So what are the physical effects of taking steroids?

The information contained on the links from this page is the reason STED-Ed was created. Here you will find details on the potential side effects of taking Anabolic Androgenic Steroids. Some of these side effects may start to develop shortly after steroid use starts and some may take years to develop. Some will results in physical deformities that require surgery to correct and some of these side effects are potentially life threatening. None of these side effects have been made up, they are all real potential risks of taking steroids.

There are many websites out there that claim these side effects are reversible, or are not guaranteed to happen, can be avoided with certain steroids...blah blah blah!!! The facts are that the side effects listed below are real risks that anyone using steroids should be aware of. STED-Ed is not saying that you will experience all of them, but they can and do happen.

Click on the links below for more information on the potential side effect:

Abscess

An abscess is a collection of pus that has collected in muscle tissue; it is generally surrounded by inflamed tender tissue. An abscess forms from injecting into a muscle and can be as a result of poor blood flow within the muscle, poor injecting technique or when counterfeit steroids are use. Abscesses are more common with oil based steroids which generally take longer than water based steroids to absorb into the body.

If blood flow is an issue the fluid injected will remain within the muscle and become stale and infected, this can form deep within the muscle so early signs may not be spotted easily. An abscess can also form from infection as a result of using no sterile equipment.

One other possibility is a sterile abscess. This is not caused by an infection but can occur when a blood vessel is damaged by a needle. This is quite easy to do and you may not know it has occurred until a few days later. Blood will leak from the blood vessel and will have nowhere to go. It will therefore sit between the muscle fibres and cause a lump.

You should always expect some sort of pain after injecting steroids. This should ease after a few days. If you find that the area is tender, raised, red or causing discomfort you should seek medical attention immediately. Never attempt to treat an abscess yourself...get this wrong and you could cause the infection and pus to enter the blood stream and head to your brain. Once the infection enters the bloodstream things become more complicated and the treatment will take a lot longer and be more intense. An untreated abscess can result in septicaemia which is life-threatening.

In very rare cases an abscess can heal itself...but in most cases a course of anti-biotics will be needed (in this case you will have to explain to your GP how it happened). In some cases an operation may be needed to drain the pus and if left untreated major surgery can be needed to remove infected muscle tissue.

An operation to treat an abscess can be major surgery and require a long rehabilitation period. This may include carrying a drainage bag around after the operation to continue to drain fluid from the area.

Click this article for a bodybuilders experience of an abscess http://articles.muscletalk.co.uk/article-glute-abscess.aspx

Steroids and Acne

If you're past the age of 20 you've probably experienced some sort of acne or spots. After puberty though you should probably seek medical advice if you're still suffering from acne as you may have over active sebaceous glands.

We all have sebaceous glands which produce a waxy and oily excrement to lubricate the skin. An abundance of this excrement causes spots on the skin. Many people develop acne during puberty, especially young males who will experience a peak in their testosterone levels during this period. The androgen hormone encourages growth, development and activity of the sebaceous glands. The increase in sebaceous gland activity generally leads to an increase in Sebum production. High levels of Sebum production can increase the incidence of follicular plugs that clog pores. The increased Sebum can also accelerate the growth of the acne causing bacteria, Propionibacterium acnes, which uses the Sebum as a nutritional source. Increased Sebum levels can also contribute to increased inflammation in and around the follicle, accelerating the problem and contributing to the damage caused by the acne infection.

Anabolic Steroids such as testosterone and DHT have a very androgenic effect over and anabolic effect. This means they can be a major effect on the development of acne during a cycle.

Some athletes will experience a more serious form of acne known as acne fulminans. This shows as extreme red 'angry' spots that can cause joint pain in the knees and hips.

The back and shoulders are well known for break outs of acne in men and women who use steroids. Acne can remain even after steroid use and can a long time to diminish. You may find it does leave skin scars if the bout was particularly bad. These scars can be unsightly and can cause individuals to become conscious about their bodies.

