Less than a decade after Lance Armstrong’s heroic win of the 7th consecutive Tour de France races, his name became synonymous with cheating as he was stripped of his titles after evidence surfaced that he had been using performance-enhancing drugs. Yet Armstrong is not an anomaly. For more than three decades now, the use of steroids by professional athletes has been widely reported. Professional athletes often have a fierce drive to win, sometimes, no matter the cost. This often leads to the use of performance-enhancing drugs that primarily increase muscular abilities in athletes. The drugs of choice for performance enhancement are a type of steroid from a class of drugs called anabolic steroids, also known as anabolic-androgenic steroids, that cause an increase in muscle mass and strength, thus increasing an athlete’s physical abilities. Aside from the obvious problem of disqualification, these steroids have serious physiological effects on the body, some resulting in debilitating and often permanent damage to the male and female reproductive organs.
In order to understand the side-effects of steroids, it is essential to understand what these drugs are exactly. Steroids are a man-made version of chemicals naturally occurring in the human body where they are known as hormones (Horwitz S, 2020). Basically, steroids are synthetic drugs that closely resemble certain hormones produced in the body, a common one being cortisol, a hormone responsible for numerous activities such as the control of blood sugar levels and the decrease of inflammation. Anabolic steroids, the drug commonly used by athletes, mimic the male sex hormone testosterone. Testosterone is a hormone produced in the testes of males and, to a small degree, in the ovaries of females. Anabolic steroids are synthetic steroid hormones that resemble testosterone in promoting the growth of muscles which is an effect desired by athletes (Mayo Clinic, 2019).
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Steroids are naturally derived in the human body. The hypothalamus stimulates the pituitary gland to produce Luteinizing hormone which stimulates the testes to produce testosterone. This testosterone is produced in the Cells of Leydig of the testes in males. Anabolic steroids are artificially derived from this testosterone as well as from synthetic androgens. They mimic testosterone and act directly on muscle cells promoting growth of these muscles.
The 2 main steroid classes are corticosteroids and anabolic-androgenic steroids. Corticosteroids are used for medical conditions, usually to decrease inflammation in the body. Anabolic steroids are used for a host of reasons including building muscle bulk in sportsmen. There are different types of anabolic steroids that are commonly used in the sports industry, namely testosterone, androstenedione, stanozolol, nandrolone and methandrosteolone. The most commonly used anabolic steroid is Dianobol (Healthy.ny.gov.,2020).
Basic anabolic steroids such as Dianobol, increases protein synthesis and promotes muscle building, while having androgenic effects (causing male-like characteristics). They are thus popular amongst body builders.
Designer steroids, a dangerous class of anabolic steroids, are synthetic steroids created to be undetectable by drug tests and made specifically for athletes and not for any medical condition. They are dangerous to athletes and not approved or tested by the Food and Drug Administration. Athletes take these drugs at an extremely high dose despite the serious side effects which includes liver abnormalities and tumours, heart problems, high blood pressure and circulatory problems (Mayo Clinic, 2019).
Androstenedione is a hormone in the body that is normally converted to testosterone and a form of oestrogen. Athletes use this drug (famously known as “andro”) despite it being illegal in some countries. It is believed to allow athletes to train harder and recover more quickly.
Steroids are not easily available but can be accessed by athletes from various illegal sources. Many steroids can only be legally purchased with a doctor’s prescription as they are labelled a Schedule 4 drug. However, certain steroids can be purchased over the counter in the form of dietary supplements which are sold legally.
Aside from the black market which is booming with steroid sales, it is also easy to get steroids from personal trainers at the gym.
The cost of these steroids vary, especially on the black market where performance enhancing steroids are abundant. In south Africa the average cost of 60 days-worth of steroid capsules can start at R400. Prices can vary and rise especially on the black market and especially for the illegal steroid types such as ‘andro’. (Health24, 2016)
The long-term effect of steroids on the human body, more specifically the reproductive system, is alarming. Since anabolic steroids are synthetic derivatives of testosterone, they behave like testosterone once in the blood stream (Horwitz S, 2020). They have 2 different types of effects namely androgenic (causing the development of male characteristics) and anabolic (increasing bone and muscle mass). Athletes use anabolic steroids for their ability to stimulate the receptor molecules in the muscle cells which activates specific genes to produce proteins. At the same time, they allow the body to produce more ATP, the “fuel” needed by muscles. They also affect the activation rate of enzyme systems involved in protein metabolism thus also enhancing protein synthesis and thus increasing muscle bulk and athletic performance. This is the desired effect that causes athletes to ingest these drugs. However, there are numerous undesired effects or side-effects of anabolic steroid usage, the milder ones being acne, hair loss, irritability and aggression, and the more severe effects being heart disease, kidney disease, depression and even suicide (Duke University, 2003-2016).
