Summary
Anabolic steroids are used therapeutically for various disorders and as ergogenic aids by athletes to augment strength, muscular development, and to enhance performance. There is a wide range of concomitant temporary and permanent adverse effects with steroid administration. Several well-documented adverse actions of these hormones may develop rapidly within several weeks or less (i.e. altered reproductive function) or require up to several years of steroid intake (i.e. liver carcinoma). More recent studies indicate that glucose intolerance, insulin resistance, increased cardiovascular disease risk profiles, cerebral dangers, musculoskeletal injuries, prostate cancer, psychosis and schizophrenic episodes, among others, accompany anabolic steroid intake. There is, at present, no evidence to support the claim that athletes are less susceptible to adverse effects than those individuals receiving hormone treatment in a clinical setting. Based on the available information which has accumulated primarily from cross-sectional, short term longitudinal, and case studies, there is a need: (a) to develop a comprehensive battery of specific and sensitive markers of adverse effects, particularly those that would be able to detect the onset of adverse actions; and (b) to conduct controlled long term longitudinal studies in order to fully understand the extensiveness and mechanisms involved in the occurrence of adverse effects.
Similar content being viewed by others
References
Aakvaag A, Vogt JH. Plasma testosterone values in different forms of testosterone treatment. Acta Endocrinologica 60: 537–542, 1969
Abbott WE, Hirschfeld JW, Williams HH, Pilling MA, Meyer FL. Metabolic alterations following thermal burns. Surgery 20: 284–294, 1946
Aloia JF, Kapoor A, Vaswani A, Cohn SH. Changes in body composition following therapy of osteoporosis with methandrostenolone Metabolism 30: 1076–1079, 1981
Annitto WJ, Layman WA. Anabolic steroids and acute schizophrenic episode. Journal of Clinical Psychiatry 41: 143–144, 1980
Anthony PP. Hepatoma associated with androgenic steroids. Lancet 1: 685–686, 1975
Appel H-J, Heller-Umpfenbach B, Feraudi M, Weicker H. Ultrastructural and morphometric investigations on the effects of training and administration of anabolic steroids on the myocardium of guinea pigs. International Journal of Sports Medicine 4: 268–274, 1983
Baker PJ, Ramey ER, Ramwell PW. Androgen-mediated sex differences of cardiovascular responses in rats. American Journal of Physiology 235: H242–H246, 1978
Behrendt H. Effect of anabolic steroids on rat heart muscle cells. I. Intermediate filaments. Cell Tissue Research 180: 303–315, 1977
Behrendt H, Boffin H. Myocardial cell lesions caused by an anabolic hormone. Cell Tissue Research 181: 423–426, 1977
Berg A, Ringwald G, Keul J. Lipoprotein-cholesterol in well-trained athletes: a preliminary communication: reduced HDL cholesterol in power athletes. International Journal of Sports Medicine 1: 137–138, 1980
Bergink EW, Geelen JAA, Turpijn EW. Metabolism and receptor binding of nandrolone and testosterone under in vitro and in vivo conditions. Acta Endocrinologica (Suppl. 271): 31–37, 1985
Bernstein MS, Hunter RL, Yachmin S. Hepatoma and peliosis hepatis developing in a patient with Fanconi’s anemia. New England Journal of Medicine 284: 1135–1136, 1971
Bhargava KP, Dhawan KN, Saxena RC. Enhancement of noradrenaline pressor responses in testosterone-treated cats. British Journal of Pharmacology and Chemotherapy 31: 26–31, 1967
Bierly JR. Use of anabolic steroids by athletes: do the risks outweight the benefits? Postgraduate Medicine 82: 67–74, 1987
Bijlsma JWJ, Duursma SA, Bosch R, Huber O. Lack of influence of the anabolic steroid nandrolone decanoate on bone metabolism. Acta Endocrinologica 101: 140–143, 1982
Bird D, Vowles K, Anthony PP. Spontaneous rupture of a liver cell adenoma after long-term methyltestosterone: report of a case successfully treated by emergency right hepatic lobectomy. British Journal of Surgery 66: 212–213, 1979
