When the term “steroids” is used, it is typically used in reference to anabolic steroids intended for the purposes of improving physical performance. However, steroids are actually a class of organic molecules with similar physical structure. The male sex hormone, testosterone, is perhaps the most widely known steroid in existence. But what is less known is that the female sex hormone, estrogen, is a steroid as well. Steroids are not limited solely to androgenic effects, but are also used for structural support in cells. However, for the purposes of this article, and for ease of writing, the term steroids will be used only to refer to anabolic/androgenic steroids commonly referred to by the abbreviation “AAS” . The term anabolic refers to metabolic processes that result in increased muscular hypertrophy while “androgenic” means supporting the development of male characteristics i.e. male pattern baldness, voice deepening, facial hair, muscular development, etc (Solomon 1056). AAS have been notorious in history for rampant usage in professional sports and bodybuilding. Critics argue that steroid use is life-threatening, which certainly holds its merits, but AAS are too complex to simply be labeled as “bad.” Due to controversy surrounding this substance, the United States labeled anabolic steroids as a controlled schedule III drug in 1990. In addition to the illegality of it, most professional sports organizations have banned the use of performance enhancing drugs in their respective sport. While these organizations hold the belief that AAS are cheating, they seem to ignore the other side of the argument. In reality, modern research does not support the media’s notion that anabolic steroids are awful, unhealthy, and immoral drugs with the potential to cause murderous rampages.

It seems as though when steroids are brought up in conversation, the risk of atherosclerosis, more commonly known as heart disease, tends to be a concern-able issue. William Llewelynn, Director of Research and Development of Molecular Nutrition, wrote about steroid risks and benefits in his book William Llewellyn’s Anabolics.  The side-effects section of this book explains that short-term steroid cycling has been shown to negatively impact cholesterol levels, which can lead to increased plaque levels in the arteries and therefore a greater risk of heart disease (Llewellyn 149). While on a cycle, the user’s HDL levels tend to decrease while LDL levels increase. HDL levels are correlated to positive cholesterol values while LDL molecules may risk increased plaque levels in arteries (Solomon 1056 ). Even though this is true,  steroids are taken in cycles, usually periods of 6-12 weeks. Afterward, a short period of post-cycle therapy begins in order to alleviate temporary side-effects that may have occurred while the individual was taking supratherapeutic doses of AAS. Post-cycle therapy helps to restore the cycler’s hormones back to pre-cycling conditions and thus the change in cholesterol levels is not a permanent side effect (Llewellyn 289-290).

Another common complaint about steroid abuse is the negative effect the drugs may have on the liver. Some oral steroids certainly can cause permanent damage to the  liver as it is suspected that they interact with androgen receptors in the hepatic system. Injectable steroids on the other hand, do not pass through the liver while metabolizing and therefore are not liver toxic (Llewellyn 171-173). Therefore liver toxicity while cycling steroids is a null-issue as long as the type of steroids taken by the user are non-toxic to the liver.

The use of AAS is correlated to negative aesthetic side effects including male pattern baldness, decreased size of the testes, and gynecomastia. These are all proven potential side-effects of AAS, although they are not guaranteed simply by taking steroids. Furthermore, steroids do not cause the androgenic side effect of baldness, they only increase the rate at which somebody genetically pre-disposed to male-pattern baldness  would achieve hair loss (Llewellyn 182). So this side-effect only applies to those who are genetically pre-disposed to baldness. Christopher Bell, director and writer of the documentary Bigger Stronger Faster*, explores the controversy of steroid use and his own personal use as well. Part of this movie discusses testicular shrinkage. The male testicles may shrink while cycling as a result of artifical testosterone injections resulting in the body to produce less of its own testosterone. This side effect is not permanent, and the testicles tend to return to their normal size after successful PCT (Bell). Gynecomastia, or male breast enlargement, can be caused as a result of increased estrogen levels while cycling AAS. Estrogen levels will rise while on a cycle in an attempt to counter-balance the increase in testosterone levels. The rise in estrogen levels is not necessarily bad, but can potentially result in gynecomastia. This unaesthetic side-effect can be easily avoided with the use of aromatase inhibitors such as Nolvadex (Llewellyn 337-338). Additionally this side-effect will only occur in specific individuals, not everyone.
Modern medical research agrees with the idea that steroids are generally safe drugs when taken properly by healthy adult men. Take for example a study published in the Journal of American Physiology and Endocrinology. 61 men were placed into different groups and given differing dosages of testosterone enanthate. The results showed that those taking the higher doses had gained the most muscle mass, and those with the lowest doses had the lowest increase in mass. The only notable side-effect found in the men with the highest steroids dosages was a decrease in HDL cholesterol values. No statistically significant changes were found in liver enzymes, sexual ability, or mental health (Bhasin). What this study shows is that the only negative health effect of testosterone enanthate was a negative impact in cholesterol values  while it had the positive health effects of increasing athletic ability and muscle mass. So steroids really cannot be labeled as beneficial or harmful toward health since they benefit some areas of health while damaging others. Overall however, it seems as though AAS are not truly detrimental to a person’s well-being and therefore when considering the ethics of steroid use, negative health impacts is not a major consideration. There are drugs on the market that are arguably far worse than steroids such as amphetamines like Adderall, prescribed for treatment of Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder. Adderall has even been correlated to death by myocardial infarction, otherwise known as heart disease (Cohle, 2013). Not only does this drug have a less negative connotation than anabolic steroids, but tit is also prescribed to children as young as three years old.

