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Ages & Stages

Anabolic Steroids

The word anabolic means growing or building. Anabolic steroids, synthetic versions of the male sex-hormone testosterone, promote the growth of muscles, bones and skin. Steroid users who exercise and eat a high-protein diet will usually see significant increases in their lean muscle mass.

In 1975 the International Olympics Committee banned steroid use by all participants.The National Football League and other professional sports organizations soon followed suit. By then, however, the drugs had begun filtering down into high schools, and not just the gym locker rooms. With teen media force-feeding youngsters idealized images of muscle-bound boys and perfectly proportioned girls, more and more adolescents started turning to steroids purely for cosmetic reasons.

“Many of them aren’t athletes,” observes Dr. Gene Luckstead, a sportsmedicine specialist in Amarillo, Texas. “They just want to ‘look better,’ bulk up, strut around the beach. Until adolescents decide that the price tag is too high, it is likely to continue.”

You would think that unwanted side effects such as shrunken testicles and breast growth (gynecomastia) for boys and facial hair and deep, masculine voices for girls would deter kids from these drugs, but three-fourths of all steroid users are teenagers. Because their bodies are still developing, the synthetic hormone can stunt a youngster’s growth permanently.

A lucrative black market has made it easy for teenagers of either sex to procure illegal steroids over the Internet, through mail-order businesses, at the gym, from friends “and sometimes from their coaches,” Dr. Luckstead says disapprovingly. There are roughly a dozen different brands available, in both oral and injectable forms. Abusers typically combine multiple steroid preparations, in a practice known as “stacking,” for six to fourteen weeks. Then they temporarily reduce the dosage or stop altogether before beginning another cycle. To “pyramid” is to slowly escalate the number of drugs taken, or the dose and frequency of one or more steroids; reach a peak amount midway through the cycle; and gradually taper the dose. Adherents claim that pyramiding maximizes muscle-building and minimizes adverse side effects, though this is difficult to prove scientifically. Perhaps the greater incentive for stacking and pyramiding is that the two practices help abusers outfox drug tests.

Anabolic steroids should not be confused with corticosteroids, a family of synthetic hormonal drugs frequently prescribed to treat asthma and other common conditions.

Other Performance-Enhancing Drugs

The ban on anabolic steroids has also created a market for substances that are purported to provide the same benefits as anabolic steroids, but without the undesirable side effects and at a fraction of the cost. Because products such as creatine and androstenedione are classified as dietary supplements, they do not fall under the regulatory power of the U.S. Food and Drug Administration. Therefore, children can purchase them without a prescription and without their parents’ knowledge or consent.

Creatine monohydrate is a synthetic version of a natural substance in the body that powers muscle contractions. At doses of 5 to 20 grams per day, the powdered supplement does appear to increase adult athletes’ muscle strength and energy for short periods of repetitive, high-intensity exercise. However, we don’t know much about its effects, positive and negative, on adolescents, or its long-term impact on the body.

As for androstenedione, once ingested, a natural enzyme in the body converts it to testosterone. There was sufficient belief that the supplement enhanced athletic performance and could possibly be harmful that the National Football League, the International Olympic Committee and the National Collegiate Athletic Association all prohibited its use. Professional baseball, however, still allows its players to take the tablets.

Related Paraphernalia

  • Vials
  • Resealable plastic bags
  • Hypodermic needles, for injecting drugs into muscle tissue

Legal or Illegal

Many steroids have legitimate medical uses in humans and animals. They are available by prescription only.

Signs of Steroid Use

  • Severe acne
  • Wild mood swings and angry, combative behavior known as “roid rages”
  • Delusions
  • Feelings of invincibility

In Teenagers

  • Premature halt in physical growth

In Men

  • Shrunken testicles
  • Hair loss
  • Breast development (gynecomastia)
  • Impotence
  • Reduced sperm count
  • Painful or difficult urination

In Women

  • Growth of facial hair
  • Irregular menstruation
  • Cessation of menstruation
  • Enlarged clitoris
  • Breast reduction
  • Deep-pitched voice

Possible Long-Term Effects

  • Liver damage
  • Primary liver cancer
  • Jaundice
  • Fluid retention
  • High blood pressure
  • Trembling
  • Bad breath
  • Swollen feet or ankles
  • Aching joints
  • Increased chance of injury to muscles, tendons and ligaments
  • In men, lowered sperm count and infertility
Last Updated
Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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