The effect of anabolic steroids on the male and female reproductive system, however, is significant and potentially serious and permanent.
The male body naturally produces testosterone in the testes. Luteinizing hormone (LH), secreted by the pituitary gland, stimulates the cells of Leydig to produce this testosterone. Sperm production is regulated by testosterone as well as by FSH (follicle-stimulating hormone) secreted by the pituitary gland. Anabolic steroids travel in the blood and suppress FSH and LH production in the pituitary gland and this decreases the production of testosterone in the testes as well as decreasing sperm production. This can result in gynecomastia (abnormal development of mammary glands in men causing breast enlargement), enlargement of the prostate gland, shrinking of testicles (azoospermia) and absence of sperm in semen (oligospermia). Increased testosterone in the body thus decreases natural testosterone production in the testicles and can change the histology of the testes by affecting the uniform arrangement of the seminiferous tubules. Oligospermia and azoospermia eventually lead to infertility in males with an associated higher risk of testicular cancer (Horwitz S, 2020).
In females, anabolic steroids have a similar effect. They travel in the blood system and cause a suppression of FSH and LH in the pituitary gland. Without FSH, follicles will not mature in the ovary and thus a Graafian follicle will not be available to release an ovum into the fallopian tube. Furthermore, without LH, even if the Graafian follicle is formed, ovulation will be affected and thus, once again, an ovum may not be released into the fallopian tubes (Horwitz S, 2020).
The anabolic steroid suppresses follicle-stimulating hormone (FSH) in the pituitary gland. If ovulation is inhibited, then there is no chance of fertilization by sperm to cause a pregnancy. The incidence of infertility in females using anabolic steroids, is thus high.
The effect of these hormones on the reproductive organs may also result in menstrual irregularities, no menstruation (amenorrhea) and an enlarged clitoris. The presence of testosterone in the blood will furthermore cause increased masculinity, a deepening voice, excessive hair growth on the face, upper torso widening and male pattern baldness. Female athletes thus develop masculine appearances (Horwitz S, 2020).
Foetuses are also affected by steroid use. The effect of anabolic steroids in pregnancy can lead to virilization of a female foetus. Testosterone enters the foetal blood via the umbilical cord and causes the foetus to develop male physical characteristics (Horwitz S, 2020).
Steroid-use is not just harmful to the body but goes against fairness and equality in sport. Anti-doping authorities say that using performance-enhancing drugs goes against the ‘spirit of sport’ because it overrides equality of opportunity for athletes. Steroid users have an unfair advantage as they have more oxygen-carrying blood being fed into their muscles thus allowing their muscles greater endurance and speed and placing them ahead in sport. Using these drugs to gain a competitive advantage is basically a form of cheating and is most certainly a display of dishonesty and poor sportsmanship. It goes against the age-old adage, “May the best man win” because men, or women using these drugs, are no longer on the same playing field as their co-competitors, and can thus not honestly accept the accompanying accolades for achievements that are not a true reflection of their sporting abilities (Health.ny.gov. 2008).
Unsurprisingly, the professional sporting world does not take kindly to this type of cheating and have devised methods and laws to regulate the sport industry and control the use of performance enhancing drugs in sport. The World Anti-Doping Agency (WADA) was established in 1999 for the purpose of creating and applying anti-doping policies for all sports organizations and governments around the world. Organizations that do not comply could have their events cancelled or face sanctions from WADA or ineligibility to host events (drugabuse.gov 2020).
According to the Anabolic Steroids Control Act of 1990, the possession or selling of anabolic steroids is illegal. In America, the penalties for possessing these steroids is a maximum sentence of 1 year in prison and a minimum penalty of $1000 if it is a first drug offence. The maximum sentence for trafficking is five years in prison and the minimum penalty is $250000 if it is an individual’s first drug offence (drugabuse.gov 2020).
Athletes testing positive for the use of anabolic steroids can and have been disqualified from sporting events and sometimes banned after having their previous titles stripped. The media attention and disgrace linked to this should be a deterrent for athletes considering these means of gaining advantage in competitive sport.
A further legislation regulating the sale of these steroids is the scheduling of drugs by the Department of Health. According to this schedule, anabolic steroids are categorised as a Schedule 4 drug. Any drug rated above Schedule 2 can only be prescribed by doctors. This makes it impossible for an athlete to purchase these steroids via a pharmacy unless he has a prescription from a certified medical doctor (Administration, D., 2004).
