Steroids in Combat sports: Adverse effects on health
Basic effects of increased testosterone
Testosterone is a hormone which has multiple effects in men and women. These
effects can be divided into two basic groups: androgenic and anabolic. Androgenic effects
include the development of the male reproductive system, i.e. sperm. Anabolic effects
include growth of skeletal muscle. Testosterone works on these different systems by
attaching to specific receptors, including muscle receptors. Some testosterone is converted
by the body into estrogen. Estrogen is the primary female sex hormone. Athletes who use
performance-enhancing drugs desire the anabolic effects while minimizing the androgenic
Steroids and estrogen blockers
There are many products which are used to obtain anabolic effects. Some example
products include testosterone, nandrolone, and stanozolol. Other products, such as DHEA
and androstenedione, have been marketed as supplements. These products directly stimulate
the androgen receptors throughout the body.
In addition to these steroids, anti-estrogens can be used to decrease the conversion of
testosterone to estrogen which would increase the testosterone levels. Products include
estrogen receptor blockers (i.e. clomiphene) and aromatase inhibitors (i.e. anastrozole).
Adverse health effects
Steroids have many harmful effects on an athlete’s body. The body uses various
hormones to control metabolic activities. In children and adolescents, steroids can lead to
early stoppage of bone growth resulting in growth retardation which is irreversible. Steroids
can increase the risk of tendon and muscle injury. They may cause osteonecrosis (bone
death and destruction) in the hip and shoulder. Steroids decrease sugar (glucose) tolerance
and thyroid function. Male-pattern baldness can start or accelerate with the use of steroids.
Men develop gynecomastia, which is increased growth of breast tissue. This growth is
irreversible and requires surgical excision. Conversely, women’s breasts will shrink.
Women will also develop hirsutism, or the growth of male-pattern hair at the face, armpits,
and pubic areas. Vocal cord hypertrophy leads to deepening of the voice, a condition
particularly harmful to females. These changes lead to masculinization in females which is
The heart and blood vessels are also affected by steroids. An athlete’s cholesterol
profile will deteriorate, via an increase in “bad” cholesterol (LDL) and a decrease in “good”
cholesterol (HDL). An increase in red blood cell count will lead to polycythemia and
“thickening of the blood.” High blood pressure develops. The risk of forming blood clots,