Trouble as steroid users hit middle age

As anabolic steroid use increases in Australia, health experts warn the long-term health impacts are only just being understood

“The alarming scientific findings are beginning to filter in,” said Harvard Medical School’s Professor Harrison Pope, who presented new US research to Australian health experts at the APSAD Alcohol and Drugs Conference last week.

“For more than ten years now we have been worrying that we will soon start seeing the impact of long-term anabolic steroid use, and now it is beginning to happen.

“Users need to be aware, clinicians need to be aware and services need to prepare. In the US, a potential public health crisis is looming,” he said.

Use of anabolic-androgenic steroids (AAS) began among elite athletes in the 1950s, but AAS use did not spread to the broader population until the 1980s and 1990s.

Today, most illicit AAS users are not competitive athletes, but rank-and-file gym clients. The oldest members of this large new group, who began AAS use as youths in the ’80s and ’90s, are only now reaching middle age, and the long-term health harms of AAS are starting to become evident.

A US study published this year – the first large controlled study of its kind – underscored the long-term cardiovascular toxicity of AAS, with three out of 86 of the AAS users recruited already having experienced a heart attack by age 45.

Another study has shown that many men experience protracted severe hypogonadism, where testosterone levels plummet and the testes shrink, with an associated drop in libido and erectile disfunction. The latest studies indicate that some men may never recover normal testicular function, even after many years.

There is also new evidence to suggest that very high circulating levels of testosterone and other AAS may lead to premature death of brain cells. This means that long-term AAS users may possibly be at risk for developing cognitive deficits or even dementia at a premature age.

In Australia, AAS use is generally under-researched and very little is known about the long-term effects, experts say.

“We believe that anabolic steroid use in Australia is increasing,” said Dr Matthew Dunn, APSAD Conference Co-Convenor and Senior Lecturer at Deakin University.

“We know the immediate and short-term harms they cause, but we’ve always been less clear about the long-term impacts. As research like this starts to emerge, we want users to consider the implications and make an informed choice.

“Do they have a family history of heart problems? Are they young now, but want to have a family in the future? If your body stops producing testosterone and doesn’t start back up, who will you go to seek help?

“This is clearly an area we need to understand better and communicate to those using these drugs,” he said.

A national study from 2012 found two-thirds of young men who began injecting drugs within the past three years were using steroids, overtaking methamphetamine and heroin use.

AAS interceptions by the Australian Customs and Border Protection Service increased by 174% from 2696 in 2009/2010 to 7381 in 2014/15.

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