If you are naturally prone to acne or spots you should seriously re-consider steroid use. In all cases personal hygiene should be kept on top of. The skin should always be clean and regular washing through-out the day is a must.

Acromegaly

Acromegaly is a condition where the anterior pituitary gland produces an abundance of growth hormone which leads to the over growth of body tissue.

The use of Human Growth Hormone as a Performance Enhancing Drug will encourage the onset of Acromegaly. Generally the use of steroids will not bring on Acromegaly, HGH is not a steroid.

It is worth noting that the effects of Acromegaly cannot be reversed. HGH in adults will not cause extension of the bones but will be responsible for the thickening of the bones. This will be noticeable particularly in the forehead just above the eye brows where the bones may become more pronounced.

You should be aware that Acromegaly is one of the most horrific side effects associated with the use of Performance Enhancing Drugs. It will not only affect bones but you can expect an increase in the size of your heart and kidneys. This can lead to serious health complications and even reduce life expectancy.

If you are using HGH you should watch for the following symptoms:

  • Excess hair growth
  • Prominent facial features
  • Coarsening of the skin

Blood Pressure

Blood pressure or hypertension is potentially dangerous side effect when using steroids. It is a major risk for cardiovascular disease and increased risk of stroke, when a blood vessel bursts in the brain. Continued high blood pressure may also damage the inside of arterial walls which can cause restrictions in blood flow.

Several factors affect steroids have on blood pressure. This includes dosage and length of cycle. Increased doses have become a serious issue amongst steroid users who feel the need to take in more and more steroid. High doses are directly linked to high blood pressure.

Those steroid users who chose not to have a break from steroids and continue to cycle are running the risk of putting themselves in an early grave. The longer a cycle the higher the risk of heart attack and stroke.

Studies suggest that increased sodium and water retention from steroid use is a major factor affecting blood pressure.

Headaches, impaired vision, nose bleeds, risk of stroke and heart problems can all be caused by high blood pressure.

A health check prior to the use of steroids or any strenuous exercise is highly recommended. This will show up any issues with blood pressure and cardiovascular system that may be elevated by a steroid cycle.

Around 1 in 3 adults in England and Scotland have high blood pressure and nearly half of them are not receiving treatment for the condition. British Heart Foundation​

Steroids and Cholesterol

We all know that we have good and bad cholesterol, but what is cholesterol?

Cholesterol is a fatty substance carried around the body by proteins. When cholesterol and proteins come together they are called lipoproteins. This is where we get the good and the bad cholesterol;

Bad cholesterol is also known as Low-density lipoproteins (LDL) and is carried from the liver to the cells that need it.

Good cholesterol is also known as High-density lipoprotein (HDL) and this carries cholesterol away from the cells and back to the liver where they are broken down.

Having too much LDL in the blood can lead to fat deposits in your arteries and can lead to high blood pressure, strokes and other health complications.

So what does this mean for steroid users?

Testosterone, oestrogen, progesterone and DHT seem to have the greatest effect on cholesterol levels.

Oestrogen in particular seems to be responsible for keeping good HDL cholesterol elevated. Although other hormones such as testosterone and particularly DHT may raise total and LDL cholesterol, it seems they do this by overpowering oestrogen. Now take into consideration that you are altering the hormone state of your body and generally increasing the amount of testosterone you have. You should now be starting to see the link between high cholesterol and anabolic steroid use.

Regular cholesterol checks are needed for anyone using Anabolic Androgenic Steroids to ensure blood pressure is normal and reduce the risk of heart attack.

Fatigue

If you're reading this then the chances are that you are training pretty hard at the minute and hopefully sticking to a reasonable diet. Without the proper rest periods this can lead to exhaustion.

Individuals use steroids to allow them to train harder and more often. This takes the body to a level that it may not be used to or capable of. It is important to build in rest periods into your exercise routine to allow your body to recover from the damage you will have done during strenuous exercise.

