Skip to main content

Advertisement

SpringerLink
Log in

Steroid Use and Long-Term Health Risks in Former Athletes

  • Current Opinion
  • Published:
Sports Medicine Aims and scope Submit manuscript

Abstract

This article focuses on anabolic steroid adverse effects on the cardiovascular system and mental health issues as well as the possible increase in the incidence of neoplasms in anabolic steroid users. On the basis of findings in the literature, the authors consider these three issues as the most significant concerning morbidity and mortality among anabolic steroid users. A study by Pärssinen et al. (2000) has shown an increased incidence of premature mortality among power lifters. Anabolic steroids and other concomitantly used drugs are the probable cause of this increased mortality, as power training itself does not increase health risks and all types of physical activity promote health.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I

Similar content being viewed by others

References

  1. National Institute on Drug Abuse (NIDA). About anabolic steroid abuse [Tearoff]. NIDA Notes 2000 Aug; 15 (3): 15

    Google Scholar 

  2. Bhasin S, Storer TW, Berman N, et al. The effects of supra-physiological doses of testosterone on muscle size and strength in normal men. N Engl J Med 1996; 335 (1): 1–7

    Article  PubMed  CAS  Google Scholar 

  3. Lin GC, Erinoff L, editors. Anabolic Steroid Abuse. Rockvilee (MD): National Institute on Drug Abuse, 1990 (NIDA Research Monograph Series 102)

    Google Scholar 

  4. Jänne OA, Palvimo J, Kallio P, et al. Androgen receptor and mechanism of androgen action. Ann Med 1993; 25: 83–9

    Article  PubMed  Google Scholar 

  5. LeGros T, McDonnell D, Murry T, et al. The effects of 17α-methyltestosterone on myocardial function in vitro. Med Sci Sports Exerc 2000; 32 (5): 897–903

    PubMed  CAS  Google Scholar 

  6. Melchert RB, Welder AA. Cardiovascular effects of androgenic anabolic steroids. Med Sci Sports Exerc 1995; 27 (9): 1252–62

    PubMed  CAS  Google Scholar 

  7. Sullivan ML, Martinez CM, Gennis P, et al. The cardiac toxicity of anabolic steroids. Prog Cardiovasc Dis 1998; 41 (1): 1–15

    Article  PubMed  CAS  Google Scholar 

  8. Bahrke MS, Yesalis CE, Wright JE. Psychological and behavioural effects of endogenous testosterone and anabolic-androgenic steroids. Sports Med 1996; 22 (6): 367–90

    Article  PubMed  CAS  Google Scholar 

  9. Boada LD, Zumbado M, Torres S, et al. Evaluation of acute and chronic hepatotoxic effects exerted by anabolic-androgenic steroid stanozolol in adult male rats. Arch Toxicol 1999 Nov; 73 (8–9): 465–72

    Article  PubMed  CAS  Google Scholar 

  10. Bronson FH, Matherne CM. Exposure to anabolic-androgenic steroids shortens life span of male mice. Med Sci Sports Exerc 1997; 29 (5): 615–9

    Article  PubMed  CAS  Google Scholar 

  11. Brower KJ. Anabolic steroids. Psychiatr Clin North Am 1993; 16 (1): 97–103

    PubMed  CAS  Google Scholar 

  12. Haupt HA. Anabolic steroids and growth hormone. Am J Sports Med 1993; 21 (3): 468–74

    Article  PubMed  CAS  Google Scholar 

  13. Haupt HA, Rovere GD. Anabolic steroids: a review of the literature. Am J Sports Med 1984; 12 (6): 469–84

    Article  PubMed  CAS  Google Scholar 

  14. Kibble MW, Ross MB. Adverse effects of anabolic steroids. Clin Pharm 1987; 6: 686–92

    PubMed  CAS  Google Scholar 

  15. Yesalis Charles E. Anabolic steroids in sport and exercise. Champaign (IL): Human Kinetics Publishers, 1993

    Google Scholar 

  16. Sarna S, Sahi T, Koskenvuo M, et al. Increased life expectancy of world class male athletes. Med Sci Sports Exerc 1993; 25 (2): 237–44