It is important to note that thus far the discussion of health impacts of AAS only applies to healthy adult men and not children or women. The effects of AAS in those less than 18 years of age are not completely understood as very little research has been done in that area. Women on the other hand, since their bodies do not typically create large amounts of testosterone like in men, may experience adverse and permanent side-effects. Some of these side-effects include excessive facial hair, enlarged clitoris, and infertility (Llewellyn 195-200). For these reasons, if steroids are to be taken by a female, they should be forewarned of the dangers in advance. Children should not take AAS as their is not enough research on them to know if any serious damage could be caused.
Furthermore some commonly believed side-effects of steroids are not even proven. Take for example, the story of Chris Benoit. Benoit was a professional wrestler for WWE back in the mid 2000‘s, but it seems he is more famous for being the poster child for “roid rage”. Roid rage is supposedly “violent and uncontrolled anger as a side effect of anabolic steroid use” according to Merriam-Webster online dictionary. Benoit murdered his wife, child, and then committed suicide. It was discovered that he had been taking heavy doses of anabolic steroids when his murder was under investigation. When the media found out about it, his murder-suicide was immediately blamed as a side effect of steroids. Of course, their is no actual evidence linking the murder to have been caused as a result of taking steroids. This is a type of fallacious argument known as an undistributed middle. In reality it is much more likely that steroids were not the cause of the murder, but rather that he was taking illicit drugs as a result of some sort of imbalance in mental cognition. As seen in the study by Bhasin injection of AAS did not alter cognitive functioning significantly. Anecdotally, Mark Bell, brother of Christopher Bell of the documentary Bigger, Stronger, Faster* had taken steroids for years before the release of the film. Mark Bell’s wife stated in the movie “I've never seen Roid Rage. I've never seen any difference in his personality or how he is with me, how he is with Jake. It hasn't done anything that all those after-school specials tell you that it's gonna do.” (Bell).

Furthermore, this film explains that the illegality of steroids is mainly a result of political reasons rather than actual scientific research. In fact, it was brought to attention in the film that medical research at the time did not support adverse side-effects of AAS. During the congressional hearing that resulted in the illegalization of AAS in the United States, a child’s suicide was brought to attention. The father of this child blamed his suicide on anabolic steroids, although the child was also taking anti-depressant medication which is correlated to mental instability. Once again, anabolic steroids were not proven to have been the cause of this child’s suicide yet the father’s speech during the hearing seemed to have more impact on the congressional decision than all of the scientific research available at the time (Bell).

The current stigma surrounding steroids is the notion that they are “cheating” and “unnatural,” however this view once again fails to represent the entire picture. The common argument when considering sports and steroids is that steroids are cheating because they are not naturally found in the body, and that by taking them the person’s athletic abilities are unfairly enhanced above those who do not use them. Now, it is true that a person with higher testosterone levels than another tends to gain muscle mass faster, but that is not always true. In fact, steroids are only one of various factors contributing to athletic performance. Genetics play a significant role as well. Profesional Strength Coach Mark Rippetoe writes in his book Practical  Programming: for Strength Training
There are at least 73 genes associated with fitness and performance. While humans all  swim in the same genetic pool, their is a huge amount of variation in both the genes  possessed and the genes actively expressed. And so, like it or not, here is the rule: DNA  makes RNA makes protein makes function. The reality is that genetic potential ultimately  affects the performance of every individual. These variations lead to differences in     performance potential. (2006, p. 105)

