side sffects ;Testicular Atrophy

Anabolic/androgenic steroids may produce atrophy (shrinkage) of the testicles. Testosterone is synthesized and secreted by the Leydig cells in the testes. Its release is regulated by the hypothalamic-pituitary-testicular axis, a system that is very sensitive to sex steroids.When anabolic steroids are administered, the HPTA will recognize the elevated hormone levels, and respond by reducing the synthesis of testosterone. If the testes are not given ample stimulation, over time they will atrophy, a process that can involve both a loss of testicular volume and shape. This atrophy mayor may not be obvious to the individual. In some cases, the testes will appear normal even though their functioning is insufficient. In other cases, shrinkage is very apparent. Visible testicular atrophy is one of the most common side effects of steroid abuse, appearing in more than 50% of all anabolic/androgenic steroid abusers.

Although testicular atrophy is very common in frequency, it is also regarded as a temporary reversible side effect.296 The gonads, by their nature, will vary in size under hormonal influence. Atrophy should not produce permanent damage. Note, however, that it can be a somewhat persistent issue. It may take many weeks or months of sufficient LH stimulation after steroid discontinuance for original testicular volume to be restored. Likewise, testicular atrophy is usually the root cause of prolonged post-cycle hypogonadism. In extreme cases, full recovery can take more than 12 months, and may even require medical intervention. A post-cycle recovery program inclusive of HCG (which mimics luteinizing hormone activity) may be used to minimize this recovery phase.297 This drug is also frequently effective for maintaining testicular mass when used on a periodic basis during steroid administration.29B HCG must be used with caution, however, as overuse may cause desensitization of the testes to LH,299 complicating HPTA recovery.

Some of the more potent anabolic/androgenic steroids, including testosterone, nandrolone, trenbolone, and oxymetholone, appear to be more suppressive of testosterone release than many other AAS drugs.This may be explained in part by the additional estrogenic or progestational activity inherent in these steroids, as estrogens and progestins both also provide negative feedback inhibition of testosterone release.30o 301 It is important to note, however, that all anabolic/androgenic steroids are capable of suppressing testosterone secretion. This includes primarily anabolic compounds such as methenolone and oxandrolone, which are normally regarded as milder in this regard. While these compounds may be less inhibitive of testosterone synthesis under some therapeutic conditions, when taken in the supratherapeutic doses necessary for physique-or performance-enhancement, significant atrophy and suppression are common, and distinctions less pronounced.

side sffects :Prostate Cancer

Prostate cancer is dependent on androgens. This disease will not develop if androgens are eliminated from the body at a young age (as with castration), and abatement of androgenic activity in patients with active disease is regarded as a standard path of treatment. A complete picture of the involvement of androgens, however, remains unclear. Studies show there is no association between the testosterone level and likelihood of developing prostate cancer.273 On the same note, the administration of exogenous testosterone during androgen replacement therapy seems to have no effect on the risk for developing this disease. A review of the: available medical literature also does not support an increased risk of prostate cancer in steroid abusers,275 which typically endure excessive levels of androgenic: stimulation. The present model suggests that while' testosterone is a necessary component of prostate cancer/' it does not appear to be a direct trigger for its onset

New diagnoses of prostate cancer are sometimes reported during testosterone replacement therapy anq steroid abuse. Such reports may be the result of a previously undiagnosed condition or unrelate~ development of this disease, with androgen stimulation assisting the tumor growth rate. Many forms of prostatE cancer possess functional androgen receptors, and arJ highly androgen responsive. As such, they can bJ stimulated to grow under the influence of testosterone 01 other anabolic/androgenic steroids. Given this effect, AA~ drugs are usually contraindicated in patients with ~ history of prostate cancer. While steroid administratio~l appears unlikely to cause prostate cancer,

side effects :Libido/Sexual Dysfunction

Anabolic/androgenic steroids may alter sexual desire and functioning. The nature of this alteration, however, can vary depending on individual circumstances.Testosterone is the primary male sex steroid, and is responsible for increasing sexual desire and supporting many male reproductive-system functions.264 Since all anabolic/androgenic steroids influence the same primary receptor as testosterone, abuse of these drugs (characterized by high levels of stimulation) is usually linked to strong increases in sexual desire, as well as copulation and orgasm frequency.265 The effect of steroid abuse on erectile function is more variable. In many cases, a significant increase in the frequency and duration of erections is noted. In other instances, however, periodic issues with having or maintaining erections are reported, even when steroid levels are high and libido is significantly increased. Sexual issues are also common after steroid discontinuance, when endogenous androgen levels are low.

Studies with dihydrotestosterone and aromatase inhibition demonstrate that estrogen is not necessary for the support of male libido and sexual functioning.266 Many non-aromatizable steroids are, therefore, capable of sustaining male sexual functioning given the right level of androgenic stimulation. Difficulties remain possible in many instances, however, especially when primarily anabolic compounds such as methenolone, nandrolone, oxandrolone, and stanozolol are used alone. These drugs many not provide sufficient androgenicity to compensate for the suppression of endogenous testosterone.267 Given the diverse nature in which sex steroids influence human psychology, the existence of other influencing factors during steroid abuse cannot be excluded, including estrogenic activity.268 The addition or substitution of testosterone during a cycle is usually regarded as the most reliable way to correct issues with male sexual interest and functioning, as it supplements the full spectrum of sex steroid activity.

Priallism:

In very rare instances, anabolic/androgenic steroids have been linked to priapism.269 270 271 This is a condition characterized by the development of an erection that will not return to its flaccid state within four hours. Priapism is a potentially very serious condition, which can require medical or surgical intervention. If left untreated, priapism can lead to permanent penile damage, erectile dysfunction, or even gangrene, which may necessitate removal of the penis. When priapism is linked to steroid use, testosterone is usually responsible. Furthermore, this condition appears to be more frequent in younger patients undergoing treatment for hypogonadism. This may be due in part to a rapid increase in androgenicity, in a male reproductive system that has not yet been exposed to high levels of stimulation. Priapism is very unlikely to develop in adult steroid abusers.