    PubMed  CAS  Google Scholar 

  17. Fogelholm M, Kaprio J, Sarna S. Healthy lifestyles of former Finnish world class athletes. Med Sci Sports Exerc 1994; 26 (2): 224–9

    Article  PubMed  CAS  Google Scholar 

  18. Kujala UM, Kaprio J, Taimela S, et al. Prevalence of diabetes, hypertension, and ischemic heart disease in former elite athletes. Metabolism 1994; 43 (10): 1255–60

    Article  PubMed  CAS  Google Scholar 

  19. Wight Jr JN, Salem D. Sudden cardiac death and the ‘athlete’s heart”. Arch Intern Med 1995; 155: 1473–80

    Article  PubMed  Google Scholar 

  20. Tikkanen HO, Härkönen M, Näveri H. Relationship of skeletal muscle fiber type to serum high density lipoprotein cholesterol and apolipoprotein A-I levels. Atherosclerosis 1991; 90: 49–57

    Article  PubMed  CAS  Google Scholar 

  21. Tikkanen HO, Hämäläinen E, Sarna S, et al. Association between skeletal muscle properties, physical fitness, physical activity and coronary heart disease risk factors in men. Atherosclerosis 1998; 137: 337–89

    Article  Google Scholar 

  22. Wade AJ, Marbut MM, Round JM. Muscle fiber type and aetiology of obesity. Lancet 1990; 335: 805–8

    Article  PubMed  CAS  Google Scholar 

  23. Kujala UM, Sarna S, Kaprio J, et al. Natural selection to sports, later physical activity habits and coronary heart disease. Br J Sports Med 2000; 34: 445–9

    Article  PubMed  CAS  Google Scholar 

  24. Palatini P, Giada F, Garavelli G, et al. Cardiovascular effects of anabolic steroids in weight-trained subjects. J Clin Pharmacol 1996; 36: 1132–40

    PubMed  CAS  Google Scholar 

  25. Dickerman RD, McConathy WJ, Schaller F, et al. Echocardigraphy in fraternal twin bodybuilders with one abusing anabolic steroids. Cardiology 1997; 88: 50–1

    Article  PubMed  CAS  Google Scholar 

  26. Dickerman RD, Schaller F, McConathy WJ. Left ventricular wall thickening does occur in elite power athletes with or without anabolic steroid use. Cardiology 1998; 90: 145–8

    Article  PubMed  CAS  Google Scholar 

  27. Nieminen MS, Rämö MP, Viitasalo M, et al. Serious cardiovascular side effects of large doses of anabolic steroids in weight lifters. Eur Heart J 1996; 17: 1576–83

    Article  PubMed  CAS  Google Scholar 

  28. Anastasiou-Nana MI, Nanas JN, Karagounis LA, et al. Relation of dispersion of QRS and QT in patients with advanced congestive heart failure to cardiac and sudden death mortality. Am J Cardiol 2000; 85 (10): 1212–7

    Article  PubMed  CAS  Google Scholar 

  29. Stolt A, Karila T, Viitasalo M, et al. QT interval and QT dispersion in endurance athletes and in power athletes using large doses of anabolic steroids. Am J Cardiol 1999; 84 (3): 364–6

    Article  PubMed  CAS  Google Scholar 

  30. McCarthy K, Tang ATM, Dalrymple-Hay MJR, et al. Ventricular thrombosis and systemic embolism in bodybuilders: etiology and management. Ann Thorac Surg 2000; 70: 658–60

    Article  PubMed  CAS  Google Scholar 

  31. Hausmann R, Hammer S, Betz P. Performance enhancing drugs (doping agents) and sudden death: a case report and review of the literature. Int J Legal Med 1998; 111: 261–4

