Anabolic Steroid Abuse
One of the main reasons people give for using steroids is to improve their performance in sports. Among competitive bodybuilders, steroid use has been estimated to be very high. Among other athletes, the incidence of use probably varies depending on the specific sport.
Another reason people give for taking steroids is to increase their muscle size and/or reduce their body fat. This group includes some people who have a behavioral syndrome (muscle dysmorphia) in which a person has a distorted image of his or her body. Men with this condition think that they look small and weak, even if they are large and muscular. Similarly, women with the syndrome think that they look fat and flabby, even though they are actually lean and muscular.
Some people who use steroids to boost muscle size have experienced physical abuse. They are trying to increase their muscle size to protect themselves. In one series of interviews with male weightlifters, 25 percent who engage in anabolic steroid abuse reported memories of childhood physical trauma, compared with none who did not use steroids.
In a study of women weightlifters, twice as many of those who had been raped reported using anabolic steroids and/or another purported muscle-building drug, compared to those who had not been raped. Moreover, almost all of those who had been raped reported that they markedly increased their bodybuilding activities after the attack. They believed that being bigger and stronger would discourage further attacks because men would find them either intimidating or unattractive.
Finally, some adolescents use steroids as part of a pattern of high-risk behaviors. These adolescents also take risks such as drinking and driving, carrying a gun, not wearing a helmet on a motorcycle, and abusing other illicit drugs.
While conditions such as muscle dysmorphia, a history of physical or sexual abuse, or a history of engaging in high-risk behaviors may increase the risk of initiating or continuing steroid abuse, researchers agree that most steroid users are psychologically normal when they start using the drugs.
Some anabolic steroids are taken orally, others are injected intramuscularly, and still others are provided in gels or creams that are rubbed on the skin. Doses taken by users can be 10 to 100 times higher than the doses used for medical conditions.
Steroid users typically "stack" the drugs, meaning that they take two or more different anabolic steroids, mixing oral and/or injectable types and sometimes even including compounds that are designed for veterinary use. Abusers think that the different steroids interact to produce an effect on muscle size that is greater than the effects of each drug individually, a theory that has not been tested scientifically.
Often, they also "pyramid" their doses in steroid cycles of 6 to 12 weeks. At the beginning of a cycle, the person starts with low doses of the drugs being stacked and then slowly increases the doses. In the second half of the cycle, the doses are slowly decreased to zero. This is sometimes followed by a second cycle in which the person continues to train but without drugs. The primary belief is that pyramiding allows the body time to adjust to the high doses and the drug-free cycle allows the body's hormonal system time to recuperate. As with stacking, the perceived benefits of pyramiding and cycling have not been substantiated scientifically.