- anabolic androgenic steroids (AAS) are synthetic derivatives of testosterone, family of hormones that occurs naturally in the body and are responsible for the development and function of the reproductive system.
- Testosterone is the most important of these hormones in the male body and is produced by the testes. Production of testosterone is stimulated by luteinizing-hormone which is secreted by the pituitary gland. Except of regulation of growth, development and function of male sexual organs, the testosterone has also masculinizing and virilising effects. At the end of the puberty, the level of testosterone is suddenly rising and remaining at the high level from four to six months. Cartilages in the long bones of hands and legs are closing, the voice is deeper, facial hair is developed and male sexual organs are growing during this time period.
- Testosterone has also anabolic effects. Steroids retain the nitrogen in the body which is basic element needed for production of proteins which are needed for development and growth of muscle tissue.
- In the past, scientists thought that there is significant difference between anabolic and androgenic steroids. They considered that chemists could be able to create a new kind of steroids which would be able to produce muscle tissue without any masculinizing side effects. But it was considered as impossible. There is no anabolic steroid without some androgenic effect.
Application in medicine
- AAS have limited application in the treatment of following diseases:
- during treatment of prolonged anaemia when red blood cells are unable to regenerate
- during treatment of breast cancer
- during treatment of hereditary angioedema
- for support production of testosterone if the body is weakened after surgery
- during treatment of menopausal symptoms: in small measures connected with the use of estrogen
- men who have removed testicles as the result of cancer, the AAS is used for maintaining of secondary male sexual characteristics
- it is used for boys in puberty who have insufficient functioning of pituitary gland for period of four to six months, to achieve growth and development of secondary sexual characteristics
History of un-therapeutic use
- at the beginning of 30s a lot of scientists have worked on the testosterone synthesis. At first, in 1935 David and Laquer, later Butenandt and Hanish and at the end Ružica and Weltstein have published methods how to produce synthetic testosterone. In the same year Kochakian and Murlin demonstrated anabolic steroids connected with accumulation of muscle tissue for the first time. In 1939 there was a report given to League of Nations which contained opinion that serving of sexual hormones can increase the sport performance.
- present history of abuse of AAS is beginning in 1954 between Russian and American weightlifters on the championships in Vienna. In 1956 pharmaceutical company Ciba created first oral AAS – Methandrostenolone and even in this year a lot of athletes from the USA used this product before the Olympics in Melbourne. Before the Olympic Games were held in Mexico the usage of anabolic steroids for strength increase became public secret between sportsmen. They were used mainly in power disciplines and in athletics.
- in 1975 the anabolic steroids were connected to list of banned substances by International Olympic Committee. Despite of this prevention, the usage of steroids was still rising. Public interest started to increase about this together with restriction and it became in the spotlight when Ben Johnson´s gold medal for 100m in Olympic Games in Soul was taken from him.
Expansion of anabolic steroids
- at the beginning of 70s the abuse of anabolic steroids increased significantly out of the professional sports. The main group of users were bodybuilders. AAS were abused for gaining muscular appearance and because of competitions or because of work. Anabolic steroids were used not
only by bodybuilders but also by employees of protective guards and sometimes even by policemen.
- it is estimated that in the USA there are more than million of those who used anabolic steroids or still using. Canada estimated 80.000 young people in age 11 - 18 who tried AAS at least once. In Great Britain the school study showed that between 15 - 16 years old people are 2.2% of boys and around 1% of girls who have tried AAS at least once. Another study was carried among those who practice bodybuilding or strengthening and the result was much higher here – around 7.7%. It is very difficult to estimate the actual amount of users of the whole population.
Methods of use
- Anabolic steroids are taken orally or by injection – to the muscle. Recent study from England showed that approximately 49% of users use both methods, 32% just injections and 19% use anabolic steroids by oral way.
- AAS are used in cycle which length is up to 12 weeks (even when this period can be changeable) followed by the period without anabolic steroids- time to rest. These cycles can be repeated two or three times per year. Users of anabolic steroids think that the period without anabolic steroids allows their hormonal system to reduce side effects. That could means that they can reduce the symptoms of the side effects.
- steroids are used in many combinations (stacking) during the cycle, usually by the way of pyramid when doses are gradually increased till the maximum amount which is then used till the end of cycle. Many times are AAS combined with other drugs.
