Technische Universität München

The Entrepreneurial University

AAS are used by athletes in dosages exceeding physiological replacement levels by 10 to 50 times or more. This leads to hyperandrogenic conditions in the organism and results in anabolic steroid-induced endocrine imbalance and many somatic and psychic adverse effects on health.  

The main side effects of AAS are:  
  • Cardiovascular – myocardial infarctions, arrhythmias, sudden cardiac death, thrombosis, increase in the atherogenic LDL-cholesterol
  • Hepatic – liver cyst formation, liver tumours  
  • Endocrine and reproductive – impairment of thyroid function, insulin resistance and diminished glucose tolerance, suppression of ACTH, LH, FSH levels, changes in both male and female sex hormone concentrations  
    • Male reproductive system - impaired spermatogenesis, infertility, testicular atrophy, erectile difficulties, changes in the libido, gynaecomastia, balding and, probably, prostate hypertrophy
    • Female reproductive system - inhibition of ovulation, menstrual irregularities, infertility, ovarian cyst formation, enlargement of the clitoris, decreased breast size, atrophy of the uterus, changes in libido, lowering of the voice, alopecia and hirsutism  
    • Children and adolescents - development of pubic hair, clitoral/phallic enlargement and other signs of virilisation or precocious puberty
  • Skeletal – tendon rupture, rhabdomyolisis, premature closure of epiphyses and growth retardation in adolescent users
  • Psychic – fluctuation of moods, irritability, uncontrolled aggression, other affective or psychotic symptoms and syndromes
  • Others – steroid acne, renal Wilm’s tumour, sleep apnea syndrome and increased risk of hepatitis and AIDS (associated with shared needles)
In women the breast atrophy, hypertrophy of the clitoris, the voice changes, hirsutism and alopecia are generally irreversible. Although most of the other AAS-induced side effects are considered to be reversible after steroid withdrawal, some case reports suggest that problems may persist for years and that recovery does not always occur. In addition, the long-term health effects of AAS abuse are unknown. For example, the altered hormonal milieu observed after testosterone prohormones supplementation is similar to the hormonal profile observed in men with prostate cancer, testicular cancer and pancreatic cancer.  

Other anabolic agents side effects:  
The side effects of clenbuterol, like those of other β2-agonists, are increased heart rate, arrhythmias, sudden cardiac death, muscle tremor and cramps, headache, nervousness, insomnia. As zeranol is used only in animals, there is no information about its side effects in humans, but animal studies suggest toxic effects on the liver and increased risk of hepatic carcinogenesis. In women tibolone use may result in nausea, vomiting, myalgia, headache, hirsutism. The side effects of SARMs are unknown as no drug of this type appeared on the market to date.