When using Anabolic Androgenic Steroids a general feeling of being 'unwell' can be a result of the following:

  • Low natural testosterone levels
  • Low blood sugar
  • Reduced liver function
  • Lack of rest periods
  • Bad reaction to one or more steroids

Following a steroid cycle hormones will usually take a period of time to resume back to normal levels. During this time you may feel exhausted and run down. Ensure a post cycle therapy if followed and a period of time is allowed where no substances are used to allow the body to fully recover.

Steroids and Gynecomastia 'aka' Bitch Tits

No male wants breasts...well most males do not want breasts. Not only is Gynecomastia unsightly it can also be damaging to a person’s self confidence.

Gynecomastia is a condition where breast tissue forms around the nipple area and breasts develop. When using steroids the body is overloaded with artificial testosterone and as a result stops producing its 'own natural testosterone. This can lead to an increase in oestrogen. With this imbalance of hormones breast tissue begins to form around the nipple area and a males breast can start to take the form of a female breast.

It is important to ensure Post Cycle Therapy is followed to ensure hormone levels are kick started and balanced as soon as possible. This will ensure the testosterone / oestrogen balance is restored as quickly as possible and the risk of side effects is minimised.

Warning signs include tenderness around the nipple and puffiness. You may also find hard lumps around the nipple area. Sometimes the breast tissue can reduce once a cycle has finished but for most there will be a need for surgery to remove the excess tissue.

Steroids and Headaches

No one really knows why headaches occur when people are using Anabolic Androgenic Steroids. It may be because of the increased toxic substances in body that are hard to metabolise.

Changes in hormones levels, blood pressure, dehydration, and even muscle strain can all be possible causes of headaches. High blood pressure to the point of causing headaches is very serious and you should seek medical attention straight away.

Steroids and the Heart

The heart is a muscle...and a very good one at that. It is constantly in use (thankfully). The use of steroids increases muscle mass and the heart tissue will also be affected.

The heart can become over developed with increases in the thickness of the heart wall tissue. With this the heart becomes inefficient and under strain.

In a study by Aaron L. Baggish, investigators found that the left ventricle, the heart's main pumping chamber, was significantly weaker during contraction in participants who had taken steroids compared to a group of similar non-steroid users.

A healthy left ventricle pumps out 55 percent to 70 percent of the blood that fills the heart. Eighty-three percent of steroid users in the 12-person study had a low pumping capacity that previous studies have linked to increased risk of heart failure and sudden cardiac death. In contrast, only one of the non-steroid users had a low ejection fraction.

Steroid users also exhibited impaired diastolic function, which is when the left ventricle relaxes and fills with blood. The researchers showed that ventricle relaxation among steroid users, as demonstrated by the left ventricle's ratio of early-to-late blood filling, was reduced by almost half (0.93 compared with 1.80 among non-users). The left ventricle's structure was similar in both steroid-users and non-users.

Anyone with underlying heart conditions should be particularly cautious on the use of steroids. Comprehensive health checks will identify any issue with heart rhythm, valve issues, or heart disease that may be exaggerated by steroid use.

Heart attacks, irregular heart rhythm, and other cardiovascular issues are all major concerns when using steroids.

Steroids and Infertility

Infertility is to be expected during a steroid cycle. Steroids are actually very good at causing temporary infertility. This is not to say that it should be used as a contraceptive method.

So how do anabolic steroids affect male fertility? Sperm are formed in the body when brain hormones the testicles to produce sperm. In the testicle, cells called Leydig cells are turned on to produce the male hormone, testosterone. When this occurs, there are very high levels of testosterone that are present in the testicle, although there is a normal amount of testosterone in the blood stream.

When men use anabolic steroids, they trick the body into thinking that the testicles do not have to produce testosterone. When this happens, the amount of testosterone in the testicles is extremely low, despite normal or very high levels in the bloodstream (although this will be synthetic testosterone). When this situation occurs, follicle stimulating hormone also is not released. This combination causes the testicles to shrink and to produce little if any sperm.

