Anabolic Steroid Abuse
By Michael Capobianco
Fall 2023
Gentlemen, imagine this scenario and let me know if it resonates. Meet Steve, a college-age male who is dedicated to working out three days a week. Since he’s constantly scrolling through TikTok, he sees many jacked men with attractive women around them. As a result, Steve begins to intensify his workouts but can’t seem to achieve the standards portrayed to him on social media.
As he continues to explore the fitness world and strive to meet the standards, Steve encounters popular fitness influencers who suggest different types of anabolic steroids and rank them from best to worst. Steve then purchases the most popular kind and begins to take them, but slowly starts to develop physical and mental challenges.
Does this situation sound familiar? With the advent of fitness influencers, anabolic steroids have been normalized and marketed towards young men as a necessity in their fitness journey without any mention of risks that can impact consumers’ physical and mental well-being.
What are Anabolic Steroids?
Anabolic steroids are synthesized (chemically made) versions of testosterone, the male hormone produced in your gonads (sex organs), and the main androgen which stimulates growth in males such as muscles. Anabolic steroids upregulate and increase the number of androgen receptors, thus enabling increased training intensity and indirectly contributing to increased muscle size and strength. They also have a stimulatory effect on the brain releasing neurotransmitters like dopamine and serotonin.
How are they used?
Anabolic steroids can be administered through the mouth via tablets, injections through needles, and applied as a skin cream or gel. Most fitness influencers talk about their “cycle,” but what does this mean? This can be broken down in three ways:
Cycling refers to someone using anabolic steroids in a rotation of 6–12-week periods. It will often be referred by users as their “on” period.
Stacking is where users combine several types of anabolic steroids or incorporate other harmful substances to maximize their effectiveness.
Pyramiding is where users gradually increase the dose to a peak and then reduce the amount.
How do Performance-Enhancing Steroids Affect Young Men?
You might be asking yourself, well what’s the big deal? What’s so bad about a drug that boosts a man’s ability to put on muscle? Well, the negatives outweigh the positives. Let’s get it straight: anabolic steroids have negative effects on men’s health. After all, these are NOT over-the-counter drugs and can have life-altering implications if abused. Steroids can affect men’s health, physically and mentally. Let’s talk about each one.
Physical Effects
Steroids can have visible effects on the user. When you are exposed to anabolic steroids over a long-term period, there is a possibility these effects can become permanent and irreversible. Here are some physical effects that have been researched and observed.
Cardiovascular issues – Anabolic steroids contribute to increased blood pressure; this can increase the risk of heart attacks and strokes.
Liver damage - Anabolic steroids can strain the liver and can cause tumors and or cysts. Also, steroids can increase hepatoxicity. This is chemically driven liver damage caused by various agents such as steroids.
Acne - Steroids increase certain glands’ activity including the sebaceous glands which increase sweating causing acne.
Testicular atrophy - Steroids provide artificial testosterone to the body which causes a man’s testicles to slow production. The more your body relies on this artificial testosterone, the less your testicles will produce it naturally. This slowing in production will reduce sperm count and shrink your “junk” to raisins. This can lead to major hormonal imbalances if steroids are abused early in a young man’s life. Lastly, it can lead to infertility.
Mood swings- lately anabolic steroids are known to cause the user to go into a state of irritability. (AKA “roid rage”).
Mental effects
Steroids can also alter an individual’s mental condition. People can start developing mental illness while on steroids, but they may also be driven to use in the first place because of previous insecurities. Most young men decide to use steroids because they don’t feel “big” enough. Let’s talk about that.
Addiction and dependency - Steroids themselves aren’t addictive but the results of your gains are. When men start to see their muscles start to grow, they use more and more. Eventually becoming dependent on the drug and experiencing withdrawals.
Withdrawal - Like most drugs as soon as you stop using is where the dependency shows its face. Typically, withdrawal is a sign of some kind of addiction. Some common symptoms include depression, decreased sex drive, insomnia, fatigue, and taking steroids to avoid these symptoms.
Muscle dysmorphia - Muscle dysmorphia is perhaps the most common mental health issue experienced by steroid users today. This is a big topic so I’m going to give it its own section below. Yeah, it’s that serious.
People can start developing mental illness while on steroids, but they may also be driven to use in the first place because of previous insecurities. In fact, most young men decide to use steroids because they don’t feel “big” enough.
Muscle dysmorphia
Many steroid users suffer from muscle dysmorphia, a form of body dysmorphic disorder in which the person has a preoccupation or obsession with muscle size. Those with muscle dysmorphia are more likely to commit suicide and suffer from a substance use disorder. A study was conducted where researchers took 233 experienced male lifers and found 44% of them have used or were currently using steroids. The researchers sent these subjects a questionnaire to evaluate if any factors were consistent with steroid use. They found the biggest factor contributing to steroid use was body image. Muscle dysmorphia is so big in the lifting community it’s commonly referred to as “Bigorexia.”