Boyd PR, Mark GV. Multiple hepatic adenomas and a heptocellular carcinoma in a man on oral methyltestosterone for eleven years. Cancer 40: 1765–1770, 1977
Bradshaw JS, Abbott WE, Levey S. The use of anabolic steroids in surgical patients. American Journal of Surgery 99: 600–607, 1960
Brämswig JH, Nieschlag E, Schellong G. Pituitary-gonadal function in boys after high dose testosterone treatment for excessively tall stature. Acta Endocrinologica 107: 97–103, 1984
Brämswig JH, Schellong G, Borger H-J, Breu H. Testosteron-Therapie hochwuchsiger Jungen Ergebnisse bei 25 Jungen. Deutsch Medizinische Wochenschrift 106: 1656–1661, 1981
Bruguera M. Hepatoma associated with androgenic steroids. Lancet 2: 1294–1295, 1975
Burstein S, Grumbach MM, Kaplan SD. Early determination of androgen-responsiveness is important in the management of microphallus. Lancet 2: 983–986, 1979
Camerino B, Sala G. Anabolic steroids. Progress in Drug Research 2: 71–134, 1960
Caminos-Torres R, Ma L, Snyder PJ. Testosterone-induced inhibition of the LH and FSH responses to gonadotropin-releasing hormone occurs slowly. Journal of Clinical Endocrinology and Metabolism 44: 1142–1153, 1977
Capaccio JA, Kurowski TT, Czerwinski SM, Chatterton Jr RT, Hickson RC. Testosterone fails to prevent skeletal muscle atrophy from glucocorticoids. Journal of Applied Physiology 63: 328–334, 1987
Carrasco D, Pallardo L, Prieto M, Moll JL, Cruz JM, Berenguer J. Hepatic adenomata and androgen treatment. Annals of Internal Medicine 100: 316, 1984
Carrasco D, Prieto M, Pallardo L, Moll JL, Cruz JM, et al. Multiple hepatic adenomas after long-term therapy with testosterone enanthate. Journal of Hepatology 1: 573–578, 1985
Carter CH. The anabolic steroid, stanozolol: its evaluation in debilitated children. Clinical Pediatrics 4: 671–680, 1965
Castelli WP, Doyle JI, Gordon T, Hines CG, Hjortland MC, et al. HDL cholesterol and other lipids in coronary heart disease: the cooperative lipoprotein phenotyping study. Circulation 55: 767–772, 1977
Chatterton RT. Inactivation and excretion of steroids. In Zaneveld & Chatterton (Eds) Biochemistry of mammalian reproduction, pp. 501–506, John Wiley & Sons, New York, 1982
Cheesman KL. Steroid hormones: biosynthesis, secretion, and transport. In Zaneveld & Chatterton (Eds) Biochemistry of mammalian reproduction, pp. 401–454, John Wiley & Sons, New York, 1982
Clarkson PM, Hintermister, R, Fillyaw M, Stylos L. High density lipoprotein cholesterol in young adult weight lifters, runners, and untrained subjects. Human Biology 53: 251–257, 1981
Clerico A, Ferdeghini M, Palombo C, Leoncini R, Delchicca MG, et al. Effect of anabolic treatment on the serum levels of gonadotropins, testosterone, prolactin, thyroid hormones and myoglobin of male athletes under physical training. Journal of Nuclear Medicine and Allied Sciences 23: 79–88, 1981
Cocks JR. Methyltestosterone-induced liver-cell tumors. Medical Journal of Australia 2: 617–618, 1981
Cohen JC, Hickman R. Insulin resistance and diminished glucose tolerance in powerlifters ingesting anabolic steroids. Journal of Clinical Endocrinology and Metabolism 64: 960–963, 1987
Coombes GB, Reiser J, Paradinas FJ, Burn I. An androgen-associated hepatic adenoma in a transexual. British Journal of Surgery 65: 869–870, 1978
Creagh TM, Rubin A, Evans DJ. Hepatic tumours induced by anabolic steroids in an athlete. Journal of Clinical Pathology 41: 441–443, 1988
Davidson JM, Camargo CA, Smith ER. Effects of androgen on sexual behavior in hypogonadal men. Journal of Clinical Endocrinology and Metabolism 48: 955–958, 1979
Dhem A, Ars-Piret N, Waterschoot MP. The effects of nandrolone decanoate on rarefying bone tissue. Current Medical Research and Opinion 6: 606–613, 1980
Doerr P, Pirke KM. Regulation of plasma oestrogens in normal adult males. Acta Endocrinologica 75: 617–624, 1974