Injecting Steroids

Sticking a needle into your body is always going to be risky, particularly if the person giving the injection hasn't been trained in the procedure. People who are trained include nurses, doctors and specially trained medical professionals. This does not include the guy at the gym who has experience of steroid use and tells you he has seen it all and that he knows best!!! The common side effects of poor injection technique are as follows:

Pain

Intramuscular injection causes two forms of pain. The first is that sharp scratch as the needle penetrates the skin. The second is a deeper discomfort, as the injection separates the muscle fibres, creating a pocket of fluid within the muscle. The larger the volume of fluid, the greater the pain. Bigger muscles like the gluteus and thighs can comfortably accommodate two to three millilitres of fluid. With smaller muscles like the shoulders one millilitre is about the limit. The fluid disappears as the drug gets absorbed, but the site remains slightly damaged and inflamed from the needle stick for a while longer. The degree of pain and how long the drug sits there depend on the type and brand of drug. Oil based steroids are slower to be absorbed by the body than water based and so the pain can last for a lot longer.Needle size also influences the amount of pain. Larger-diameter needles cause more damage than narrower ones. Needle diameter (in millimetres) is called the gauge. The larger the gauge, the finer the needle in thickness. Obviously, finer needles cause less tissue damage. The narrower the needle, however, the more difficult it is to push the fluid through, and the viscosity of oil-based steroids is simply too thick to pass through tiny needles. To improve comfort and safety with regular injections, it's better to use the smallest needle possible.The length of the needle is also important. You need a 1 1/2-inch needle to deliver a deep intramuscular injection into larger muscles like the buttocks, whereas a shorter 5/8-inch or half-inch needle can be used to inject smaller muscles. If you push a two-inch needle into a smaller muscle, you're likely to hit an underlying nerve or blood vessel and this can cause some serious long term health issues.

Bruising

Every time a needle pierces muscle, a small amount of internal bleeding occurs. Under normal circumstances that's not a problem. But if the needle hits a blood vessel, the blood loss into the surrounding tissue can cause an unsightly (and painful) bruise, or hematoma. An injection-site bruise doesn't usually require treatment, but it will take a week or so to resolve. Bruising can be minimised by applying direct pressure on the injection site with a cotton swab or facial tissue. Keep pressing for a minute or two until you're sure the bleeding has stopped. Remember that a trained health-care worker draws back on the syringe before injecting. A back-flow of blood into the syringe indicates that the needle is in a blood vessel. WITHDRAW - injecting here can be dangerous and potentially fatal.

Scar Tissue

An injection needle actually damages muscle. As it plunges inside, it inflicts a tiny hole that heals by forming a scar. A small amount of scar tissue from one injection is no big issue; however, repeated needle sticks eventually create a large area of scarring. And subsequent injections into the hard scared area become more difficult and painful. Many people may not realise that scar tissue does not function in the same way that muscle tissue does. Scar tissue will not contract. It will sit between the muscle fibres and does not play any function other than covering over holes. Scar tissue build up can be minimised in several ways; 1, stop injecting! 2, rotating injecting sites. Rotating sites means changing the area you are injecting into to give the area time to heal and generally give it a rest.

Nerve Damage

Be warned that injecting into muscle is not as risk free as it may seem. Most muscles cover nerves, blood vessels and other important anatomical structures. For instance, the radial nerve lies immediately under the triceps horseshoe, the sciatic nerve under the lower portion of your glutes and the quadriceps teardrop directly over the lining of the knee joint. If your misplaced needle hits an artery or vein, the extra blood loss creates a good-sized bruise. Remember this, if someone else is injecting you they cannot tell if the pain is increasing or if it becomes to much. By the time you have registered the pain, said ouch or moved they will have carried on pushing in and by then it may be too late. Hit a nerve with your needle, and it feels like an electric shock shooting through the area. If this happens seek medical attention immediately.

Infection

Another possible side effect of poor injection technique is infection. All injections should be administered using a sterile equipment in a clean environment. The gym changing room doesn't qualify as a sterile area.

Cleansing the skin with an alcohol swab can help reduce the risk of infection. If the needle does get dirty after it's removed from the sterile packaging, then there's a risk of introducing a bacterial infection under your skin. That can develop into an abscess filled with pus, which usually needs to be lanced or surgically removed. Fake or counterfeit steroids that have not undergone proper sterilization can also increase the risk of bacterial infection.