Fortunately, there are methods of testing for the presence of banned substances in a competing athlete. Urine testing is the commonly used method and involves 2 steps namely a screening test and a confirmatory test. The screening test uses a procedure called immunoassay to detect metabolites or other substances in the urine. The confirmatory test is done through gas chromatography and mass spectrometry.
All athletes know that their urine will be tested for drugs and, to avoid detection of steroids in their urine, offenders could stop using this drug well before the competition. Unfortunately for them, steroids can still be detected long afterward because anabolic steroids are extremely lipophilic molecules. They do not remain long enough in the liver to be metabolized or long enough in the kidney to be excreted in the urine, but instead seek out fat cells and accumulate there remaining in the body for a very long period until they move back into the blood stream where they can easily be detected even at a much later time (Drugabuse.gov. 2020).
The drive to win at all costs is huge amongst professional athletes, not just for the fame and opportunities that come with it, but for the fortune as well. Professional athletes are amongst the wealthiest celebrities in the world with numerous prospects even after their on-field career has come to an end. It is thus the reason why so many professional athletes have, in the past, taken to the use of anabolic steroids or other performance-enhancing drugs to improve their chances of a win. Many, however, have gained infamy once they were discovered, some famous athletes guilty of this being Lance Armstrong, Marion Jones and Ben Johnson.
Lance Armstrong was a professional cyclist famous for his many Tour de France wins and his bronze medal in the Summer Olympics in 2000. He was found guilty of attaining unfair advantage in sport due to prolonged use of anabolic steroids (Lance Armstrong Biography 2020). The 1st doping allegations against him occurred after his 1999 Tour de France win. Although he denied the allegations, he was found guilty of having used performance-enhancing drugs (PED) over the course of his career by a United States Anti-Doping Agency (USADA) investigation. He was stripped of all his achievements from 1998 onward. He also lost his 7 Tour de France titles and received a lifetime ban from all sports, thus ending a promising cycling career. In 2013 he publicly acknowledged his involvement in doping and was forced to pay 5 million US dollars after losing a civil lawsuit with the United States Department of Justice. He had admitted to using the anabolic steroid testosterone and human growth hormone, as well as EPO, a hormone naturally produced by human kidneys to stimulate red blood cell production thus increasing the amount of oxygen delivered to muscles and improving endurance (Biography.com. 2020).
Olympics champion sprinter, Marion Jones, became the 1st woman to win five track-and-field medals at a single Olympics during the 2000 Olympic Games, which was the crowning achievement for this seasoned American athlete. In 2006 Jones tested positive for a banned substance but was later cleared after denying the use of steroids (Marion Jones/ American athlete, 2020). However, in 2007, after 4 failed drug tests, she admitted to having used steroids and subsequently returned her medals. The International Association of Athletics Federations undertook to nullify all her results since September 2000 including her titles in the 2000 Olympic Games. Jones was also officially stripped of her 5 medals from the Sydney Games. She was sentenced to 6 months in prison for providing false statements to federal investigators regarding her use of steroids during competitive sporting events (Encyclopedia Britannica. 2020).
Ben Johnson, a Jamaican-born Canadian, defeated gold medallist icon Carl Lewis at the 1988 Summer Olympics with a record-breaking time of 9.79 seconds in the 100-meter sprint. Days after winning gold for this, his urine tested positive for the banned anabolic steroid stanozolol. He was stripped of his medal and his world record, and sent home to Canada in disgrace (Hero or Villain?, James Montague). The gold medal was rightfully awarded to Lewis. This moment and this run in Seoul became one of the most infamous as there were numerous other sprinters in that same race that tested positive for steroids as well (James Montague, C., 2012). The disqualification of Johnson was a national disappointment and highlighted steroid abuse by professional athletes.
Jonson, Jones and Armstrong went from hero to zero because of the use of anabolic steroids. This was a huge disappointment in the sporting field as sport is universally popular and a method of bringing people of a community or even a country, together. However, over and above the disappointment to fans, athletes should never forget the debilitating effect of anabolic steroids on the male and female reproductive systems. The possibility of infertility or testicular cancer in male athletes, infertility and masculinizing effects on female athletes and possible harm to female foetuses due to testosterone entering the foetal blood system, is not an insignificant consideration. The accompanying mental and emotional stress can also be severe and debilitating. The effect of anabolic steroids on the male and female reproductive system is thus severely damaging. Anabolic drug-use, should thus never be a consideration for anybody especially a true sportsman or woman!
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