Dorfman RI, Kincl FA. Relative potency of various steroids in an anabolic-androgenic assay using the castrated rat. Endocrinology 72: 259–266, 1963
Evans RG. Methandienone in long-term cortiscosteroid therapy. Acta Allergologica 17: 220–231, 1962
Evans WJ, Ivy JL. Effects of testosterone propionate on hindlimb immobilized rats. Journal of Applied Physiology 52: 1643–1647, 1982
Fahey TD, Brown CH. The effects of an anabolic steroid on the strength, body composition and endurance of college males when accompanied by a weight training program. Medicine and Science in Sports 5: 212–216, 1973
Falk H, Thomas LB, Popper H, Ishak KG. Hepatic angiosarcoma associated with androgenic-anabolic steroids. Lancet 2: 1120–1123, 1979
Farrel GC, Joshua DE, Uren RF, Baird PJ, Perkins KW, et al. Androgen-induced hepatoma. Lancet 1: 430–432, 1975
Farrell PA, Maksud MG, Pollock ML, Foster C, Anholm J, et al. A comparison of plasma cholesterol, triglycerides, and high density lipoprotein cholesterol in speed skaters, weightlifters, and nonathletes. European Journal of Applied Physiology 48: 77–82, 1982
Foglia VG, Basabe JC, Chieri R. Evolution of diabetes after early testosterone treatment in rats. Diabetologia 5: 258–259, 1969
Foglia VG, Schuster N, Rodriguez RR. Sex and diabetes. Endocrinology 41: 428–433, 1947
Foss GL. The oral application of methyltestosterone and its simplification of androgen therapy. British Medical Journal 1: 11–12, 1939
Foss GL, Simpson SL. Oral methyltestosterone and jaundice. British Medical Journal 1: 259, 1959
Frankle MA, Eichberg R, Zachariah SB. Anabolic androgenic steroids and a stroke in an athlete. Archives of Physical Medicine and Rehabilitation 69: 632–633, 1988
Freed DLJ, Banks AJ, Longson D, Burley I. Anabolic steroids in athletics: crossover double-blind trial on weightlifters. British Medical Journal 2: 471–473, 1975
Goldfarb S. Sex hormones and hepatic neoplasia. Cancer Research 36: 2584–2588, 1976
Goldman B. Liver carcinoma in an athlete taking anabolic steroids. Journal of the American Osteopathic Association 85: 56, 1985
Greenberg S, George WR, Kadowitz PJ, Wilson WR. Androgen-induced enhancement of vascular reactivity. Canadian Journal of Physiology and Pharmacology 52: 12–22, 1974
Gribbin HR, Flavell-Matts SG. Mode of action and use of anabolic steroids. British Journal of Clinical Practice 30: 3–9, 1976
Guyda H, Friesen H, Bailey JD, Leboeuf G, Beck JC. Medical Research Council of Canada therapeutic trial of human growth hormone: first 5 years of therapy. Canadian Medical Association Journal 112: 1301–1309, 1975
Haffner SM, Hushwaha RS, Foster DM. Studies on the metabolic mechanism of reduced high-density lipoproteins during anabolic-steroid therapy. Metabolism 32: 413–420, 1983
Hagerman FC, Jones-Witters P, Ranson R. The effects of anabolic steroid ingestion on serum enzyme and urine 17-ketosteroid levels. Journal of Sports Medicine 15: 287–295, 1975
Hartmann G, Addicks K, Donike M, Schanzer W. Testosterone application influences sympathetic activity of intracardial nerves in non-trained and trained mice. Journal of Autonomic Nervous System 17: 85–100, 1986
Haupt HA, Rovere GD. Anabolic steroids: a review of the literature. American Journal of Sports Medicine 12: 469–484, 1984
Heath GW, Ehsani AA, Hagberg JM, Hinderliter JM, Goldberg AP. Exercise training improves lipoprotein lipid profiles in patients with coronary artery disease. American Heart Journal 105: 889–895, 1983
Henderson JT, Richmond J, Sommerling MD. Androgenic-anabolic steroid therapy and hepatocellular carcinoma. Lancet 1: 934, 1973
Hernandez-Nieto L, Brugera M, Bombi JA, Comacho L, Rozman C. Benign liver-cell adenoma associated with long-term administration of an androgenic-anabolic steroid (methandienone). Cancer 40: 1761–1764, 1977
Hervey GR, Knibbs AV, Burkinshaw L, Morgan DB, Jones PRM, et al. Effects of methandienone on the performance and body composition of men undergoing athletic training. Clinical Science 60: 457–461, 1981
