special subjects
Anabolic Steroids
Symptoms and Signs of Anabolic Steroid Use
The most characteristic sign of anabolic steroid use is a rapid increase in muscle mass. The rate and extent of increase are directly related to the doses taken. Patients taking physiologic doses have slow and often unnoticeable growth; those taking megadoses may increase lean body weight by several pounds per month. Increases in energy level and libido (in men) occur but are more difficult to quantify. Psychologic effects (usually only with very high doses) are often noticed by family members: Wide and erratic mood swings Irrational behavior Increased aggressiveness (“roid rage”) Irritability Increased libido Depression Increased acne is common in both sexes; libido may increase or, less commonly, decrease; aggressiveness and appetite may increase. Gynecomastia, testicular atrophy, and decreased fertility may occur in males. Virilizing effects (eg, alopecia, enlarged clitoris, hirsutism, deepened voice) are common among females. Also, breast size may decrease; vaginal mucosa may atrophy; and menstruation may change or stop. Virilization and gynecomastia may be irreversible. 