Anabolic Steroids for Muscle Building

What’s Inside? Do They Raise Testosterone? Can They Cause PE?

❓ What’s Actually in Anabolic Steroids?

👉 Most anabolic steroids contain synthetic derivatives of testosterone.These substances mimic natural testosterone and are often taken in high, non-therapeutic doses.

They come in various forms:

• Injections 💉

• Pills 💊

• Creams or gels 🧴

They do raise the testosterone level — but often far beyond the normal physiological range.

📈 Do They Really Increase Testosterone?

Yes, but here's the catch:

✅ Externally supplied testosterone increases muscle mass❌ But it also shuts down natural production via feedback inhibition

👉 Over time, the body reduces or stops its own testosterone production, leading to:

• Testicular atrophy

• Infertility

• Mood changes

• Loss of libido

⚠️ Can They Cause Pulmonary Embolism (PE)?

Yes — indirectly.

High levels of exogenous testosterone can lead to:

• Increased red blood cell count (polycythaemia)

• Higher blood viscosity

• Pro-thrombotic state

➡️ This increases the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE)➡️ Especially when combined with dehydration, inactivity, or smoking

🩺 What Should You Do in PLAB 2?

In a GP station:

✅ Take a full history, including drug use✅ Explain the risks clearly but non-judgmentally✅ Advise stopping steroid use✅ Offer support for withdrawal and refer to specialist services (endocrinology or substance misuse)

💬 Final Word

Anabolic steroids are not harmless gym aids.They mimic testosterone, suppress natural hormones, and can increase serious risks — including pulmonary embolism.

📚 References

Angell PJ, Chester N, Sculthorpe N, et al

Performance enhancing drug abuse and cardiovascular risk in athletes: implications for the clinician

British Journal of Sports Medicine 2012;46:i78-i84.