How is Bigorexia related to Steroids?
People with Bigorexia lack confidence in their self-image. Studies have found that as steroid usage goes up so does men suffering from bigorexia. According to clinical and social psychologist Scott Griffiths, “Anabolic steroids are now the number one most commonly inject drug among new injection drug users in this country [Australia]. That’s ahead of heroin, meth, opioids, and all other drugs.” Furthermore, Griffiths explains that “Fewer than one and ten steroid users in this county play a sport.” This suggests it's not men using steroids to increase their sports performance, but rather to get bigger in the gym. He explains when users see the short-term muscle boost in their bodies, they gain confidence.
Additionally, another study suggests that 2.9 to 4 million Americans have used anabolic steroids at some time, and 98% of usars are men. One-third of this group have experienced dependency, where they continue to use steroids for many years, despite adverse medical and mental effects. While the public and media tend to focus on anabolic steroid use among athletes, more than 80% of steroid users have never used these drugs for competitive purposes. Anabolic steroid users get so wrapped up in the way they look they start to go down a rabbit hole that’s hard to climb out of.
What Causes Bigorexia?
Bigorexia is not caused by one specific thing but rather a multitude of problems. These problems brew into a perfect storm which causes bigorexia.
Sociocultural factors - Society can create pressures for men to look a certain way. This is reinforced when you look anywhere from TV, magazines, kid’s toys, and social media. Social media is the biggest factor of this insecurity build-up in men, but I’ll talk about that later.
History of abuse - Some men may have gone through trauma or abuse, which leads to bigorexia. Griffiths says bullying at a young age can cause this.
Psychological factors - Factors such as perfectionism, low self-esteem, or obsessive-compulsive disorders. Can cause individuals to exercise as a coping mechanism.
I would like to add that I am not against traditional manly traits and or more masculine roles. I am simply pointing out how some individuals can feel empty in one of these areas and feel a need to address it. Going to the gym is a great self-confidence booster! But I don’t want to see young men pump themselves up full of artificial testosterone and feel like it's making these problems better.
The Role of Social Media
In recent years, young men have had constant exposure to social media, including fitness media, where creators have a large influence on men. These fitness influencers have pushed the use of steroids. They show off their unrealistic physique and follow this with nothing but praise from other influencers. When men compare themselves to these juiced-up juggernauts it leads to dissatisfaction, which turns into muscle dysmorphia. According to a recent study, 69% of male adolescents suffer from body dissatisfaction or body dysmorphia. This increase in body dissatisfaction has led to an increase in steroid usage. Another study shows a link to social media platforms to body dissatisfaction. The study concludes that higher muscle dissatisfaction with higher use of social media platforms such as Facebook, Snapchat, and Instagram. In my research, it’s not uncommon for influencers to be open about their steroid abuse. They will say that it’s not good for them, but they continue to push the content of them using. This is poison for young men
A Scientist’s Perspective
I had a chance to speak with Dr. Stefan Hienze-Milne, who was able to offer insight into this topic. Stefan has a PhD in Pharmacology and works at the Nova Scotia Cancer Care Program. He wrote a fantastic article titled, men are buy potentially risky steroid substitutes online to get the “ideal body”. I suggest giving it a look to learn more about how steroids and SARMS affect men. While working towards his PhD, Stephan was very interested in SARMS, or selective androgen receptor modulators, which act in a very similar way to Anabolic steroids. SARMS act on the same androgen receptors as anabolic steroids and have the same effects as most anabolic. Dr. Hienze-Milne, “I think SARMS are interesting because we don’t know much about them. We don’t know much about their long-term impacts and their impact on muscle growth. Unlike Testosterone and other anabolic steroid conjugates which have been thoroughly studied.” Some pharmacological differences include that SARMS are administered orally while anabolic are mostly injectable, which increases the accessibility of them to the public.
When I asked Dr. Hienze-Milne about the dangers of anabolic steroids, he explained, “This conversation can be applied to SARMS as well, but both can be hepatotoxic, as in toxic for your liver. People have been present acutely in hospitals with drug-induced liver injury from any form of steroids. This is because they have toxic metabolites. When your body breaks down the drug to eliminate it, the liver produces other chemicals that are hepatotoxic.” When doing his research, he found that SARMS are also dangerous for the other compounds they might contain. He pointed me to a study where researchers bought SARMS from internet pharmacies. They found that among the 44 products they bought only 52% contained 1 or more SARMS, while 39% contained other unapproved drugs. It's worth mentioning that Dr. Hienze-Milne does think SARMS could have a potential positive role in treating people with muscle-wasting diseases like cancer.
