You play to win. You're always looking for a way to get an edge over your opponents.

The best athletes rely on practice and hard work to help them do their best. How about you? Ever tempted to use steroids? Well, keep this in mind—not only is it illegal, dishonest, and unfair, but you will be putting your health at risk!

Hype, Juice, Pump

You may have heard steroids called roids, juice, hype, or pump. Anabolic-androgenic steroids are powerful prescription drugs that some athletes use not for medical reasons, but as a way to boost athletic performance and build muscle and body mass. They work by acting like the body's natural male hormone, testosterone. Don't confuse them with corticosteroids, which are a different type of steroid used to treat diseases like asthma, arthritis, and many other medical conditions.

Remember, steroids might give you bigger muscles, but they cannot improve talent or skill. Athletic ability comes from a combination of things like your body size, age, gender, diet, and training—not just strength or muscle mass.

Steroids 101

Steroids can be taken in the following ways:

• By mouth (pills)
• By injection with a needle into the muscle
• On a patch, which allows the drug to soak through the skin

Some athletes take very large doses, called "megadoses." Others increase how much they take over time, called "pyramiding." Some "cycle" on and off steroids. Taking different kinds of steroids together, sometimes with other drugs, is called "stacking."

Know the risks

Steroid use always causes bad side effects. They can really mess up your body. Megadoses do not give faster results and using in cycles is not safer. Stacking is really dangerous. Even though some of the side effects go away when you stop using steroids, some may not.

Remember! These steroids act like the male hormone testosterone—so for both guys and girls, they can cause

• Acne, really bad acne, especially on face and back
• Baldness
• A slow down of growth in athletes who aren't done growing yet
• High blood pressure, unhealthy cholesterol changes, and heart disease
• Blood clots and stroke
• Liver damage, jaundice, or liver cancer
• Headaches, aching joints, and muscle cramps
• Nausea, vomiting, and diarrhea
• Sleep problems
• Increased risk of ligament and tendon injuries, which can end your athletic career for good

In addition, anyone injecting steroids with a needle and sharing needles with other users is at high risk for serious infections like hepatitis or HIV, which cause the AIDS virus. Using one type of illegal drug may also make other drug use more likely, and cause even more health risks.

In guys, steroid use causes the body to produce less testosterone. The result? Your testicles shrink. What else?

• A low sperm count
• Impotence (inability to get an erection)
• Breast and nipple growth
• Enlarged prostate (a gland in the penis)

Steroids can be pretty tough on girls' bodies too, causing

• Breast shrinkage
• More face and body hair
• Voice deepening
• Problems with menstrual periods
• Clitoris enlargement

Steroids can also mess with your mind and cause

• "Roid rage"—severe, aggressive behavior that may result in violence, such as fighting or destroying property
• Severe mood swings
• Hallucinations—seeing or hearing things that are not really there
• Paranoia—extreme feelings of mistrust and fear
• Anxiety and panic attacks
• Depression and thoughts of suicide

Performance Enhancers?

Besides steroids, some athletes use other substances that they think will make them better athletes. Some are illegal. All are unsafe. None can take the place of a good strength and conditioning program and a well-balanced diet. Here’s a list of some common “performance enhancers” and their known effects.

• Androstenedione (“andro”) — an over-the-counter supplement that claims to build muscle and increase strength (although scientific studies have shown it doesn’t). Really, it has the same risks as steroids. Andro has been banned by most major sport organizations and the US Food and Drug Administration (FDA).
• Creatine — Another over-the-counter supplement that claims to “bulk you up.” Can cause muscle and stomach cramps and dehydration. While not legally banned, its use is prohibited by the National Collegiate Athletic Association.
• Ephedra — Claims to burn fat and help you lose weight. Can actually cause heart attacks, stroke, seizures, and sudden death. Banned by all major sports organizations and the FDA.
• Protein supplements — Claim to build muscle and bulk. Can cause serious kidney problems from protein overload. Not banned at this time.

It is important to know that these substances are called “dietary supplements,” so they are not included in what is regulated by the FDA. That means they are not tested by the FDA to see if they really work or are safe. No FDA regulation means all sorts of claims can be made, like the product is “all natural” or “guaranteed to work,” but there does not have to be proof! Don’t fall for these claims! There is no science to back them up! Remember, to do your best as an athlete there is no replacement for a healthy diet, proper training, and practice.

Better safe than sorry!

Steroid use is dangerous, so it has been banned by most professional and amateur athletic organizations. These organizations include the International Olympic Committee, National Collegiate Athletic Association, and the National Football League. If you are serious about your sport and your health, you don't need drugs to prove yourself. Instead, keep yourself healthy by

• Training safely, without drugs
• Eating a healthy diet
• Getting plenty of rest
• Setting realistic goals (Be proud of yourself when you reach your goals!)
• Getting training, coaching, and advice from reliable professionals
• Playing safely and using protective gear
• Talking with your pediatrician about your health and nutrition, and how to prevent injuries and gain strength safely

Share this information with friends and teammates. Take a stand against the use of anabolic steroids and other drugs. Truly successful athletes combine their natural abilities with hard work to achieve their best. There is no quicker or easier way.

For more information

National Institute on Drug Abuse www.nida.nih.gov

National Clearinghouse for Alcohol & Drug Information http://ncadi.samhsa.gov

World Anti-Doping Agency www.wada-ama.org

International Olympic Committee www.olympic.org

National Collegiate Athletic Association www.ncaa.org

National Center for Drug Free Sport www.drugfreesport.com

Please note: Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of the resources mentioned in this publication. Web site addresses are as current as possible, but may change at any time.

The persons whose photographs are depicted in this publication are professional models. They have no relation to the issues discussed. Any characters they are portraying are fictional.

Copyright © 2007 American Academy of Pediatrics, Updated 2/07