Steroid Side Effects and How to Stop them Part 2

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Controlling yourself during a cycle is simply a matter of maturity, intelligence, and discipline. If you find that you are becoming easily irritated, constantly arguing with others, or becoming extremely upset over minor things, the use of androgenic compounds should be reduced or eliminated altogether. Might does not make right, and any bodybuilder who allows steroids to control their demeanor is simply affirming the stereotypes people have about overly muscular people.

Benign Prostatic Hyperplasia: BPH is simply an enlargement of the prostate, a walnut-sized gland that surrounds the urethra whose function is to squeeze fluid into the urethra as sperm move through during sexual climax. This fluid, which helps make up semen, energizes the sperm and makes the vaginal canal less acidic. This condition is now considered a normal part of aging for men, with more than half of men in their 60’s and upwards of 90% of men in their 70’s-80’s will show some symptoms. As the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to press against the urethra like a clamp on a garden hose. The bladder wall becomes thicker and irritable. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination. Eventually, the bladder weakens and loses the ability to empty itself. Urine remains in the bladder. The narrowing of the urethra and partial emptying of the bladder cause many of the problems associated with BPH.

Although no conclusive medical evidence exists that long term use of testosterone will lead to an increase in BPH or an acceleration in its development, such a conclusion can readily be made by understanding the mechanisms through which BPH develops. DHT is a primary culprit in the development of BPH, and it is theorized that estrogen may play a role as well. Men who cannot produce DHT do not develop BPH, and the primary treatment for BPH is Proscar (Finasteride), which inhibits the 5a-reductase enzyme. It is this enzyme which is responsible for converting testosterone (along with Halotestin) into DHT. Studies done with animals have suggested that BPH may occur because the higher amount of estrogen within the gland increases the activity of substances that promote cell growth.

Knowing that use of testosterone will increase both levels of DHT and estrogen if the appropriate accessory medications are not used, you can see where I draw my conclusions. It is highly likely that long term use of testosterone, whether it be for performance enhancement of hormone replacement therapy purposes, will accelerate the onset of BPH. Thusly, one should use both an anti-aromatase and 5a-reducatase inhibitor when using testosterone.

Birth Defects: This applies only to female steroid users, as steroid use by males cannot induce birth defects. Any female using steroids should have a pregnancy test before doing so and use an effective form of birth control while on them. When used by a female who is pregnant, Anabolic Androgenic Steroids (AAS) can cause Adreno-genital syndrome, which will result in the inappropriate growth of the genitals in a developing fetus.

Cancer: Steroids are commonly believed to cause cancer, even by many who use them. This is primarily for one reason, the hysteria surrounding the death on former football great Lyle Alzado, who died of a brain tumor in 1992. Prior to his death, Lyle went on a very public campaign divulging his many years of steroid abuse, and pointing the figure at Anabolic Androgenic Steroids (AAS) as the causative factor behind his cancer. The media latched on to this and exploited it for all it was worth, despite the fact that Lyle’s own physician readily admitted that Anabolic Androgenic Steroids (AAS) could in no way caused the cancer the killed his patient.
The fact is that the number of cases that have directly linked steroids to cancer is statistically insignificant, and all are related to the use of C17 alpha alkylated compounds. Again, C 17 alpha aklylation is a chemical modification that allows steroids to be used orally. This makes them mildly hepatotoxic, and continued use over long periods of time can place serious stress on the liver. The few cases of liver damage and subsequent cancer that have been confirmed to be related to the use of Anabolic Androgenic Steroids (AAS) have occurred in primarily in sick patients whose liver function had already been compromised in some fashion, not athletes. Furthermore, the steroid involved in these cases was almost always Anadrol-50. This makes complete sense, as Anadrol comes in a very high dose per pill (50 mg) when compared to other oral steroids. Furthermore, the amount of Anadrol that was often to prescribed to patients was astronomical, the Physician’s Desk Reference (known as the PDR, the reference guide physicians use when prescribing drugs) recommended 1-5 mg/kg of body weight per day. To put this into perspective, a 200 lb individual would be given anywhere between 100-500 mg of Anadrol per day. This is between 2-10 tabs of Anadrol daily. Anyone having used real Anadrol (and there’s very few that have, almost ALL of the oxymetholone available today is severely underdosed) knows that even 100 mg is an incredibly effective dose that will always be accompanied by a host of negative side effects.

