Mark McGwire’s admission last week that he used steroids during his baseball career reopened the discussion about the risks and benefits of the drugs.
Steroids are synthetic versions of hormones the body produces naturally. Birth control pills are one example of a steroid. The types of steroids McGwire used are an artificial version of the male hormone testosterone.
Testosterone is responsible for the fetal development of male genitalia. Once the child is born, testosterone helps with the growth of bones and muscle as well as sexual development.
Athletes have long used artificial steroids — taken orally or injected — to enhance muscle growth, hasten the repair of muscle strain and prolong workouts.
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For decades, the medical community has acknowledged the effectiveness of steroids in building muscle and improving athletic performance.
“It helps your body to build more muscle, helps you recover from exercise more quickly so you can exercise harder and more frequently,” said Philip Wenger, an assistant professor at St. Louis College of Pharmacy.
Doctors say users may also benefit from a placebo effect that spurs them to train harder.
The side effects and unprescribed usage of steroids are what make them dangerous, particularly when the drugs come off the black market and the ingredients are unregulated.
Like any drug, the risk of side effects increases with the amount and duration of use.
Initial side effects include acne, hair growth and increased aggression known as “roid rage.”
Progressively, the body responds to artificial hormones by making less on its own. That can lead to the shrunken testicles, lowered sperm count and resulting infertility seen in some users of steroids.
Steroids can also increase cholesterol, fluid retention and high blood pressure that can lead to long-term effects. Steroid users are at increased risk for stroke, heart attack and sudden death.
When a heavy user stops taking steroids, they can experience withdrawal symptoms including depression, muscle aches, nausea and irritability. Their muscles will shrink and their strength will decline over six to 12 weeks after they stop taking the drugs.
Infertility is usually reversible within a year after someone stops taking steroids.
But for a long-term user, the lowered testosterone and sperm levels can last for years.
Someone like McGwire, who said he used steroids for about a decade, is at risk for permanent damage to the heart and liver. Long-term usage has also been linked to prostate and testicular cancer.
“No one’s really looked at how long is too long,” said John Ponzillo, a critical care pharmacist at St. John’s Mercy Medical Center in Creve Coeur, Mo.
There are several prescribed usages for steroids. Before bone marrow transplants became common, steroids were used for patients with anemia.
They have been used for patients with AIDS and other syndromes that cause muscle depletion and weight loss. Steroids can spur healing in burn patients.
Some types of steroids are used to reduce inflammation. The drugs used to treat asthma attacks are a form of steroid.
But use of steroids by healthy athletes is controversial because of the risks and the competitive advantage.
When combined with weight lifting, muscle growth is further pronounced on steroids, most prominently in the shoulders, neck and upper arms.
Someone can gain 4 to 11 pounds of muscle after using steroids for 10 weeks, according to a 2007 study by Ohio State University.
“If you’re in a track and field event like discus, or in weight lifting, if you use anabolic steroids you could get stronger and you could compete better,” Ponzillo said.
As far as baseball, everyone agrees it takes arm and leg strength to knock a baseball out of a ballpark. A stronger player can theoretically swing a heavier bat at a faster speed to launch baseballs.
But sports analysts and drug experts continue to debate the benefits of steroids for a baseball player, whose hand-eye coordination, reflexes, mental acuity and speed are arguably as valuable as raw strength.