How can you tell when an injection site is infected? The area is painful, swollen, red and warm to the touch. As the days pass, an infection gradually gets worse rather than better. In contrast, the pain and redness from a non infected injection-site irritation resolves within a few days. If you don't get treatment for an infected injection site, the infection can spread, causing you to feel generally unwell, with a fever. If you reach that stage, you need to see a doctor right away.

Hepatitis and HIV

A more serious complication arises from sharing needles. That hazardous practice risks the transmission of HIV (AIDS) and hepatitis B or C. During the 1980s there were a few reported cases of HIV infection in bodybuilders sharing needles, but let's hope no one is crazy enough to share these toys nowadays...well actually they are. One story we have heard recently was a gym owner who was selling and administering steroids to 5 people at a time. He was changing the needle for each injection but was using the same barrel. This is highly dangerous and carries a huge risk of infection for at least 4 of the guys. All injecting equipment (everything) should be brand new and sterile for every injection. If you are not satisfied that the area is sterile, that the equipment is sterile or that the fluid is not counterfeit then please, please, please, stop. Infection is a real risk and the Blood Bourne Virus' that can be contracted are life threatening. New research published by Public Health England suggests that 1 in 18 steroid users they surveyed had exposed themselves to Hepatitis C, 1 in 11 had been exposed to Hepatitis B, and 1 in 65 had currently have HIV.

Needle Breaking

The needles used are made of strong metallic materials but they are also very thin. If you find the pain to much you are likely to flinch. If someone else is holding the needle and pushing it in as you flinch it can result in the needle bending and even snapping. If the needle bends it can cause extra damage as the needle is withdrawn. If the needle breaks you will need to get this removed by a nurse or doctor and it can be very painful.

If you don't have some form of medical training, administering intramuscular injections can be risky, so please make safe, sensible decisions. If you do run into any problems, seek the advice of a medical doctor immediately.

Needle Exchange

these exist in most pharmacies around the country and will provide you with clean paraphernalia to use. This should include barrels, needles, swabs (to clean the area) and a sharps bin to put used needles and barrels in. The staff at these services should also be able to advise you on problems you may be having with injecting and take a look at your injecting sites for infections. Look for this sign for a Needle Exchange Programme -

Steroids and Kidneys

The kidneys are important for the elimination of waste material from the blood and the regulation of salt and water levels as well as the regulation of blood pressure.

Kidney damage from steroid use is usually associated with oral steroids due to the higher work rate to filter the blood.

Swelling of the kidneys, poor kidney function, and in some cases kidney damage and failure are all possible side effects of steroid use.

Leal Herlitz, MD (Columbia University Medical Center) and her colleagues recently conducted the first study describing injury to the kidneys following long-term abuse of anabolic steroids. The investigators studied a group of 10 bodybuilders who used steroids for many years and developed protein leakage into the urine and severe reductions in kidney function. Kidney tests revealed that nine of the ten bodybuilders developed a condition called focal segmental glomerulosclerosis, a type of scarring within the kidneys. This disease typically occurs when the kidneys are overworked. The kidney damage in the bodybuilders has similarities to that seen in morbidly obese patients, but appears to be even more severe.

When the bodybuilders discontinued steroid use their kidney abnormalities improved, with the exception of one individual with advanced kidney disease who developed end-stage kidney failure and required dialysis. Also, one of the bodybuilders started taking steroids again and suffered a relapse of severe kidney dysfunction.

The researchers propose that extreme increases in muscle mass require the kidneys to increase their filtration rate, placing harmful levels of stress on these organs. It's also likely that steroids have direct toxic effects on the kidneys. "Athletes who use anabolic steroids and the doctors caring for them need to be aware of the potentially serious risks to the kidney," said Dr. Herlitz.

It is important to maintain a regular fluid intake and be aware of any pain around the kidney area during a steroid cycle.