My point is not to minimize the dangers of long term use of 17-AA AAS, but the truth is that short term use of them (4-8 weeks) is a relatively safe proposition.

Cardiovascular Disease: Refer to chapter

Depression: Use of Anabolic Androgenic Steroids (AAS) can have a profound affect on an individual’s disposition. Depression is most commonly exhibited in male bodybuilders post cycle, when estrogen levels can be incredibly high and endogenous production of testosterone has been suppressed. This can leave a male bodybuilder with a hormone profile more resembling that of a woman, and this can play a profound role in their attitude and outlook on life. More than once I’ve seen incredibly muscular and normally stoic males reduced to tears over sappy television commercials and lamenting their deteriorating condition as the imbalance of estrogen/testosterone wreaks havoc on them physically and mentally. Once again, this can be avoided through use of proper ancillary medications both on and off cycle. Estrogen levels must be kept in check at all times to ensure both maximum gains and minimum side effects. Please refer to the chapter, Proper Use of Ancillary Medications Both On and Off Cycle for more information.

Edema: Many Anabolic Androgenic Steroids (AAS) will affect the amount of will affect the amount of water that is stores in the various tissues of the body. To some degree this can be beneficial, the strength that one will gain through the retention of water in muscle and connective tissues will certainly help add additional LBM over time. However, the moon face of a bodybuilder on a bulking cycle suffering from extreme edema is both physically repugnant and inherently unhealthy. One should not ignore the fact that water retention can have a negative impact on both blood pressure and renal function.
Edema is associated with increased levels of estrogen, and thus the culprit for it is once again the aromatizing androgens. An athlete should always prepare for this when using these steroids, through proper application of anti-aromatases like Arimidex, Femara, or Cytadren.

Gynecomastia: Primarily referred to as “bitch tits” or gyno, gynecomastia refers to enlargement of the male breasts. Male breast tissue is ripe with estrogen receptors, just as in that of a female. Consequently, elevated estrogen levels can cause swelling and eventual growth of this tissue, leaving a man with unsightly lumps beneath both nipples. The effect is exactly that experienced by a male pre-op transsexual receiving female hormones to induce the growth of the breasts, albeit on a lesser scale. Untreated, the swollen breast tissue will harden, becoming permanent fixtures underneath your nipples until removed by surgery.

Because elevated levels of estrogen are the primary culprit behind the development of gyno, one should always use an anti-aromatase when using steroids that aromatize. This would normally be during a bulking cycle, when the use of strong, aromatizing androgens becomes a necessity. Unlike many others that have commented on the subject of gynecomastia and estrogen suppression, I would not wait until the effects of estrogen can be seen or felt before incorporating the proper ancillary drugs into my regime, they should be in place from Day 1!

It should be noted that I do recommend use of an estrogen antagonist when using Anadrol-50 (oxymetholone), as this drug exhibits estrogen-like activity despite the fact that it does not aromatize. Because of this, the estrogenic effects of Anadrol cannot be combated using an anti-aromatase, and one would need use an estrogen receptor antagonist such as Nolvadex or Clomid.

There are several Anabolic Androgenic Steroids (AAS) that exhibit progestational activity, such as many of the nandrolones or trenbolone (which is derived from nandrolone). It is possible that these steroids could produce or exacerbate gyno in a very small percentage of extremely sensitive individuals, even without elevated estrogen levels. Male bodybuilders that are extremely sensitive to the effects of progestins will have a very hard time avoiding the development of gyno, since the majority of effective steroids either aromatize, exhibit estrogenic qualities on their own (Anadrol), or have progestenic activity. These individuals would need to totally suppress estrogen production while on cycle (using both an anti-aromatase and an estrogen antagonist) or find someway to acquire the drug RU-486, the so-called abortion pill. Use of RU-486 would be the ideal situation for these individuals, as it is a progesterone antagonist. Unfortunately, this drug is nearly impossible to obtain.
 
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