Potential Harm from Performance-Enhancing Compounds

The misuse of muscle-enhancing compounds has been linked to a spectrum of possible adverse reactions. These range from aesthetically displeasing conditions such as skin problems and male chest enlargement, to serious health threats like cardiac events and hepatic malignancies. While many of these consequences are reversible upon cessation of compound intake, some effects may be enduring, including vocal changes in women.

The majority of insights into the prolonged impacts of muscle-enhancing compounds on people are derived from anecdotal accounts instead of structured scientific studies. Although these accounts suggest a relatively rare occurrence of fatal consequences, the possibility of serious complications might be underrecognized or underreported, particularly as they could manifest years after usage. Animal tests support these suppositions, showing that extended exposure to such compound levels akin to those used by athletic individuals resulted in an increase in premature mortality rates.

Endocrine Disruptions

The abuse of these compounds can disrupt the body's natural hormone production, leading to both reversible and lasting alterations. Reversible changes include diminished sperm output and testicular shrinkage, while permanent effects encompass alopecia and chest development in men. Research has shown a significant prevalence of testicular shrinkage and/or chest enlargement in male weight trainers.

For females, these substances can induce virilization effects. This includes a reduction in breast size and body fat, a coarsening of the skin, clitoral growth, and a deepening of the voice. Females may also see an upsurge in body hair alongside a thinning of hair on the scalp. Persistent administration may render some of these changes irreversible.

Muscle and Bone Implications

Normally, puberty and adolescence are times when sex hormones trigger growth surges and eventually signal the cessation of bone growth. However, when a young individual uses anabolic compounds, the artificially elevated hormone levels can prematurely halt bone growth.

Cardiovascular Concerns

The misuse of these substances has been tied to cardiovascular ailments, including myocardial infarction and cerebrovascular accidents, even in those under 30. These compounds alter blood cholesterol levels by increasing low-density lipoprotein (LDL) and reducing high-density lipoprotein (HDL), promoting atherosclerosis where fatty deposits block arteries. This can lead to cardiac or cerebral events if blood flow is obstructed. Additionally, there's an elevated risk of blood clots forming in vessels, potentially impairing cardiac function and blood circulation.

Hepatic Risks

Abuse of these compounds has been linked to liver tumors and the rare peliosis hepatis condition, which involves the formation of blood-filled cysts in the liver that can burst, causing internal hemorrhage.

Dermatological Effects

The misuse of these substances can lead to dermatological issues such as acne, cyst formations, and greasy skin and hair.

Infection Hazards

Injectors of these compounds who utilize nonsterile methods or share infected needles risk contracting and spreading deadly viruses like HIV and hepatitis B and C. Furthermore, the production of these compounds in unregulated environments heightens this danger. Users may also develop endocarditis, a severe infection causing inflammation of the heart's inner lining. Injection sites can become painful and may develop abscesses.

Behavioral Impact

There have been indications from case studies and limited research that high dosages of anabolic compounds can amplify irritability and aggression. Reports from users link high dosages to aggressive acts, including physical altercations and property crimes, which are more likely when these compounds are used. A handful of controlled experiments have shown inconsistent results on whether these substances directly lead to aggression, with some but not all anabolic compounds increasing irritability and aggressive behavior.

In summary, while the extent of the contribution of compound misuse to violence and behavioral disorders remains unclear, extreme cases appear to be rare yet potentially underestimated. Some users may turn to other illicit substances to mitigate the adverse effects of anabolic compounds, with a study noting a number of individuals first using opioids to combat the irritability and sleep disturbances caused by these muscle-enhancing drugs.