to over production of female hormones, some men can develop breasts, a condition known as gynecomastia.

In women, the most common side effects include development of a male physique, deepening of the voice, growth of chest and facial hair, acne, enlargement of the clitoris and male-pattern baldness. Menstrual irregularities are also common.

Other serious problems include the development of liver tumours, prostate cancer, heart disease and stroke. There have also been several reports of sudden death in otherwise healthy, young athletes. Finally, because of needle-sharing, there is a risk of HIV/AIDS, hepatitis B and C as well as other infectious diseases.

One of the most commonly talked about side effects is so-called “Roid Rage”. In fact, the connection between testosterone levels and aggressive behaviour is well known. It is also suspected that there is a connection between steroid use and the development of other psychotic disorders.

When taken in pill form, testosterone is quickly made inactive by your liver. Chemists have been busy modifying its chemical structure to get past this "inconvenient" problem. This has led to the development of many substances that act just like steroids, but are often unscrupulously sold as “supplements”. Make no mistake – your body will change them back to their active steroid form. This is one reason why unsuspecting athletes are often caught with positive drug tests.

Today, most steroids are taken as injections into the muscle, as creams, or as pills. Although evidence suggests that steroids will lead to gains in strength and endurance beyond what can be expected from training alone, this requires very large amounts. Thus, to maximize the dose taken, athletes will “stack” the medications by taking several different forms at once.

So that’s the skinny on steroids. Unfortunately, nothing in life comes for free and there is no substitute for hard work at the gym!

For more information on steroids and drugs in sports, check out these websites:

The World Anti-doping Agency


The Official Site of the Turin Winter Olympic games


We would like to thank Dr. A. Andrew Ray for his medical expertise. Dr. Ray is a Urology resident at the University of Western Ontario (London). He attended medical school at Dalhousie University (Halifax, NS).


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