Hickson RC, Galassi TM, Kurowski TT, Daniels DG, Chatterton Jr RT. Androgen and glucocorticoid mechanisms in exercise-induced cardia hypertrophy. American Journal of Physiology 246 (Heart Circulation and Physiology 15): H761–767, 1984
Hickson RC, Kurowski TG. Anabolic steroids and training. Clinics in Sports Medicine 5: 461–469, 1986
Hickson RC, Kurowski TT, Andrews GH, Capaccio JA, Chatterton Jr RT. Glucocorticoid cytosol binding in exercise-induced sparing of muscle atrophy. Journal of Applied Physiology 60: 1413–1419, 1986
Holder LE, Gnarra DJ, Lampkin BC, Nishiydama H, Perkins P. Hepatoma associated with anabolic steroid therapy, case study, 10 yr. old male patient. American Journal of Roentgenology 124: 638–643, 1975
Holma P. Effect of an anabolic steroid (methandienone) on central and peripheral blood flow in well-trained male athletes. Annals in Clinical Research 9: 215–221, 1977
Honrath WL, Wolff A, Meli A. The influence of the amount of solvent (sesame oil) on the degree and duration of action of subcutaneously administered testosterone and its propionate. Steroids 2: 425–428, 1963
Hurley BF, Seals DR, Hagberg JH, Goldberg AC, Ostrove SM, et al. High-density-lipoprotein cholesterol in bodybuilders v powerlifters: negative effects of androgen use. Journal of the American Medical Association 252: 507–513, 1984
Ishak GI. Hepatic lesions caused by anabolic and contraceptive steroids. Seminars in Liver Disease 1: 116–128, 1981
Jackson ST, Rallison ML, Buntin WH, Johnson SB, Flynn RR. Use of oxandrolone for growth stimulation in children. American Journal of Diseases in Children 126: 481–484, 1973
James KC, Nicholls PJ, Roberts M. Biological half-lives of [4-14 C] testosterone and some of its esters after injection into the rat. Journal of Pharmacy and Pharmacology 21: 24–27, 1969
Johnson FL. The association of oral androgenic-anabolic steroids and life-threatening disease. Medicine and Science in Sports 7: 284–286, 1975
Johnson FL, Feagler JR, Lerner KG, Majerus PW, Siegel M, et al. Association of androgenic-anabolic steroid therapy with development of hepatocellular carcinoma. Lancet 2: 1273–1276, 1972
Johnson LC, Fisher G, Silvester LJ, Hofheins CC. Anabolic steroid: effects on strength, body weight, oxygen uptake and spermatogenesis upon mature males. Medicine and Science in Sports 4: 43–45, 1972
Johnson LC, O’Shea JP. Anabolic steroid: effects on strength development. Science 164: 957–959, 1969
Junkmann K. Long-acting steroids in reproduction. Recent Progress in Hormone Research 13: 389–419, 1957
Kalliomaki JL, Pirila AM, Ruikka I. A therapeutic trial with ethylestrenol in geriatric patients. Acta Endocrinologica (Suppl.) 63: 124–128, 1962
Kannel WB, Castelli WP, Gordon T. Cholesterol in the prediction of atherosclerotic disease: new perspectives based on the Framingham study. Annals of Internal Medicine 90: 85–91, 1979
Keele DK, Worley JW. Study of an anabolic steroid: certain effects of oxymetholone on small children. American Journal of Diseases in Children 113: 422–430, 1967
Kew MC, Van Coller B, Prowse CM, Skikne B, Wolfsdorf JI, et al. Occurrence of primary hepatocellular cancer and peliosis hepatis after treatment with androgenic steroids. South African Medical Journal 50: 1233–1237, 1976
Kilshaw BH, Harkness RA, Hobson BM, Smith AWM. The effects of large doses of the anabolic steroid, methandrostenolone, on an athlete. Clinical Endocrinology 4: 537–541, 1975
Kochakian CD. Effect of male hormone on protein metabolism of castrate dogs. Proceedings of the Society for Experimental Biology and Medicine 32: 1064–1065, 1935
Koenig H, Goldstone A, Lu CY. Testosterone-mediated sexual dimorphism of the rodent heart: ventricular lysosomes, mitochondria, and cell growth are modulated by androgens. Circulation Research 50: 782–787, 1982
Kopera H. The history of anabolic steroids and a review of clinical experience with anabolic steroids. Acta Endocrinologica (Suppl. 271): 11–18, 1985
