76 In addition, animal models indicate that anabolic steroids suppress the immune system, 77 which could worsen infections. This puts these steroid users at risk for acquiring life threatening viral infections, such as HIV and hepatitis B and C.
Many people who inject anabolic steroids may use nonsterile injection techniques or share contaminated needles with other users.
It is commonly believed that anabolic steroids will produce irreversible enlargement of the clitoris in females, although there are no studies on this. 65 With continued administration of steroids, some of these effects become irreversible. 64 Women may experience excessive growth of body hair but lose scalp hair.
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Specifically, breast size and body fat decrease, the skin becomes coarse, and the voice deepens. In females, anabolic steroids cause masculinization. 59,62 Anabolic steroids may also act upon the hormone system to increase the risk of testicular cancer, especially when steroids are used in combination with insulin-like growth factor. 56,61 Irreversible changes include male-pattern baldness and breast development (gynecomastia) in men. Changes that can be reversed include decreased sperm production, 56–59 decreased function of the testes (hypogonadism) that leads to low testosterone levels, 60 and shrinking of the testicles (testicular atrophy). Steroid use disrupts the normal production of hormones in the body. Steroids also increase the risk that blood clots will form in blood vessels, potentially disrupting blood flow and damaging the heart muscle, so that it does not pump blood effectively. If blood is prevented from reaching the heart or brain, the result can be a heart attack or stroke, respectively.
47,48 High LDL and low HDL levels increase the risk of atherosclerosis, a condition in which fatty substances are deposited inside arteries and disrupt blood flow. Steroids contribute to the development of cardiovascular disease partly by increasing the level of low-density lipoprotein (LDL) 47 and decreasing the level of high-density lipoprotein (HDL). Steroid use has been associated with high blood pressure 41 decreased function of the heart’s ventricles 23,41,42 and cardiovascular diseases such as heart attacks, 43 artery damage, 44 and strokes, 45,46 even in athletes younger than 30.