Possible unwanted side effects

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Many androgens are capable of being metabolized to compounds which can interact with other steroid hormone receptors including the estrogen, progesterone, and glucocorticoid receptors, producing additional (usually) unwanted effects:

* Possible elevated blood pressure
* Cholesterol levels –Some steroids can cause a increase in LDL, Decreased HDL levels. This can cause a increase in risk of cardiovascular disease or coronary artery disease in men with high risk of bad cholesterol.
* Acne– Due to the stimulation of sebaceous gland
* Conversion to DHT (Dihydrotestosterone). This can accelerate or cause premature baldness and prostate cancer.
* Altered left ventricle morphology – AAS can induce an unfavourable enlargement and thickening of the left ventricle, which loses its diastolic properties with the mass increase. However the negative relation of left ventricle morphology to decreased cardiac function has been disputed.
* Hepatotoxicity – Caused particularly by oral anabolic steroid compounds which are 17-alpha-alkylated in order to not be destroyed by the digestive system.
* Gingival overgrowth - AAS is closely associated with significant levels of gingival enlargement.

Male-specific side effects

* Gynecomastia – Breast development in males. It is usually due to high levels of circulating estrogen. These high levels are the result of the increased level of conversion of testosterone to estrogen via the aromatase enzyme.
* Reduced sexual function and temporary infertility
* Testicular atrophy – Temporary side effect that is due to decreases in natural testosterone levels inhibiting spermatogenesis. As most of the mass of the testes is developing sperm, the size of the testicles usually returns to normal within a few weeks of discontinuing anabolic steroid use when spermatogenesis resumes.

Female-specific side effects

* Body hair increase
* Deepening of the voice
* Enlarged clitoris (clitoral hypertrophy)
* Temporary decrease in menstrual cycles

Adolescent-specific side effects

* Stunted growth – Abuse of the agents may prematurely stop the lengthening of bones (premature epiphyseal fusion through increased estrogen)
* Accelerated bone maturation
* Slight beard growth

An ideal anabolic steroid (a hormone with purely anabolic effects and no virilizing or other side effects) has been widely sought. Many synthetic anabolic steroids have been developed in an attempt to find molecules that produced a higher degree of anabolic rather than virilizing effects. Unfortunately, the most effective steroids known for increasing lean body mass also have the strongest androgenic characteristics.