Is it unfair if one athlete has an athletic advantage over another simply because his genome is more tailored toward that sport? If that is the case then is it unfair if one athlete’s muscle mass is higher than another’s simply because he is genetically inclined to naturally higher testosterone levels and not because he works harder? If so, then steroids are not the cause of unfairness, genetics is. If steroids were to be regulated around national sports associations, then it would actually be possible to minimize testosterone level differences as a variable in sports performance. If all athletes were put on to similar steroid cycles then no one would have a significant advantage over the other in regards to testosterone. Now, some critics may argue that steroids would make sports less fair because some athletes would simply take higher doses than others. Once again, this does not encompass the full scale of steroid use. As with the majority of things in life, steroids follow the concept of diminishing returns. In this case it means that each dosage increase will result in less performance increase than the previous increase.  Take for example the study previously mentioned that was published in the American Journal of Physiology, Endocrinology, and Metabolism. Three groups were given high dosages of testosterone enanthate: 125mg (milligram), 300mg, and 600mg. The groups found an average increase in lean body mass (lbm) of 7.48lbs, 11.44lbs, and 17.38lbs respectively (Bhasin). Dividing lbm by amount of testosterone enanthate injected shows the amount of muscle gained per mg of testosterone. The three groups had pounds of lbm increase per miligram of testosterone values of .0598, .0381, and .0290 respectively. This clearly demonstrates that dosing of AAS does not follow a linear increase, but rather AAS have a threshold point in which increasing dosage fails to increase performance any more. While the exact value to which increasing dosage fails to provide any significant benefit is unknown and may differ between individuals, this shows that AAS do in fact hold a performance increase threshold.

Another common argument as to why steroids are cheating is that they are a shortcut. Steroids are far from a shortcut in any respect. Muscular hypertrophy requires two factors: a stressor and recovery period (Rippetoe 23-24). A stress is any sort of extreme tension placed on the muscle and central nervous system , while a recovery period is the time where no stress is applied to the body and the body adapts to the previous stress allowing the muscles to gain protein and increase in efficiency. While AAS do support muscular hypertrophy and motor neuron recruitment in the central nervous system, the body still requires a stressor to create an adaptation to facilitate muscle growth. This means that the athlete still needs to work out and lift weights in order to gain the performance advantage. Steroids effectively increase recovery efficiency, which means that the individual who is taking steroids will recover quicker. This also means that people who are cycling can workout harder than before since their bodies are now capable of recovering from heavier stress. And in respect to sports, this means that steroids allow athletes to put in more effort than before.  By this logic, steroids can make sports more competitive by allowing athletes to work harder for improved performance. The people who would benefit most are those who are truly dedicated, since they would be capable of working out more than if they were not cycling steroids. 

Overall AAS are an extremely misunderstood drug with over-exaggerated health implications and under-rated health benefits. Changes in cognitive functioning in humans has never been supported by research. Steroids have not been shown to be detrimental to health and are in fact safer than many prescription medications. In professional sports, steroids can allow athletes to achieve previously unheard of athletic ability while also allowing them to train harder than ever before. The subject of roid rage has been debunked as a myth built on the faulty premise of fallacious argumentation. AAS have no reason to be illegal in the United States because their original decision to become illegal was not based on scientific evidence. Legalization of steroids would benefit society as those taking them would no longer have to hide their faces in shame, but can instead be admired for their hard-earned achievements. These people would no longer have to live lives of disgrace and stereotyping, but instead be encouraged to break records and become the strongest and most athletic human beings they can possibly be.

References:
Bigger, stronger, faster* [Motion picture]. (2008). Magnolia Home Entertainment.
Bhasin, S. (2001). Testosterone dose-response relationships in healthy young men.   American  Journal of Physiology Endrocinology and Metabolism.
Cohle, S. (2013). Fatal coronary artery intimal hyperplasia due to amphetamine use.  Cardiovascular Pathology, 22(3), E1-E4.
Llewellyn, W. (2010.). William Llewellyn's Anabolics (E-Book ed., p. 1496).
Solomon, E., Berg, L., & Martin, D. (2011). Endocrine Regulation. In Biology (9th ed.) Pacific  Grove, CA: Brooks/Cole Thomson Learning.
Rippetoe, M., & Kilgore, L. (2006). Practical programming for strength training. Wichita Falls  Tex.: Aasgaard.