Kory RC, Bradley MH, Watson RN, Callahan R, Peters BJ. A six-month evaluation of an anabolic drug. Norethandrolone, in underweight persons. II. Bromsulphalein (BSP) retention and liver function. American Journal of Medicine 26: 243–248, 1959
Kramhoft M, Solgaard S. Spontaneous rupture of the extensor pollicis longus tendon after anabolic steroids. Journal of Hand Surgery 11: 87, 1986
Krieg M, Smith K, Bartsch W. Demonstration and a specific androgen receptor in rat heart muscle: relationship between binding, metabolism and tissue levels of androgens. Endocrinology 103: 1686–1694, 1978
Lamb DR. Anabolic steroids in athletics: how well do they work and how dangerous are they? American Journal of Sports Medicine 12: 31–38, 1984
Lennon HD, Saunders FJ. Anabolic activity of 2-oxa-17α-methyldihydrotestosterone (oxandrolone) in castrated rats. Steroids 4: 689–697, 1964
Lesna M, Spencer I, Walker W. Liver nodules and androgens. Lancet 2: 1124, 1976
Liao S, Liang T, Fang S, Casteneda E, Shao TC. Steroid structure and androgenic activity. Journal of Biological Chemistry 248: 6154–6162, 1973
Liddle GW, Burke HA. Anabolic steroids in clinical medicine. Helvetica Medica Acta 27: 504–513, 1960
Limbeck GA, Ruvalcaba RHA, Mahoney CP, Kelley VC. Studies on anabolic steroids: IV. The effects of oxandrolone on height and skeletal maturation in uncomplicated growth retardation. Clinical Pharmacology and Therapeutics 12: 798–805, 1971
Limberd JJ. Anabolic steroids in the training and treatment of athletics. Comprehensive Therapy 11: 25–30, 1985
MacGillivray MH, Kolotkin M, Munschauer RW. Enhanced linear growth reponses in hypopituitary dwarfs treated with growth hormone plus androgen versus growth hormone alone. Pediatric Research 8: 103–108, 1974
Marti-Henneberg C, Niirianen AK, Rappaport R. Oxandrolone treatment of constitutional short stature in boys during adolescence: effect on linear growth, bone age, pubic hair, and testicular development. Journal of Pediatrics 86: 783–788, 1975
Mauss J, Borsch G, Bormacher K, Richter E, Leyendecker G, Nocke W. Effect of long-term testosterone oenanthate administration on male reproductive function: clinical evaluation, serum FSH, LH, testosterone, and seminal fluid analyses in normal men. Acta Endocrinologica 78: 373–384, 1975
Mayer M, Rosen F. Interaction of anabolic steroids with glucocorticoid receptor sites in rat muscle cytosol. American Journal of Physiology 229: 1381–1386, 1975
Mays ET, Christopherson W. Hepatic tumors induced by sex steroids. Seminars in Liver Disease 4: 147–157, 1984
McCaughan GW, Bilous MJ, Gallagher ND. Long-term survival with tumor regression in androgen-induced liver tumors. Cancer 56: 2622–2626, 1985
McKillop G, Todd IC, Ballantyne D. Increased left ventricular mass in a body builder using anabolic steroids. British Journal of Sports Medicine 20: 151–152, 1986
Meadows AT, Naimam JL, Valdes-Dapena M. Hepatoma associated with androgen therapy for aplastic anemia. Journal of Pediatrics 84: 109–110, 1974
Mellion MB. Anabolic steroids in athletics. American Family Practice 30: 113–119, 1984
Michna H, Stang-Voss C. The predisposition to tendon rupture after doping with anabolic steroids. International Journal of Sports Medicine 4: 59, 1983
Mokrohisky ST, Ambruso DR, Hathaway WE. Fulminant hepatic neoplasia after androgen therapy. New England Journal of Medicine 296: 1411–1412, 1977
Moldawer M. Anabolic agents: clinical efficacy versus side effects. Journal of the American Medical Women’s Association 23: 352–369, 1968
Molteni A, Brownie AC, Skelton FR. Production of hypertensive vascular disease in the rat by methyltestosterone. Laboratory Investigations 21: 129–137, 1969
Molteni A, Skelton FR, Brownie AV. Effect of adrenalectomy on the development of androgen-induced hypertension. Laboratory Investigations 23: 429–435, 1970
