Jakarta, 23 September 2024 – Recently, people had their eyes on Paris, as athletes from across the globe swam, dribbled, and shot in the 2024 Summer Olympics and Paralympics Games. However, there was an undercurrent of distrust and resentment in the City of Love, as months before, 23 athletes were accused of alleged doping in a major scandal (Mann, 2024). Today, the use of performance-enhancing drugs is frowned upon. However, this was not always the case, as the use of these drugs was generally accepted in the early years of the Games (Ritchie, 2014). Though once confined to power sports, today, the use of one class of performance-enhancing drugs, anabolic steroids, has spread to other types of sports (O’Hagan, 2015). Putting aside arguments over the sportsmanship of doping, is the use of anabolic steroids that bad for the human body?

Before looking at the side effects of anabolic steroids, we first need to look at how they work. Anabolic steroids or anabolic-androgenic steroids (AAS)  are actually a class of synthetic substances derived from testosterone, a hormone naturally found in the human body. These substances have a boosted version of testosterone’s anabolic effect, which is the ability to stimulate protein production and muscle growth (Mazzeo, 2018). 

AAS can be administered orally or through injections to the muscle, both of which lead to them entering the bloodstream. Like cars on a highway, the AAS will be carried across the human body through the bloodstream and eventually exit into their target cells. Once they enter these cells, AAS either bind to special molecules known as “androgen receptors” or go through “biotransformation,” the modification of a substance by an organism with biochemical reactions (Bond et al., 2022; de Sousa et al., 2018). In the case of AAS, they can be converted into three different things: more potent androgens, less potent or inactive androgens, or estrogens. The type of biotransformation that AAS molecules undergo depends on the enzyme that the AAS binds to (Bond et al., 2022). 

When AAS are bound to an androgen receptor, a series of events occurs, which ends with the movement of the androgen receptor to the nucleus. The androgen receptor will then form a substance known as a “homodimer,” allowing it to bind to the cell’s genes in special locations known as androgen response elements (AREs). The genes that the receptors bind to contain the information needed to create the necessary substances for muscle growth. By binding to the gene, the translation of the genetic information into these needed substances can begin, thus increasing the expression of muscle growth-related genes (Bond et al., 2022).

Although anabolic steroids are an effective way to accelerate muscle growth, many view them as a shortcut, abusing them with high doses and long-term usage in the hope of obtaining and maintaining a powerful body. About 30% of users develop dependencies, leading to years of abuse that can lead to damaging consequences across multiple organ systems and changes to metabolic profiles (AlShareef et al., 2020).

One of the most impactful organ systems affected by anabolic steroids is the cardiovascular system. Anabolic steroids cause stress on cardiac cells, and over time, the long-term damage leads to cardiac dysfunction and increased risk of irregular heartbeat and sudden death (Ayubi et al., 2023). The vascular system also suffers, with higher blood pressure leading to further cardiovascular system complications (Rasmussen et al., 2018).

The liver, which works day and night to metabolize and detoxify the blood, is another major organ affected by the abuse, leading to liver dysfunction and potentially severe liver disease (Solimini et al., 2017). Similarly, the kidneys are also prone to chronic kidney injury due to prolonged AAS use. Possible renal damage have been identified in AAS users with evidence suggesting that AAS may have toxic properties towards kidney cells, promoting chronic kidney disease (Sultan et al., 2023). 

As a hormone, misuse of AAS can also affect the brain, as it causes a decrease in libido and sexual dysfunction, like erectile dysfunction in males. The majority of AAS users experience low levels of testosterone even after discontinued use (Kujawska et al., 2018). Prolonged abuse, especially over a year, may impair sperm production, requiring hormonal therapy to bring back fertility (Ayubi et al., 2023). Additionally, it also compromises a person’s fat metabolism and insulin sensitivity, which makes them more susceptible to detrimental cardiovascular diseases (Robinson et al., 2023).

Considering the detrimental side effects AAS have on the human body, it is tough to say that the benefits of AAS outweigh their harms. AAS may have a use in building muscles, but their dependence-causing nature may impair people’s ability to make responsible decisions about AAS use. We believe that despite the sacrifices athletes make to strive towards victory, anabolics steroids are too detrimental for their bodies to be used as a way to gain an edge. However, it is ultimately up to the sporting community to decide if they are willing to pay the price to gain the upper hand.