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Muscling in on the act

Body dysmorphia is becoming a problem for young men just as anorexia is a major problem for women

Jo Carlowe | 2003

At an infertility clinic in the northeast of England, the staff have got used to the steady stream of male patients whose bodies ripple with muscles, but whose testicles are disproportionately small.

Dr Jane Stewart, consultant in reproductive medicine at the International Centre for Life in Newcastle upon Tyne, says a sizeable proportion of the men she sees each year fall into this category, and each time the signs - small testes, large muscles and infertility - point to one obvious cause: these men are abusing anabolic steroids. 'If men take high doses of steroids, it suppresses the hormone stimulus to the testes reducing sperm production and the size of the testicles,' she says.

Doctors use steroids, a drug derived from the male sex hormone testosterone, to promote growth and repair in body tissue. Burns victims or patients with osteoporosis can benefit. However, steroids have been misused since the 50s when the Russians recognised their performance-enhancing effects. Sports professionals and amateurs in other countries soon followed suit. But while the spotlight may fall on professional sports stars, abuse is far more widespread than we might imagine.

The majority of patients that Dr Stewart sees are in their thirties - the age at which they and their partners have tried and failed to conceive and have come to realise that medical intervention has become necessary. But these more mature steroid abusers are just the tip of the iceberg.

A recent survey of 1,000 English school children revealed that anabolic steroids were the third most commonly offered drugs behind cannabis and amphetamines - more than six per cent of boys and one per cent of girls claimed they had been offered them. And when the Departments of Health for England, Scotland and Wales commissioned a report entitled Anabolic Steroid Use in Great Britain , focusing on 21 British gyms, they found that more than nine per cent of male respondents and two per cent of women had taken steroids. A study in the northeast suggested the figure could be way higher, with nearly 40 per cent of male gym goers saying they had used anabolic steroids.

Many of the people abusing steroids are body builders or weightlifters, but others are the 'occupational users' such as door supervisors, security men, prison wardens and policemen.

Ironically, while sports professionals who exploit performance-enhancing drugs steal headlines, they are probably taking these drugs 'safely'. The men in the gymnasium locker rooms of south London, Newcastle or Glasgow, who hand over ´┐Ż150 for an eight-week steroid cycle are unlikely to have the same access to liver- function tests, blood monitoring and top toxicological advice.

Sports nutritionist and former natural body-building champion Anita Bean, author of The Complete Guide to Strength Training, spent 10 years pounding her body into shape at hardcore gyms in the southeast, before winning her title.

She watched in frustration as women who trained only half as hard developed thicker muscles by popping pills.

'All around me, women and men would talk about how many shots or tablets they were taking. There was one lady who took steroids who was incredibly strong and developed a deeper voice. The steroids were mostly supplied by the gym owners, who make a tidy extra income.'

Keith, a strength trainer who knows at least 30 steroid users, says dealing is 'fairly open, although not generally done in front of strangers'.

'The drugs originate in Europe,' says Keith, 'where in some countries it is possible to purchase them from a chemist. They are bought in bulk and sent to the UK. There is also the internet and a small number of mail-order companies operating out of Asia who will mail your order to your home.'

Most users take a cycle of steroids for between six and 12 weeks and then break for a similar duration. Many take multiple drugs - known as 'stacking' - and medics suggest that the doses used by body-builders may be up to 40 times higher than the amounts prescribed to patients for medical reasons. In a study of 110 users, half had taken three or more different drugs and most were injecting them. In the northeast of England (where much of the research has come from), it was estimated that 60 per cent of people accessing needle exchanges were not using heroin but injecting anabolic steroids.

As well as infertility, excessive use of steroids has been associated with liver disease, jaundice and prostatic cancer. Men using steroids are prone to acne and baldness and heavy users may develop breast tissue (gynaecomastia), which may have to be removed surgically. Steroids can also lower high-density lipoprotein ('good' cholesterol) and raise blood pressure. Dr Roslyn Carbon, sports physician for UK Athletics, says steroids can also cause a host of psychological side-effects including increased aggression ('roid rage'), irritability, reckless behaviour and depression.

In women, the effects are similar, but include a deepening of the voice, menstrual irregularities, a reduction in breast size and enlargement of the clitoris.