    Article  PubMed  CAS  Google Scholar 

  32. Maron BJ, Shirani J, Poliac LC, et al. Sudden death in young competitive athletes, clinical, demographic and pathological profiles. JAMA 1996; 276: 199–204

    Article  PubMed  CAS  Google Scholar 

  33. Maron BJ, Poliac LC, Roberts WO. Risk for sudden cardiac death associated with marathon running. J Am Coll Cardiol 1996; 28 (2): 428–31

    Article  PubMed  CAS  Google Scholar 

  34. Kenny A, Shapiro LM. Sudden cardiac death in athletes. Br Med Bull 1992; 48 (3): 534–45

    PubMed  CAS  Google Scholar 

  35. Jensen-Urstad M. Sudden death and physical activity in athletes and nonathletes. Scand J Med Sci Sports 1995; 5: 279–84

    Article  PubMed  CAS  Google Scholar 

  36. Luke JL, Farb A, Virmani R, et al. Sudden cardiac death during exercise in a weight lifter using anabolic androgenic steroids: pathological and toxicological findings. J Forensic Sci 1990; 35: 1441–7

    PubMed  CAS  Google Scholar 

  37. Lynberg K. Myocardial infarction and death of a body builder after using anabolic steroids. Ugeskr Laeger 1991; 153: 587–8

    Google Scholar 

  38. Uzych L. Anabolic-androgenic steroids and psychiatric-related effects: a review. Can J Psychiatry 1992; 37 (1): 23–7

    PubMed  CAS  Google Scholar 

  39. Bahrke MS, Wright JE, Strauss RH, et al. Psychological moods and subjectively perceived behavioral and somatic changes accompanying anabolic-androgenic steroid use. Am J Sports Med 1992; 20 (6): 717–24

    Article  PubMed  CAS  Google Scholar 

  40. Pope HG, Katz DL. Psychiatric and medical effects of anabolic-androgenic steroid use: a controlled study of 160 athletes. Arch Gen Psychiatry 1994; 51 (5): 375–82

    Article  PubMed  CAS  Google Scholar 

  41. Pope HG, Kouri EM, Hudson JI. Effects of supraphysiologic doses of testosterone on mood and aggression in normal men: a randomized controlled trial. Arch Gen Psychiatry 2000; 57 (2): 133–40

    Article  PubMed  CAS  Google Scholar 

  42. Hannan C, Friedl K, Zold A, et al. Psychological and serum homovanillic acid changes in men administered androgenic steroids. Psychoneuroendocrinology 1991; 16: 335–42

    Article  PubMed  CAS  Google Scholar 

  43. Su T-P, Pagliaro M, Schmidt P, et al. Neuropsychiatric effects of anabolic steroids in male normal volunteers. JAMA 1993; 269 (21): 2760–4

    Article  PubMed  CAS  Google Scholar 

  44. Thiblin I, Runeson B, Rajs J. Anabolic androgenic steroids and suicide. Ann Clin Psychiatry 1999; 11 (4): 223–31

    PubMed  CAS  Google Scholar 

  45. Thiblin I, Lindquist O, Rajs J. Cause and manner of death among users of anabolic androgenic steroids. J Forensic Sci 2000; 45 (1): 16–23

    PubMed  CAS  Google Scholar 

  46. Brower KJ, Blow FC, Young JP, et al. Symptoms and correlates of anabolic-androgenic steroid dependence. Br J Addiction 1991; 86: 759–68

    Article  CAS  Google Scholar 

  47. Brower KJ, Blow FC, Beresford TP, et al. Anabolic-androgenic steroid dependence. J Clin Psychiatry 1989; 50 (1): 31–3

    PubMed  CAS  Google Scholar 

  48. Chen CJ, Yu MW, Liaw YF. Epidemiological characteristics and risk factors of hepatocellular carcinoma. J Gastroenterol Hepatol 1997 Oct; 12 (9–10): S294–308

