The Effects of Performance Enhancing Drugs on Men, Part 1

"It’s a genetically predisposed crap shoot."

Posted Sep 01, 2016

During the Summer Olympics in Rio, a number of Russian athletes were disqualified due to doping, or using performance enhancing drugs. But this is not just an Olympic issue. It’s estimated that up to 3,000,000 males in the United States are taking performance enhancing drugs [PEDs] of some sort. So this week and next week I will be writing about PEDs.

I first became alarmed about the use of PEDs when not one but two sex therapists consulted within a few months about young male patients who had perfectly normal sex drives before they briefly used PEDs, but almost no sex drive after they had stopped. These weren't serious weight lifters with massive muscles. They were just normal guys who wanted to get a bit bigger than they could by lifting weights alone.

One of the first things I did was to interview a medical laboratory scientist who used to take anabolic steroids while he was lifting weights. He had also helped monitor the effects of performance enhancing drugs on other athletes. I think you'll find his perspective to be very down to earth and on point.

Q. Have you personally experienced long term effects from doping?

A. At my peak, I was lifting four nights a week for one-and-a-half hours in a town nearly a mile above sea level. My red blood cell count reached a level higher than I have seen during a 35-year career in laboratory medicine. And I now need to have a pint of blood removed at least every three weeks to avoid the complications from having very high testosterone levels that appear to have reset my blood cell production to an extremely uncomfortable high.

Q. On the weightlifter forums, men will often say their sex drive increases when they started taking steroids.

A. The initial testosterone increase can be expected to increase the sex drive (along with the power of suggestion). But then the long term effects start to kick in.

Q. When a man who is doping says his testicles are getting smaller, the standard response is “Don’t worry, when you’re done with this stack, you can take another stack that will make your testicles get back to normal.”

A. Yes worry. You may not be like the guy who tells you not to worry. While he might experience no damage to his testicles, your testicles might have permanent damage. It’s a genetically predisposed crap shoot.

Q. What about the penis? Will it shrink?

Not to my knowledge. It might cause a difference in hardness, but not size.

Q. People who are using performance enhancing drugs will also take women’s breast cancer drugs to reverse symptoms such as gynecomastia (male breast growth). Why?

A. The excess testosterone converts to estrogens in the male body. This causes what weightlifters call “bitch tits.” Some steroid abusers today are using aromatase inhibitors (women’s breast cancer drugs) for that reason. They help shut down the excess estrogen.

Q. How does adding extra testosterone help improve performance?

A. Current thinking is that above the threshold of 300, the extra testosterone makes little difference to normal function. But taking extra testosterone increases the amount of free testosterone. The free testosterone is probably what helps increase the muscle mass and unwanted side effects. (Typically only a small portion of free testosterone is active in the body because it’s bound by sex hormone binding globulin or SHBG. When men take testosterone and steroids, the amount of free testosterone increases.)

Q. Do we know what happens in the brain to create roid rage?

A. No. That’s a great question though. Sex steroids have been investigated to death — yet no one has bothered to study roid rage and link it to other behavioral disorders associated with testosterone.

Q. Does roid rage result in an increased sex drive?

A. Some of the guys indicated that at first their partners liked the effect of added testosterone — until the side effects became more of a problem. Perhaps the increased sex drive was associated with behavior that gradually became too aggressive.

Q. Sex therapists are seeing male patients who are experiencing a shutdown of libido and who only took a very limited course of steroids.

A. Yes, that’s what I mean about genetic predispositions and the problems continuing even if a man has already quit juicing. Like I said, it’s a genetic crap shoot.

Next week we'll explore some of the physiology involved in using performance enhancing drugs.

[Thanks to Jim Kohl.]

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