Moore DC, Tattoni DS, Limbeck GA, Ruvalcaba RHA, Lindner DS, et al. Studies of an anabolic steroid: V. Effect of prolonged oxandrolone administration on growth in children and adolescents with uncomplicated short stature. Pediatrics 58: 412–422, 1976
Mosbach EH, Shefer S, Abell LL. Identification of the fecal metabolites of 17αmethyltestosterone in the dog. Journal of Lipid Research 9: 93–97, 1968
Mulvihill JJ, Ridolfi RL, Schultz FR, Borzy MS, Haughton PBT. Hepatic adenoma in Fanconi anemia treated with oxymetholone. Journal of Pediatrics 87: 122–124, 1975
Nagelberg SB, Laue L, Loriaux DL, Liu L, Sherns RJ. Cerebrovascular accident associated with testosterone therapy in a 21-year-old hypogonadal man. New England Journal of Medicine 314: 649–650, 1986
Nilsson B, Nilsson IM, Hedner U. Δ-4-Ethyl-estrenol in recurrent deep venous thrombosis. Acta Medica Scandinavica 209: 45–49, 1981
Noble RL. Androgen use by athletes: a possible cancer risk. Canadian Medical Association Journal 130: 549, 1984
O’Shea JP. Anabolic steroid: effects on competitive swimmers. Nutrition Reports International 1: 337–342, 1970
O’Shea JP, Winkler W. Biochemical and physical effects of an anabolic steroid in competitive swimmers and weightlifters. Nutrition Reports International 2: 351–362, 1970
Overbeek GA, DeVisser JA. A comparison of the myotropic and androgenic activities of the phenylpropionates and decanoates of testosterone and nandrolone. Acta Endocrinologica 38: 285–292, 1961
Overbeek GA, Vander Vies J, DeVisser J. The so-called ‘pure’ anabolic agents. Journal of the American Women’s Association 24: 54–59, 1969
Overly WL, Dankoff JA, Wang BK, Singh VD. Androgens and hepatocellular carcinoma in an athlete. Annals of Internal Medicine 100: 158–159, 1984
Pertzelan A, Blum I, Grunebaum M, Laron A. The combined effect of growth hormone and methandrostenolone on the linear growth of patients with multiple pituitary hormone deficiencies. Clinical Endocrinology 6: 271–276, 1977
Pope Jr HG, Katz DL. Bodybuilder’s psychosis. Lancet 1: 863, 1987
Port RB, Petasnick JP, Ranniger K. Angiographic demonstration of hepatoma in association with Fanconi’s anemia. American Journal of Roentgenology 113: 82–83, 1971
Potts GO, Arnold A, Beyler AL. Comparative myotrophic and nitrogen retaining effects of several steroids. Endocrinology 67: 849–854, 1960
Potts GO, Arnold A, Beyler AL. Dissociation of the androgenic and other hormonal activities from the protein anabolic effect of steroids. In Kochakian (Ed.) Handbook of experimental pharmacology, Vol. 43, Anabolic-androgenic steroids, pp. 361–406, Springer-Verlag, Berlin-Heidelberg, New York, 1976
Raiti S, Trias E, Levitsky L, Grossman MS. Oxandrolone and human growth hormone. American Journal of Diseases in Children 126: 597–600, 1973
Recant L, Lacy P. Fanconi’s anemia and hepatic cirrhosis. American Journal of Medicine 39: 464–475, 1965
Remes K, Vuopio P, Jarvinen M, Harkonen M, Aldercreutz H. Effect of short-term treatment with an anabolic steroid (methandienone) and dehydroepiandrosterone sulphate on plasma hormones, red cell volume and 2,3-diphosphoglycerate in athletes. Scandinavian Journal of Clinical Laboratory Investigations 37: 577–586, 1977
Richardson JR, Weinstein MB. Erythropoietic response of dialyzed patients to testosterone administration. Annals of Internal Medicine 73: 403–407, 1970
Roberts JT, Essenhigh DM. Adenocarcinoma of prostate in 40-year-old bodybuilder. Lancet 2: 742, 1987
Robin JC, Suh OW, Ambrus JL. Studies on osteoporosis: VII. Effect of 17β-hydroxy-4-estren-3-one 17-decanoate on experimental osteoporosis: a preliminary report. Steroids 40: 125–132, 1982
Rogol AD. Drugs to enhance athletic performance in the adolescent. Seminars in Adolescent Medicine 1: 317–324, 1985
Rommerts FFG. How much androgen is required for spermatogenesis? Journal of Endocrinology 116: 7–9, 1988
Romshe CA, Sotos JF. The combined effect of growth hormone and oxandrolone in patients with growth hormone deficiency. Journal of Pediatrics 96: 127–131, 1980
