Body Image and Steroid Use. Part 2

Seeking an Edge
Andrew Feldman, M.D., chief of sports medicine at St Vincent’s Hospital in New York City believes the upswing in steroid use can be best understood from an even broader perspective — that of the whole cultural shift in Western society toward fewer distinctions between males and females.

The author of the popular “Jock Doc’s Body Repair Kit,” Feldman points out that every aspect of how men and women relate to one another has changed in the past two decades. “There are more women in the workplace and more men assuming roles in the home,” he said. This results in more overlap in their roles, expectations and all other aspects of life — including their involvement in competitive athletics.

Women participating in traditionally male sports, such as in the WNBA, on women’s football and hockey teams, and in body building contests, have raised levels of competition for women to new heights. “Wherever there are sports, there’s competition. And wherever there’s athletic competition, some participants will want to gain an ‘edge’ over their competitors,” Feldman said.

Cascading Patterns Impact Youth
Pressure to gain the edge is now commonly felt well before high school graduation. According to the NIDA’s Monitoring the Future survey of 50,000 students conducted each year since 1975, illegal steroid use by high school seniors rose to in the 1990s, with more girls admitting to steroid doubling.

Perhaps more disturbing, a 1998 study of almost 1,000 middle school students in Massachusetts found that 2.7 percent had already taken steroids to improve their athletic performance, including some boys and girls as young as 10 years old.

According to Yesalis, anabolic steroids are “made to order” for youth seeking a lean, athletic body at any cost. Youngsters, like their idealized movie star and athletic role models may experience a decrease in body fat, increased muscle size and strength, and enhanced physical abilities. But they are seldom aware of the long-term negative health effects associated with these short-term gains.

The Dangers of Steroid Use
According to the NIDA, some common side effects are trembling, fluid retention, aching joints, acne, high blood pressure and lowered HDL (the “good” cholesterol).

Other possible health consequences of steroid abuse include:

• jaundice
• tumors
• tendon rupture
• short stature
• heart attacks
• enlargement of the heart’s left ventricle
• peliosis hepatis (blood-filled cysts in the liver)
• homicidal rage
• delusions

There are also some effects that are gender or age-specific, such as:

For women, the cessation of menstruation and smaller breasts, in addition to growth of facial hair, voice deepening and a masculinized appearance.

For men, development of breasts, reduced sperm count, shrunken testicles, difficulty or pain in urinating and an enlarged prostate.

For adolescents, premature skeletal maturation and accelerated puberty, which results in stunted growth.

Steroid-Use Symptoms
According to Yesalis, parents, coaches and school staff learning to recognize the hallmarks of high doses of anabolic steroid could curb the use of significant amounts of these performance-enhancing drugs among students.

“With low-dose usage, there’s no dramatic evidence,” he said, “but higher doses result in a rapid gain in muscle mass and strength. Parents or coaches who see quickly and steadily improving athletic performance have every reason to suspect the use of anabolic steroids is responsible. Except when steroids are being used, athletic performance improvements occur irregularly and unevenly. Sudden, massive improvements are a real tip-off.”

Another red flag is a preoccupation with physique and when young people believe themselves to be puny and weak, despite their obviously well developed musculature, Yesalis said.

Feldman notes that steroid users often develop unusual eating patterns or reactions to food, as well as numerous psychosocial patterns, including more aggressive and violent behavior patterns, coupled with ever-increasing amounts of time devoted to training and shaping their bodies. “There is often an obsession with how their bodies look, a quality of never being satisfied with their current body shape or size,” he said.

Feldman recommends that parents or coaches who suspect that a youth has begun or is continuing to use an illegal anabolic steroid to enhance his or her body image or athletic performance should establish and maintain as much open communication as possible while becoming better informed about community resources to diagnose and treat steroid abusers. He said, “It’s very important for adults to know when they are not getting through to a young user on the topic and thus need professional psychological or medical professionals to help.”

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