Testosterone plays a key role in athletic performance by stimulating protein synthesis, muscle growth, and body mass increases. Other hormones, such as growth hormone and erythropoietin, are used to enhance performance by promoting muscle recovery or increasing oxygen-carrying capacity.
Anabolic steroids are synthetic derivatives of testosterone designed to improve muscle size and strength. These steroids also contribute to secondary male sex characteristics, such as increased body hair and a deeper voice.
Athletes who misuse anabolic steroids often take them in supraphysiologic doses, well beyond normal therapeutic levels. Research indicates that higher doses are associated with greater increases in muscle mass, though use is typically structured through practices such as stacking (combining different steroids), pyramiding (gradually increasing and tapering doses), or cycling (alternating periods of use and abstinence).
Anabolic steroid use extends beyond elite athletes and strength trainees. Surveys indicate that approximately 7% of male American high school seniors have used anabolic steroids. Among these users, about one-third were not involved in school-sponsored sports, and one-fourth reported that their primary motivation for using steroids was appearance enhancement rather than performance.
The primary ergogenic benefits of anabolic steroid use include:
However, these effects depend on the athlete’s training status, dosage, and duration of use. Strength-trained athletes may experience significant gains, while novice lifters may see minimal improvements beyond natural training adaptations.
One of the primary reasons athletes and non-athletes take anabolic steroids is to increase lean muscle mass and strength. Research suggests that:
However, not all weight gained from steroid use is muscle. Some of the increases in body weight are attributed to intracellular water retention, which can be mistaken for actual muscle growth.
While anabolic steroids can enhance performance, they come with significant health risks, including:
A study by Pope et al. found that 60% of steroid users experience increased irritability and aggression. While some athletes perceive this as beneficial in contact sports, it can pose serious risks to both the user and those around them.
Research suggests steroid abuse may be linked to muscle dysmorphia (also known as reverse anorexia), where users perceive themselves as small despite substantial muscle mass.
Prohormones, such as androstenedione and dehydroepiandrosterone (DHEA), are marketed as testosterone boosters but have weaker androgenic effects compared to anabolic steroids. Many prohormones have been banned due to their potential health risks and limited performance benefits.
The 2004 Anabolic Steroid Control Act classified several prohormones as controlled substances. Studies on their efficacy show mixed results, with some demonstrating no significant improvements in strength or muscle mass. Additionally, these supplements may contribute to hormonal imbalances and increased health risks.
It is important to note that legal status does not necessarily mean permissibility in sport. Organizations such as WADA and the NCAA maintain strict policies on banned substances, so athletes must stay up to date with the regulations that apply to their sport.
Athletes should exercise caution when considering prohormones for performance enhancement due to limited evidence supporting their effectiveness and the potential for adverse effects.
HCG is sometimes used in weight loss interventions but has not been proven effective for inducing weight loss. The primary factor contributing to weight reduction in these cases is caloric restriction rather than the direct effects of HCG.
Insulin is an anabolic hormone that regulates blood glucose and facilitates amino acid uptake into cells. Because of its anabolic properties, insulin is sometimes misused by bodybuilders.
HGH is a protein hormone secreted by the anterior pituitary gland that has anabolic and metabolic functions.
EPO is a hormone produced by the kidneys that stimulates red blood cell production.
Beta-agonists, such as clenbuterol, were originally developed for asthma treatment but have been used to enhance muscle growth and fat loss.
Beta-blockers are drugs that block beta-adrenergic receptors, preventing epinephrine and norepinephrine from binding. They are often used for cardiovascular conditions but have also been misused in sports requiring steady hand control (e.g., shooting, archery).
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