However, by sharing information and seeking advice from The Underground Steroid Handbook or the internet, many users have learned to combat side-effects by juggling a cocktail of additional powerful drugs with their cycle of steroids.

Take Bradley, who has been using steroids on and off for 20 years. 'The only side-effect I have suffered is a little gyno [breast tissue development], but this is easily combated by using Nolvadex.'

Breast tissue develops because substantial use of steroids can cause androgens (male sex hormones) to convert into oestrogen. Nolvadex is the trade name for the oestrogen-blocking drug Tamoxifen, used as a treatment for breast cancer.

Other drugs commonly used in conjunction with anabolic steroids include Clomiphene - a fertility drug given to women to induce ovulation - and human chorionic gonadotrophin (HCG) another female fertility drug used by male steroid-users after they have completed a cycle of steroids to kick-start the production of testosterone.

A foray into the body-building community reveals that most anabolic-steroid users are aware of the risks, but also know that steroids will enhance their physical performance and body shape to a degree that they could never achieve through natural methods alone. For many, the rewards are just too seductive to resist. Anita Bean even recalls one user who developed liver cancer just prior to his 40th birthday, going back on steroids straight after the cancerous cells had been removed.

'Some of the guys are constantly searching for the secret weapon that will make them look right. They would take anything - even horse steroids.'

Steroids mask fatigue, speed up a person's performance and give them a faster recovery time. The drugs also increase muscle mass and strength, and all users talk about increased levels of confidence and vastly enhanced libidos. 'It was like going through puberty again. I lost count of the erections I had in a day,' says one male user.

Danny, a 25-year-old physical trainer who has been using steroids since he was 18, claims steroids have raised his self-esteem 'through the roof'.

'The effects are amazing,' he continues. 'I have increased strength dramatically and my body looks great.'

Tellingly, however, he adds, 'Other people noticed the results before me. I am never happy with how I look - all bodybuilders are very critical of themselves.'

If this sounds reminiscent of the anorexic women who stare in the mirror at their skeletal bodies and complain of feeling fat, then it comes as no surprise to learn that someone has already coined the term 'biggerexia'.

And while many have complained that the diminishing dimensions of Barbie may have permeated into the psyche of young females, GP Dr Robert Dawson, of The Drugs in Sports Clinic and User's Support service in Durham (Discus), believes children are just as influenced by a bombardment of more macho images of the body beautiful.

'In toy stores, figurines have taken on dimensions associated with the extremes of nature and are sold with advertising campaigns using body-building terms such as massive, chiselled and rippled. Is it much wonder that body dysmorphia is a problem for young men just as anorexia is a major problem for women?' he asks.

Yet the philosophy of Discus is harm-minimisation and promotion of clean needles, rather than coercion to stop.

And while many body-building enthusiasts would prefer to achieve results naturally, the use of anabolic steroids is well tolerated within the body-building fraternity.

'The majority of those who use them are intelligent people who research for years finding out how they work and how to use them,' says Lee, a 27-year-old engineer. He has never used steroids, but has no objection to others taking them. 'How anabolic steroids are classed as the same as cocaine is beyond me.'

Likewise, strength trainer Keith, who does not take steroids, believes the negative effects are overstated.

'Ask a doctor for an off-the-record opinion and they will tell you that in general the people who use these drugs are exercising regularly, have a good diet, don't drink or smoke and are doing themselves no more harm that the average Brit who smokes, drinks and eats junk food. The real problem with performance-enhancing drugs is ignorance - many people see it as a quick fix, take the wrong dosages, the wrong drugs and use them for far too long.'

But in Anita Bean's view, body-building steroid abusers are cheating nobody but themselves. 'Steroids are not a substitute for self-esteem - you get that through good hard training.'

And Dr Carbon of UK Athletics is adamant that there is no good reason to use anabolic steroids outside a clinical setting.

But while the drug-taking sports pros have expert advisers on tap to help them deal with these side-effects, the same cannot be said for the amateurs. Parents may worry about their children abusing ecstasy or coke, but these aren't the substances that their teenage boys will turn to when they want to make that transformation from seven-stone-weakling to ´┐Żbermensch. –Mail & Guardian

Some names have been changed to protect identities




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