Long-term use of anabolic steroids by a male 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) gynecomastia

(2) testicular atrophy with infertility

(3) impotence

(4) acne

(5) accelerated 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 (peliosis hepatis, other)

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


Undesirable laboratory findings

(1) hyperlipidemia

(2) oligo or azoospermia

(3) abnormal liver function tests, including hyperbilirubinemia

(4) depressed levels of serum testosterone


Behavioral change:

(1) preoccupation and dissatisfaction with physique


Differential diagnosis:

(1) changes of puberty (acne, gynecomastia, facial hair)

(2) androgenic steroid producing tumor


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