Do anabolic steroids have any legitimate medical uses?
Anabolic steroids have several legitimate medical uses. Testicular cancer often requires the removal of the testes in men. After surgery, these men are prescribed oral anabolic steroids to replace the testosterone that their bodies are no longer able to make. This maintains their secondary sexual characteristics.(1-3) Adolescent males with pituitary malfunction are treated with injectable anabolic steroids when they reach the appropriate age for puberty. Anabolics given for four to six months in the proper dosing schedule cause the growth spurt and development of secondary sexual characteristics.(2-4) After certain kinds of surgery and cancer, the patient experiences loss of muscle tissue. Anabolic steroids are used in such cases, with exercise and diet, to build up muscle tissue.(2,3,5) Anabolic steroids in high doses are given to transsexual women who wish to be permanently masculinized.(1) This is not an officially approved medical use for anabolic steroids in the United States. Anabolic steroids may one day be used as male oral contraceptives. However, their current negative image as abusable drugs has limited this research.(6) Doses of steroids for medically approved uses range from 2.5 mg per day to 400 mg every 4 weeks.(3,5) Usually, only a single anabolic steroid is taken at one time. Athletes take 8 to 10 times the maximum recommended dose of each agent, and often take more than one type at a time.(7) In typical dosing schedules, athletes are taking the equivalent of 20 to 2000 mg of testosterone per day, 2 to 200 times the normal dose.(7,8) More information about dosing schedules, is located under the question, "How are anabolics used by athletes?" For most legal prescription applications, anabolic steroid doses approximate the small amounts of anabolic steroids that would be produced naturally by the body. The right doses for different conditions are determined in drug company laboratories under controlled experimental conditions. Before a test dose of any new drug is given to a human volunteer, extensive studies are done on animals to find out how strong the drug is and how much to give. By contrast, anabolic steroid abusers get their instructions by hearsay. Dosing directions are passed from one person to another without any evidence of effectiveness or adherence to medical prescribing standards.
1. Strauss RH. Anabolic steroids. In: ed. Drugs and performance
in sports. Philadelphia: WB Saunders, 1987:5, 59-67.
2. Brower KJ, Catlin DH, Blow FC, Eliopulos GA, Beresford TP.
Clinical assessment and urine testing for anabolic-androgenic
steroid abuse and dependence. American Journal Of Drug And
Alcohol Abuse 1991;17(2):161-71.
3. Kleiner SM. Performance-enhancing aids in sport - health
consequences and nutritional alternatives. J Amer Coll Nutr
4. Lorimer DA, Hart LL. Cardiac dysfunction in athletes receiving
anabolic steroids. DICP Ann Pharmacother 1990 Nov;24(11):1060-1.
5. Goldfien A. The gonadal hormones & inhibitors. In: ed. Basic
and clinical pharmacology. Norwalk, CT: Appleton & Lange,
6. Yesalis CE, Wright JE, Bahrke MS. Epidemiological and policy
issues in the measurement of the long term health effects of
anabolic-androgenic steroids. Sports Medicine 1989
7. Kashkin KB, Kleber HD. Hooked on hormones - an anabolic
steroid addiction hypothesis. JAMA J Am Med Assoc 1989 Dec
8. Giannini AJ, Miller N, Kocjan DK. Treating steroid abuse - a
psychiatric perspective. Clinical Pediatrics 1991
by Trent Tschirgi, R. Ph.
(c) 1992 University of Maryland Office of Substance Abuse Studies.
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