Page 84 - Athletic Health Handbook
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Tendon degeneration and collagen Athletes taking anabolic steroids physical appearance. This coupled
dysplasia has been noted in animals may develop psychologic effects that with the loss of peer attention, interest
taking anabolic steroids. These effects may range from simple mood swings in exercise, and steroid euphoria can
are most pronounced when the to violent psychoses. Electroen- compound the problem. The severity
animals were exercised at the time cephalographic changes similar to of this withdrawal depression depends
of steroid administration. Clinically, those seen with amphetamine and on the athlete’s preexisting emotional
tendon rupture has been seen in tricyclic antidepressant use have been status. A physiologic component has
athletes taking anabolic steroids. reported. Increased libido, irritability, been suggested as well. There is only
Adolescents who have not achieved and reckless behavior are also recog- one case report demonstrating an
skeletal maturity during steroid use nized. As a result, relationships with opioid-like withdrawal syndrome.
may develop steroid-induced prema- family and friends are often affected. However, several studies have
ture closure of the physes resulting Fortunately, these effects are reversible demonstrated behavior and percep-
in irreversibly shortened limbs. upon discontinuation of the agents. tions in some users indicative of
psychological dependence.
Transient decreases in the Anabolic steroids are also associ-
immunoglobulins IgA, IgG, and IgM ated with the potential for habitua- As health care professionals inter-
have also been seen during AS use. tion. This occurs primarily by a ested in the well-being of athletes,
The effect of these immunologic psychological dependence on their our role in this context should be to
alterations is uncertain. Polycythemia, effects (either from a competitive identify the patient at risk and inform
through the enhancement of erythro- standpoint or from an obsession to him or her of the potential harm AS
poesis, has been noted. Abscess forma- maintain an altered body image). possess and the legal ramifications
tion at injection sites is relatively Discontinuation has been associated associated with them. For the majority
common, however, two reported cases with a withdrawal syndrome charac- of athletes, advice on training and
of HIV transmission have been seen terized by severe depression resulting proper nutrition will bring about the
following the use of shared needles. from the insecurity associated with the desired effect in their performance
Hepatitis is, therefore, also a risk. loss of the competitive edge and/or without the need for these drugs.

© AMERICAN ORTHOPAEDIC SOCIETY FOR SPORTS MEDICINE, 2008, ALL RIGHTS RESERVED

ANABOLIC STEROIDS AND THE ATHLETE 84
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