    Article  Google Scholar 

  49. Zahm SH, Fraumeni Jr JF. The epidemiology of soft tissue sarcoma. Semin Oncol 1997 Oct; 24 (5): 504–14

    CAS  Google Scholar 

  50. Cho H, Lim IK. Expression of androgen receptor and its implication in hepatoma cells. Cancer 1997 May 19; 115 (2): 135–40

    CAS  Google Scholar 

  51. Tanaka K, Sakai H, Hashizume M, et al. Serum testosterone: estradiol ratio and the development of hepatocellular carcinoma among male cirrhotic patients. Cancer Res 2000 Sep 15; 60 (18): 5106–10

    PubMed  CAS  Google Scholar 

  52. Nakao A, Sakagami K, Nakata Y, et al. Multiple hepatic adenomas caused by long-term administration of androgenic steroids for aplastic anemia in association with familial adenomatous polyposis. J Gastroenterol 2000; 35 (7): 557–62

    Article  PubMed  CAS  Google Scholar 

  53. de Menis E, Tramontin P, Conte N. Danazol and multiple hepatic adenomas: peculiar clinical findings in an acromegalic patient. Horm Metab Res 1999 Aug; 31 (8): 476–7

    Article  PubMed  Google Scholar 

  54. Heikkilä R, Aho K, Heliövaara M, et al. Serum testosterone and sex hormone-binding globulin concentrations and the risk of prostate cancer. Cancer 1999; 86: 312–5

    Article  PubMed  Google Scholar 

  55. Demark-Wahnefried W, Lesko SM, Conaway MR, et al. Serum androgens: associations with prostate cancer risk and hair patterning. J Androl 1997 Sep-Oct; 18 (5): 495–500

    PubMed  CAS  Google Scholar 

  56. Signorello LB, Tzonou A, Mantzoros CS, et al. Serum steroids in relation to prostate cancer risk in a case-control study. Cancer Causes Control 1997 Jul; 8 (4): 632–6

    Article  PubMed  CAS  Google Scholar 

  57. Bryden AAG, Rothwell PJN, O’Reilly PH. Anabolic steroid abuse and renal-cell carcinoma. Lancet 1995; 346 (8985): 1306–7

    Article  PubMed  CAS  Google Scholar 

  58. Martorana G, Concetti S, Manferrari F, et al. Anabolic steroid abuse and renal cell carcinoma. Clin Urol 1999; 162 (11): 2089

    Google Scholar 

  59. Rosner F, Khan MT. Renal cell carcinoma following prolonged testosterone therapy. Arch Intern Med 1992; 152: 426, 429

    Google Scholar 

  60. Froehner M, Fischer R, Leike S, et al. Intratesticular leiomyosarcoma in a young man after high dose doping with Oral-Turinabol: a case report. Cancer 1999 Oct 15; 86 (8): 1571–5

    Article  PubMed  CAS  Google Scholar 

  61. Pärssinen M, Kujala U, Vartiainen E, et al. Increased premature mortality of competitive power lifters suspected to have used anabolic agents. Int J Sports Med 2000; 21: 225–7

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

No sources of funding were used to assist in the preparation of this manuscript. The authors have no conflicts of interest relevant to the contents of this manuscript.

Author information

Authors and Affiliations

  1. Laboratory of Substance Abuse, National Public Health Institute, Mannerheimintie 166, Helsinki, 00300, Finland

    Miia Pärssinen & Timo Seppälä

Authors
  1. Miia Pärssinen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Timo Seppälä
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Miia Pärssinen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pärssinen, M., Seppälä, T. Steroid Use and Long-Term Health Risks in Former Athletes. Sports Med 32, 83–94 (2002). https://doi.org/10.2165/00007256-200232020-00001

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00007256-200232020-00001

Keywords

Search

Navigation