Royer P, Rappaport R, Elsair S, Ciric O, Cachin O. A comparison of the action of hGH and anabolic steroids on growth rate in hypopituitary dwarfism. Annals of Endocrinology 31: 121–130, 1970
Ruvalcaba RHA, Limbeck GA, Tatti DS, Moore DC, Kelley VC. Studies of anabolic steroids: VIII. Adult stature of males with Down syndrome treated with oxandrolone during childhood. Journal of Pediatrics 88: 504–505, 1976
Ryan AJ. Anabolic steroids are fool’s gold. Federation Proceedings 40: 2682–2688, 1981
Saartok T, Dahlberg E, Gustafsson J-A. Relative binding affinity of anabolic-androgenic steroids: comparison of the binding to the androgen receptors in skeletal muscle and in prostate, as well as to sex hormone-binding globulin. Endocrinology 114: 2100–2106, 1984
Sala G. Clinical evaluation of the anabolic effect of 4-hydroxy-17α-methyltestosterone. Helvetica Medica Acta 27: 519–522, 1960
Sale GE, Lerner KG. Multiple tumors after androgen therapy. Archives of Pathology and Laboratory Medicine 101: 600–603, 1977
Salt PJ. Inhibition of noradrenaline uptake2 in the isolated rat heart by steroids, clonidine and methoxylated phenylethylamines. European Journal of Pharmacology 20: 329–340, 1972
Sanchez-Medal L, Gomez-Leal A, Duarte L, Rico MG. Anabolic androgenic steroids in the treatment of acquired aplastic anemia. Blood 34: 283–300, 1969
Sarna G, Tamasulo P, Lotz MJ, Bubinak JF, Shulman NR. Multiple neoplasms in two siblings with a variant form of Fanconi’s anemia. Cancer 36: 1029–1033, 1975
Shapiro P, Ikeda RM, Ruebner BH, Connors MH, Halsted CC, et al. Multiple hepatic tumors and peliosis hepatis in Fanconi’s anemia treated with androgens. American Journal of Disease in Children 131: 1104–1106, 1977
Shephard RJ, Killinger D, Fried T. Responses to sustained use of anabolic steroids. British Journal of Sports Medicine 11: 170–173, 1977
Shinohara K, Matsumoto N, Tajiri M. Oxymetholone treatment in aplastic anaemia. Acta Haematologica Japan 37: 255–265, 1974
Shiozawa Z, Tsunoda S, Noda A, Saito M, Yamada H. Cerebral hemorrhagic infarction associated with anabolic steroid therapy for hypoplastic anemia. Angiology 37: 725–730, 1986
Shiozawa Z, Yamada H, Mabuchi C, Hotla T, Saito M, et al. Superior sagittal sinus thrombosis associated with androgen therapy for hypoplastic anemia. Annals of Neurology 12: 578–580, 1982
Simonson E, Kearns WM, Enzer N. Effect of methyl testosterone treatment on muscular performance and central nervous system of older men. Journal of Clinical Endocrinology 4: 528, 1944
Snyder PJ, Lawrence DA. Treatment of male hypogonadism with testosterone enanthate. Journal of Clinical Endocrinology and Metabolism 51: 1335–1339, 1980
Strauss RH, Liggett MT, Lanese RR. Anabolic steroid use and perceived effects in ten weight-trained women athletes. Journal of the American Medical Association 253: 2871–2873, 1985
Strauss RH, Wright JE, Finerman GAM. Anabolic steroid use and health status among forty-two weight-trained male athletes. Abstract. Medicine and Science in Sports and Exercise 14: 119, 1982
Stromeyer FW, Smith DH, Ishak KG. Anabolic steroid therapy and intrahepatic cholangiocarcinoma. Cancer 43: 440–443, 1979
Stromme SB, Meen HD, Aakvaag A. Effects of an androgenic-anabolic steroid on strength development and plasma testosterone levels in normal males. Medicine and Science in Sports 6: 203–208, 1974
Sweeney EC, Evans DJ. Hepatic lesions in patients treated with synthetic anabolic steroids. Journal of Clinical Pathology 29: 626–633, 1976
Tahmindjis AJ. The use of anabolic steroids by athletes to increase body weight and strength. Medical Journal of Australia 1: 991–993, 1976
Taggart HM, Applebaum-Bowden D, Haffner S, Warnick GR, Cheung MC, et al. Reduction in high density lipoproteins by anabolic steroid (stanozolol) therapy for postmenopausal osteoporosis. Metabolism 31: 1147–1152, 1982
Taylor WN. Anabolic steroids and the athlete, McFarland & Co. Inc, Jefferson, NC, 1982