- those who use just one type of AAS in small portions for short period of time can minimize the most damaging side effects in certain measure. However this is not usual. The vast majority of users take a number of different AAS in portions that can outmatch allowed standard of for therapeutic usage up to thirty times. For example, the allowed portion of Methandrostenolon (Dianobol) is 5 mg per day however bodybuilders often use up to 40mg per day. Testosterone Enanthate, which is used for treatment of hypogonadism, is similarly taken in the amount between 50-400mg every two to four weeks but those who use this medicament on their own will order a dose sometimes up to 800mg per week.
- next danger lies in the fact that many users of AAS do not even know what types or even what amount of substances they use because they establish their anabolic system on that amount of pills in which they absolutely have no idea what is their actual composition.
Sources of anabolic steroids
-many anabolic substances are on lists of prohibited substances which are announced by national and international sports organizations. But the number of the most frequently abused substances is about 15. Each of them is sold under several different names either by oral use or in form of injections or both.
They are: Nandrolona decanoate, Methandrostenolon, Oxandrolone oxymetholone, Methenolone, Stanozolol acetate, Boldenone undecanoate, Testosterone cypionate, Testosterone enanthate, Testosterone propionate, Testosterone undecanoate, Methyltestosterone.
- majority of AAS which are not used for medical purposes are not manufactured by pharmaceutical companies but by illegal laboratories. Users report that they receive them from friends, staff from gym, dealers, vets, pharmacists and by email - it is possible to order them either in special magazines or on the internet.
- due to no control of anabolic steroids on the black market there is no surprise that there are often fake appeared in it. For example Methandrostenolone (Dianabol (R)) has been a popular steroid. When the production was stopped by pharmaceutical companies the illegal laboratories has started to produce it. There were analysed three samples marked as Methandrostenolone recently. First contained Methyl-testosterone, the second one contained caffeine and in the third there was not found any active substance. Similar to the first analysis has undergone five samples in Great Britain. They came from different illegal laboratories. The content of the samples was different from 0 to 168 depending on the content declared on the package. Sometimes the lack of control can have fatal consequences. Unverified reports say that three English bodybuilders died recently due to cardiac arrhythmia when they used fake Anabol which was treated badly and contained bronchodilator (agent which expands bronchi) Clenbuterol of which usual dose is 0.02mg. The other samples were claimed to contain amphetamine. Another bodybuilder was hospitalized with all symptoms which followed after ecstasy overdose which are muscle cramps, sweating, dizziness, headache and paranoia.
- another potential risk is that anabolic steroids from illegal laboratories may not be sterile when they are intended for injection.
- laws relating to selling and possession of anabolic steroids are not united in Europe. For example from 1997 in Great Britain the distribution of specimens (for personal gain or for free) is an offense against the drug law but ownership for personal use is not. In Germany the distribution of anabolic steroids is not illegal if there is no personal enrichment. In Baltic countries there are completely different provisions, in Sweden are the strictest laws from the whole Europe but in Greece and Turkey are AAS available freely thanks to the connection with countries of former eastern bloc.
Expected effects (why people use AAS?
- there are 2 basic reasons for usage of AAS – for better performance and look. It is not important to increase performance outside of the competitive sport. So users of anabolic steroids are doing this for:
- improved appearance
- training and in participating in bodybuilders competitions, for increase of muscles and strength due to sport
- increase muscle volume and strength from professional or personal reasons
Are anabolic steroids able to achieve desired results?
- there is no doubt about usage of AAS resulting in that kind of physical appearance which is considered to be necessary for success in bodybuilding competitions. In addition those who are interested in bodybuilding claim that it is not possible to participate in the highest competitions without support of anabolic steroids.
- it is very rational for those who want to increase their strength whether from professional or personal reasons to use anabolic steroids. Thanks to their anabolic effects the muscle mass can be increased and because there is direct correlation in certain measure between increase of muscle and increase of its strength, the growth of muscle mass is connected with the increase of its strength. However reports from studies are different in the case of effectiveness of steroids for strength increasing from twelve studies which took place between 1965-1984, five of them showed the increase of strength but seven studies did not confirmed this result. In addition two of these studies showed conflicting results. For difference results were reported reasons such as:
- differences in groups, size, experience at the beginning of the study
- small control of diet
- different training methods between subjects
- testing by strength training methods
- usage of many different substances in various (usually small) portions
- length of study
- if we consider all problems of these methods scientific authorities, despite of this, claim that:
- "Considering all the scientific reports and a huge amount of fragmentary information, the connection between anabolic steroids and their increase in strength and muscle mass is mentioned especially by weightlifters who are training hard and maintain adequate diet."