When asked if men are becoming more insecure about their body image, Dr. Hienze-Milne responds, “Yes. Not to pick on Instagram, but being able to scroll and see pictures of fitness influencers with ripped abs gives men the ability to compare themselves a lot easier. I think there is a heighted risk of body dysmorphia given social media.” He continues, “I think it’s a perfect storm to combine social media with internet pharmacies. These give men the ability, as long as you have a credit card, to buy anabolic’s online and get that body image.” He adds that there is a company called SARMS Canada that sells these drugs online. When he visited the website, out of curiosity, he would later get targeted ads for different drugs. This is dangerous for a 16-year-old to do the same thing Dr. Hienze-Milne did and become more susceptible to buying them. How come men struggling with body dysmorphia feel better about themselves without using steroids? Dr. Henize-Milne says, “Acknowledge the lack of transparency on social media and even in your gym. Also, understand the role of genetics. Some people are just jacked, and some people are just not. I don’t think you need to look like Ronnie Colman (or pick your bodybuilder) to be the healthiest you can be. If that’s your view of health reconceptualize it to a more reasonable standard. And try to be happy with yourself.”
A Trainer’s Perspective
I also spoke to a professional trainer for his input on the subject. The trainer decided to stay anonymous, but he has been training for a year. For writing purposes, let’s call my friend Joe. Joe dedicates himself to his clients and goes out of his way to be a part of their life. He explains that before he was a trainer, he was a more introverted person but as he started training clients Joe broke out of his shell. He explains, “Getting to know different sides of clients is a big part of training. When it comes to mental health, certain clients have different challenges that they don’t necessarily want anyone to know about. I build a connection with them to help take on these challenges.”
When asked if he trained anyone on steroids or knew anyone who used steroids, he explained that his close friend he trains with uses steroids. He says, “It’s a bit worrisome when people hop on steroids because if they don’t do the right research. It could have very bad effects on their bodies.” Then I asked how his friend reacted to the steroids. He responded, “The specific steroid he used was testosterone and he [his friend] would be angrier some days. My friend did enjoy using it, but it led to changes in his behavior and mental health.”
Joe explains that societal pressures and anxiety about the environment around them has a big influence on that decision. They he explains, “When you go onto social media, and see men looking the way they do, females are attracted to them. This causes young men to build insecurities.” From this Joe explains he personally thought about taking steroids due to that reason alone. “I luckily didn’t take any, but when people don’t look the way they [fitness influencers] do, after the amount of work they put in, it’s hard to not consider the option.” He expands, “It all comes down to the way you take care of your body outside of the gym.”
Lastly, I asked what he would do if a young male client came to him and was considering going on steroids. He explains, “If I was a training him, I would say wait until your sessions are up and see the difference in strength from when you started to now. I would never stop him from choosing something that he believes will make him happy, but I wouldn’t advise it. I always reiterate to my clients to build a strong base because from a strong base, you can build a building.”
A User’s Perspective
Additionally, I wanted to get some input from people that used steroids. I was able to gather one response from Reddit. One anonymous person had plenty to say. Again, for writing purposes, let’s call this person Tim. Tim explains, “I would absolutely not recommend steroids to anyone. Steroids are a drug; they can cause permanent damage if not used correctly or safely and most young men aren’t cautious.” He also says that he would never encourage young men to do steroids because that’s reckless and dangerous. Tim then writes about the side effects of steroids. “All drugs tend to have a negative side, some worse than others. I don’t think I know anyone who hasn’t experienced some negative side effects, as minor as some might be. But others can be almost if not completely unbearable.” This user said the effects can range anywhere from headaches or increased blood pressure to awful acne. He finished off by saying steroids like trenbolone are steroids that he would not recommend for a new user because the worst side of most steroids is the mildest on trenbolone. Tim says they don’t call it “divorce in a bottle” for nothing and said he had to give it up because it was too harsh for him.
Call to Action
If you want to help, and support people who may be abusing drugs, check out Shatterproof. Shatterproof is a charity that focuses on ending all types of drug abuse in America. They take all proceeds and give them to families that may have had a loved one die of drug abuse. They also use proceeds and help pay for people who might be going through an addiction. I picked this charity because steroids are a drug that people can become dependent on and there might be people who want to get help but don’t have the funds. Shatterproof is an excellent source for these individuals.
Michael Capobianco is a senior at North Central College studying finance and digital marketing. While finishing his degree, Michael also studies jazz guitar and plays around the Chicagoland area. A former athlete, he enjoys working out and wants to push for healthier habits for men. He believes a healthy body and mind is the key to success. After graduation, Michael hopes to find a job in the finance world.