NOTE: Psychiatric changes associated with anabolic steroid abuse are discussed in Chapter 18, and the withdrawal syndrome in Chapter 32.
Desired effects:
(1) increased skeletal muscle mass
Undesirable effects:
(1) gynecomastia
(2) testicular atrophy with infertility
(3) impotence
(4) acne
(5) accelerated male pattern hair loss
(6) increased facial and body hair
(7) hypertension and premature coronary artery disease
(8) fluid retention with edema
(9) jaundice
(10) rarely liver tumors (peliosis hepatis, other)
(11) excessive strain on tendons, with risk of tendon rupture
Undesirable laboratory findings
(1) hyperlipidemia
(2) oligo or azoospermia
(3) abnormal liver function tests, including hyperbilirubinemia
(4) depressed levels of serum testosterone
Behavioral change:
(1) preoccupation and dissatisfaction with physique
Differential diagnosis:
(1) changes of puberty (acne, gynecomastia, facial hair)
(2) androgenic steroid producing tumor
