Long-term use of anabolic steroids by a female athlete may result in a number of physical changes. Some of these are reversible but some may be long-lasting.


NOTE: Psychiatric changes associated with anabolic steroid abuse are discussed in Chapter 18, and the withdrawal syndrome in Chapter 32.


Desired effects:

(1) increased skeletal muscle mass


Undesirable effects:

(1) irregular menstrual cycle

(2) clitoromegaly

(3) deepening of the voice

(4) acne

(5) male pattern hair loss

(6) increased facial and body hair

(7) hypertension and premature coronary artery disease

(8) fluid retention with edema

(9) jaundice

(10) rarely liver tumors (peliois hepatis, other)

(11) excessive strain on tendons, with risk of tendon rupture

(12) galactorrhea

(13) acute renal failure


Undesirable laboratory findings

(1) hyperlipidemia

(2) decreased serum LH and FSH

(3) abnormal liver function tests, including hyperbilirubinemia


Behavioral changes:

(1) nontraditional gender role

(2) preoccupation and dissatisfaction with physique

(3) eating disorders


Differential diagnosis:

(1) changes of puberty such as acne

(2) androgenic steroid producing tumor


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