Ligaments & Tendons

Steroids increase muscle mass and weight and the ability to lift heavier weights. All of this extra strain can damage the connecting tissues within the joints.

As you lift heavier weights you will cause more damage to your muscles. With adequate rest and nutrition plans they will repair and grow. The ligaments and tendons will not do the same thing. The increase in strain will result in stretching of the connective tissues and even complete tears if the load becomes too much.

Your muscles will continue to develop and grow as the body repairs the torn muscle fibres through blood flow and protein. Unfortunately the ligaments and tendons do not have a sufficient blood flow and so can take several months to repair and in some cases can require surgery.

Stretching of the ligaments can result in unstable joints and risk of serious injury.

Steroids and the Liver

The liver is the largest organ in the body and acts as the body’s natural filtration system. It also regulates the levels of proteins, cholesterol and sugars in the body as well as storing essential vitamins and minerals. In simple terms....it’s very important!

Steroid use has been shown to cause irreversible liver damage and cancers. The damage to the liver is usually associated with oral steroids with the 17- alpha alkylated preparations. Oral steroids are difficult for the liver to metabolise leading to a decrease in the ability of the liver to clear waste products.

Some counterfeit steroids have been known to carry all kinds of bacteria and virus leading to adverse liver function. Hepatocellular jaundice which is evident by a yellowing of the skin and eyes, can be caused by an abnormal liver function as the liver cannot effectively filter the blood.

Liver damage can be associated with long term users but changes to liver cells can happen at any stage. Symptoms include, aches in the lower back, nausea, fatigue as well as yellowing of the skin and whites of the eyes.

If you are using steroids you should have liver function tests at numerous stages including before, during and after your cycles to ensure damage is minimised.

Steroids and Male Pattern Baldness

There are lots reports that the use of steroids can speed up the process of male pattern baldness.

A lot of steroid users will claim that balding is only relevant to those of us who are predisposed to balding already and that the use of Anabolic Androgenic Steroids just accelerates the process....either way who wants to go bald quickly?!?

Male pattern baldness is primarily caused by a genetic predisposition hormone DHT or dihydrotestosterone.

DHT attaches to hair follicles that are not genetically programmed to withstand certain levels of the hormone. This inflammatory process will cause the hair to progressively thin and shed over time if this process is allowed to continue.

If you are genetically prone to male pattern baldness, using steroids can accelerate your hair loss because you will have higher levels of DHT in your body.

Steroids and Sexual Dysfunction

Some male steroid users may experience erection problems and sexual dysfunction. This can include difficulty getting and sustaining an erection as well as priapism.

Priapism is a condition where a person gets an involuntary erection over long periods of time. The penis will fill with blood but will not be able to drain as it becomes trapped in the corpora cavernosa, a large chamber in the penis and it will eventually become starved of oxygen. I this happens seek medical attention straight away as the damage can be permanent and include impotence.

Involuntary erections can be embarrassing and painful.

Priapism is treatable and is generally treated successfully but this does rely on you getting help in the first place. Do not leave it to long.

Steroids and the Stomach

Stomach pains are usually associated with oral steroids. Increased toxic substances can strain the stomach. This can cause pain ranging from slight discomfort to vomiting and diarrhoea.

These symptoms can also be a sign of stomach ulcers and other gastric issues. You may also be doing damage to your stomach lining with the added toxins.

Steroids and the Testicles

This is the one that you are guaranteed to experience should you start using steroids.

Your testicles are responsible for the production of testosterone. Your brain will be monitoring your levels of testosterone and other hormones. It will send a message to the testicles and tell them to produce testosterone to ensure you have the correct level. Your brain will also tll the testes to grow and develop.

Now consider that you are about to pump your body full of synthetic testosterone. Your brain will think that it has enough testosterone (or even to much) and so will not tell your testicles to produce any more. As they are not working they shrink. It creates a negative feedback loop within your body.

Your testicles shrink through a lack of activity...think of it in the same way you would your muscles...use them a lot and they grow....stop using them and they shrink.