Anabolic steroids are not studied for benefits in the gym

       DEAR DR. ROACH: I am interested in finding out more about steroids in sports, but I am having a hard time finding medical research on anabolic steroids. One source I found even stated: “There has been no scientific research performed to find out the effect of a specific amount of steroid on a weight-training program.” I find this hard to believe. Do you have any insight as to why this is? — A.W.
       ANSWER: The use of anabolic steroids, a type of performance-enhancing drug, actually is more common in recreational athletes (18 percent, across many studies) than it is in professional athletes (13 percent). Men are four times as likely as women to use them.
       The source you read regarding lack of information is believable, not only because I couldn’t find any good research on the topic, but because anabolic steroids are not medically indicated in order to improve performance of healthy people. True to their name — “anabolism” means “building up,” as opposed to “catabolism,” which means “breaking down” — anabolic steroids build muscle and bone strength, and are used in men with low levels of testosterone resulting from a variety of medical conditions.
       There are many steroids, but the main groups are glucocorticoids (like prednisone), which are potent anti-inflammatories and immune suppressants; estrogens and progesterones, which have multiple effects on the female reproductive system and the body system as a whole; and anabolic steroids, such as testosterone.
       Since there are no good studies on how much, how often or even what drug to use to improve performance, athletes who use these drugs rely on friends for advice. Unfortunately, that may lead to dangerous patterns of use. Athletes often will use escalating and then tapering off of doses (called “pyramiding”), using more than one drug (“stacking”) and using other drugs to counteract side effects.
       The potential side effects of this kind of anabolic steroid use are terrifying, and I have seen firsthand how severe they can be. Sudden death from cardiac hypertrophy; elevated cholesterol levels leading to blocked arteries; dangerously high levels of hemoglobin in the blood (which may lead to stroke); decrease in testicular size and sperm counts; and psychiatric changes all are well-described. I understand the desire to improve athletic performance, but these drugs have too much risk.
      

DEAR DR. ROACH: My wife and I are senior citizens and still enjoy our intimate times together. I’ve been on high blood pressure meds for several years, and the past few years have experienced erectile dysfunction. Atenolol is one of my high blood pressure meds, and I am wondering if it could be a contributor to ED. If so, why wouldn’t my doctor, who has a list of all my meds, be aware of it? — R.O.C.
       ANSWER: Your doctor certainly is aware that blood pressure medicines, especially diuretics like HCTZ but also beta blockers like atenolol, may cause erectile dysfunction. But, he may not know that you have that concern. Doctors often forget to ask about sexual health, and some people don’t feel comfortable bringing it up themselves. So please discuss it with your doctor, who may wish to try a different blood pressure medication.
       ED sometimes can be a sign of other kinds of medical issues. Circulation, hormonal and neurological conditions all may cause difficulty with erectile function. Your doctor should do a physical exam and some targeted labs to find out more.
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       Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at 628 Virginia Dr., Orlando, FL 32803. Health newsletters may be ordered from www.rbmamall.com.
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