Taylor WN. Hormonal manipulation, McFarland & Co. Inc, Jefferson, NC, 1985
Toth M, Zakar T. Relative binding affinities of testosterone, 19-nortestosterone and their 5α-reduced derivatives to the androgen receptor and to other androgen-binding proteins: a suggested role of 5α-reductive steroid metabolism in the dissociation of “myotropic” and “androgenic” activities of 19-nortestosterone. Journal of Steroid Biochemistry 17: 653–660, 1982
Turani H, Levi J, Zevin D, Kessler E. Hepatic lesions in patients on anabolic androgenic therapy. Israel Journal of Medical Science 19: 332–337, 1983
Tweedle D, Walton C, Johnston IDA. The effect of an anabolic steroid on postoperative nitrogen balance. British Journal of Clinical Practice 27: 130, 1972
Van Arman CG, Drill VA. Some cardiovascular effects of nor-ethandrolone (Nilevar), testosterone, and progesterone. Journal of Pharmacology and Experimental Therapeutics 124: 59–63, 1958
Vernon PE, McKinlay M. Effects of vitamin and hormone treatment on senile patients. Journal of Neurology, Neurosurgery and Psychiatry 9: 87, 1946
Wakabayashi T, Onda H, Tada T, Iijima M, Itoh Y. High incidence of peliosis hepatis in autopsy cases of aplastic anemia with special reference to anabolic steroid therapy. Acta Pathologica Japonica 34: 1079–1086, 1984
Watson RN, Bradley MH, Callahan R, Peters BJ, Kory RC. A six month evaluation of an anabolic drug, norethandrolone, in underweight persons. I. Weight gain. American Journal of Medicine 26: 238–242, 1959
Webb OL, Laskarzewski PM, Clueck GJ. Severe depression of high-density lipoprotein cholesterol levels in weight lifters and body builders by self-administered exogenous testosterone and anabolic-androgenic steroids. Metabolism 33: 971–975, 1984
Weinstein Y, Berkovich Z. Testosterone effect on bone marrow, thymus, and suppressor T cells in the (NZBXNZW) Fl. mice: its relevance to autoimmunity. Journal of Immunology 126: 998–1002, 1981
Westaby D, Ogle SJ, Paradinas FJ, Randell JB, Murray-Lyon IM. Liver damage from long-term methyltestosterone. Lancet 1: 261–263, 1977
Westaby D, Portmann B, Williams R. Androgen related primary hepatic tumors on non-Fanconi patients. Cancer 51: 1947–1952, 1983
Whitelaw MJ, Foster TN, Graham WH. Steroidal induction of the premature growth spurt in prepubertal boys for excessive height. Acta Endocrinologica 50: 317–320, 1965
Wilson JD, Griffin JE. The use and misuse of androgens. Metabolism 29: 1278–1295, 1980
Wolf CB, Mellinger RC, Morrow LB, Zafar MS. The effectiveness of oxandrolone in promoting linear growth in growth hormone deficient children. Henry Ford Hospital Medical Journal 21: 163–167, 1973
Wood PD, Haskel WL, Klein H. The distribution of plasma lipoproteins in middle-aged male runners. Metabolism 25: 1249–1257, 1976
Woodard TL, Burghen GA, Kitabchi AE, Wilimas JA. Glucose intolerance and insulin resistance in aplastic anemia treated with oxymetholone. Journal of Clinical Endocrinology and Metabolism 53: 905–908, 1981
Wright JE. Anabolic steroids and athletics. In Hutton & Miller (Eds) Exercise and sports science reviews, pp. 149–202, Academic, New York, 1980
Zachmann M, Ferrandez A, Mursett G, Gnehm HE, Prader A. Testosterone treatment of excessively tall boys. Journal of Pediatrics 88: 116–123, 1976
Zachmann M, Prader A. Anabolic and androgenic effect of testosterone in sexually immature boys and its dependency on growth hormone. Journal of Clinical Endocrinology 30: 85–95, 1970
Zeiss J, Smith RR, Taha AM. Iliopsoas hypertrophy mimicking acute abdomen in a bodybuilder. Gastrointestinal Radiology 12: 340–342, 1987
Ziegenfuss J, Carabasi R. Androgens and hepatocellular carcinoma. Lancet 1: 262, 1973
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hickson, R.C., Ball, K.L. & Falduto, M.T. Adverse Effects of Anabolic Steroids. Med Toxicol Adverse Drug Exp 4, 254–271 (1989). https://doi.org/10.1007/BF03259912
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03259912