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Why would athletes use steroids?

Studies show that steroids increase muscle mass and strength. Strenuous exercise doubles these gains, Bhasin says.

"But do bigger muscles and more strength translate into better athletic performance? Athletes believe it does, but we scientists don't understand the mechanisms," he says. "Steroids may promote recovery from injury and allow higher training intensity. It may increase oxygen in the blood. There is some evidence it decreases reaction time and promotes hand-eye coordination."

What are the risks of abusing steroids?

There's a widely held belief that androgens are safe. Nothing could be further from the truth when abusing these drugs, Bhasin says.

He offers a long list of known side effects when misused:

  • Suicidal, homicidal, and sudden unexplained deaths
  • Prolonged shutoff of normal hormones. "All users for any length of time suppress their own testosterone production for months and sometimes for years after they stop using steroids," Bhasin says.
  • Mood disorders and psychiatric disorders
  • Cardiovascular and metabolic problems
  • Liver toxicity
  • Gynecomastia (enlarged breasts in men)
  • Risks associated with injections, such as abscesses or HIV infection
  • Risks of accessory drugs usually taken along with steroids
  • Risks associated with excessive muscle gain
  • Growth retardation in children

"I've been following and tracking steroid-related adverse effects and deaths," Bhasin says. "In one study, Scandinavian power-lifters had a risk of death five times that of matched controls."

Can steroid use by athletes be detected?

All known steroids except testosterone can be identified with urine tests. These tests are very sensitive and are very reliable. Testosterone is trickier to detect, but abuse can be detected with a urine test and confirmed with sophisticated lab tests.

"The problem is the tests detect the 28 to 30 compounds they were designed to detect. But the underground community keeps coming up with new compounds," Bhasin says. "There is a disturbing rise in materials that were never tested and were created solely for abuse."

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