Page 83 - Athletic Health Handbook
P. 83
are often purchased that are of inde-
terminate dosage without quality
control, which in and of itself consti-
tutes a health risk.

Multiple organ systems are
potentially adversely affected by AS
abuse. These include the reproduc-
tive, hepatobiliary, cardiovascular,
musculoskeletal, immunologic, and
endocrine systems. Male athletes
using AS suffer from a hypogonadal
state characterized by decreased
testosterone levels, testicular atrophy,
and impaired spermatogenesis. These
effects are usually reversible. Other,
irreversible, male effects include
baldness, acne, and gynecomastia
resulting from the peripheral aromi-
tization of the steroid to estrogen.

Women taking AS develop
reversible masculine characteristics
such as increased muscularity,
menstrual irregularity, breast shrink-
age, clitoral enlargement, and changes
in libido. Irreversible effects in women
include hirsutism, male pattern
baldness, coarsening of the skin,
and deepening of the voice.

Oral steroids may cause a reversible
elevation in liver function tests.
Cholestatic jaundice has also been
recognized. With prolonged usage,
peliosis hepatis — a rare hemorrhagic
cystic degeneration of the liver —
may occur. Long-term use of oral
agents may also be associated with
both benign and malignant liver
tumors. Most of these hepatic effects,
including some tumors, are reversible
upon discontinuation of the steroids.

Anabolic steroids are also associ-
ated with the development of nega-
tive cardiac risk factors, which may
be the area of greatest risk. These
include a decrease in HDL and an
increase in LDL fractions, hyperten-
sion, and a decrease in glucose toler-
ance. There have been reports of
both strokes and myocardial infarc-
tions occurring in athletes taking
AS for prolonged periods.

ANABOLIC STEROIDS AND THE ATHLETE 83
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