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Non-medical use of anabolic-androgenic steroids is widespread among bodybuilders. According to field surveys, around 15 to 30 percent of people routinely using fitness centers have augmented their efforts with AAS. It’s estimated that four out of five AAS users are recreational bodybuilders – not professional athletes. The majority of today’s users are people simply trying to improve their physical appearance. Even without the threat of being identified in sports doping scandals, individuals interested in optimizing their body composition must still consider several potential pitfalls with the non-medical use of anabolic steroids. Common risks often originate from social connections, legal restrictions, professional settings, family concerns, financial limitations, medical concerns and the lack of sufficient training experience.

Social connections

AAS is often administered in secrecy since social perceptions and consequences can vary greatly. When it comes to discretion, introverted people are obviously better at maintaining privacy than extroverts. Regardless of perceived acceptability, it’s important to closely evaluate every day contacts. Friends may unpredictably object to AAS use – especially intimate relationships. When the idea of using AAS is absolute, the user may forget possible legal ramifications of dealing with an illicit drug source – while a person with an outside perspective may be less able to discount the situation. Illegal acquisitions can disrupt social routines and cause marital or relationship problems.

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Anabolic steroids in performance-enhancing doses raise blood hormone levels to supra physiological amounts. This rise has a tendency to amplify self confidence and aggressive tendencies. A person’s perceptions of events can become distorted with the temporary change in brain chemistry – confidence can develop into a narcissistic attitude; annoyances can migrate to aggravating situations. Acting on impulse can lead to criminal acts, domestic violence and the termination of close friendships. It’s important for a person to remain rationale – not aggressively temperamental. In a court of law, non-medical steroid use is not a valid cop-out for acting out violently.

Legal restrictions

Surveys in the United States have suggested that around 90 percent of AAS-using bodybuilders obtain their drugs illegally. In countries where possession without a prescription is illegal, much of the drugs originate from underground laboratories, distributed through illicit trafficking networks. There are different restrictions regarding possession and distribution of anabolic steroids throughout the world. Many pharmacies in Asia legally sell steroids without a prescription. Mexican pharmacies often attract U.S. patrons due to their over-the-counter availability. In the United States, penalties for the possession and distribution of AAS were increased in 1990, when they became listed as a Schedule III Controlled Substance. It’s important to become familiar with state and federal laws regarding the possession of these drugs. Legal Muscle: Anabolics in America, by Rick Collins, is the standard reference manual for non-medical AAS use under U.S. laws. The 430-page manual provides an expert’s knowledge in the handling of controlled substance cases, particularly those involving anabolic steroids.

Professional settings

A bodybuilder considering AAS use must consider possible professional predicaments and be prepared for suitable rebuttals to allegations. Professional and educational institutions may have strong policies in place to protect their property from being perceived as a host for illicit drug trafficking. Illegal possession and distribution in the workplace is likely the greatest concern for most employers. The repercussions of AAS use on employment status will depend on the field of work. Many employers might disregard, or even condone, a rapid increase in bodyweight and musculature – while others may take offense to the exhibited transformations. Aside from professional liabilities, becoming stronger and leaner can be intimidating to a supervisor with a body composition moving in the opposite direction. People don’t like to feel worse about their own physical condition and are likely to project out of frustration – leading to unwanted attention on the bodybuilder.

Family concerns

A spouse should be informed of a decision to obtain and use AAS. A marriage is likely to weaken if hidden drugs are found in the home. The demonstrated secrecy often gets highlighted more than the drug use itself. The decision to enhance strength training efforts with AAS should be discussed with a spouse, or close family member, before using. Present clinical research and anecdotal evidence to explain associated benefits and risks. This research can be found through the Internet; for instance, medical abstracts at PubMed or online medical and bodybuilding discussion communities. With family support, a bodybuilder can use openly and safely.

If a user is incoherent from a serious accident requiring hospitalization, then a spouse or other close companion should be able to supply a list of administered drugs to medical personnel. It’s important for an operating physician to know everything a patient is taking, prior to performing surgery or recommending medications.

Financial limitations

A bodybuilder’s financial situation should influence a decision to use AAS. It’s essential to be covered under some sort of medical insurance incase an unforeseen complication arises from the use of the powerful hormones. Hospital visits not covered by insurance can cost a patient a lot of hard-earned money. Since many users obtain the drugs from underground labs, the risk of administering a contaminated substance is significant. Obtaining and maintaining a prescription from a legitimate testosterone replacement therapy clinic can be costly. Occasionally, blood chemistry reports should be analyzed to determine any growing health risks – without full medical coverage, these tests can present a hefty bill.

Furthermore, ancillary drugs and dietary supplements are often needed to combat unwanted side effects, such as anti-estrogens and diuretics. A high-protein diet, needed to provide the building blocks for muscle, is much pricier than a high-carbohydrate diet.

Medical concerns

Bodybuilders must reflect on their physical health and medical history before self-prescribing anabolic steroids. It’s vital to understand personal predispositions and ailments that could be negatively impacted by the use of AAS. Cardiovascular health can temporarily decline while administering AAS. Users often report increased levels of low-density lipoproteins, a form of cholesterol that can cause a build up of plaques in the arteries. LDL is often referred to as bad cholesterol. To make things worse, high-density lipoproteins can decline. HDL is considered good cholesterol; it protects the arteries by transporting cholesterol to the liver for elimination. Furthermore, liver enzymes can become elevated – directly from the use of oral steroids, or indirectly from an increase in muscle damage brought about from greater training volume and intensity. The concurrent use of various hepatoxic drugs, binge drinking alcohol and exposure to environmental toxins can further degrade liver values during an AAS-assisted training program.

Androgenic effects of AAS can cause serious health concerns in sensitive individuals. Women should only use AAS with extreme caution, since many androgenic effects are irreversible. Taking anabolic steroids while pregnant would be disastrous for the fetus. Young people should never use anabolic steroids, since their bodies need to retain full control of blood hormones for successful physical development and sexual maturation. AAS can promote male pattern baldness and aggravate skin conditions. Men should be familiar with their prostate health and risk factors, since heavy androgen use can influence benign prostate hypertrophy.

A physical by a licensed medical practitioner is suggested before starting an AAS cycle. An expert’s examinations can confirm good health and medical concerns; often with laboratory work, such as blood chemistry tests. Be cautious of medical advice gained from online forums, where there is often little evidence to support a responder’s credibility.

Sufficient training experience

Bodybuilders should have a full understanding of successful training principles, manipulating nutrition to meet goals and personal limitations. AAS should only be considered as a support for increased muscularity and definition – not as a magic pill. An appropriate training program and dietary structure will optimize the anabolic cycles. Periods of rapid strength gains can cause severe injuries in athletes using improper form, or simply unable to fully recruit a muscle due to lack of familiarity. No amount of anabolic hormones will make up for a lack of research and experience.

Before embarking on an anabolic tidal wave, be sure the benefits offset the risks.

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Evans, N. A. Current concepts in anabolic-androgenic steroids. Am. J. Sports Med. 32:534-542, 2004.
Parkinson, Andrew P., Evans, N.A. Anabolic-Androgenic Steroids: A Survey of 500 Users. Medicine & Science in Sports & Exercise 38 (4): 644-651, 2006.