Anabolic steroids not only produce major side effects during usage, including heart failure and depression, but they can also be potentially dangerous years after discontinuation, according to two studies presented at the 25th European Congress of Endocrinology concluded in Istanbul recently.

The studies, carried out by researchers from the Copenhagen University Hospital Rigshospitalet who investigated the impact of anabolic steroids in former users, found that former steroid users are more likely to develop heart disease and report a worse quality of life in their physical and mental health when compared to those who have never used them.

Anabolic steroids,  a group of synthetic hormones that mimic the naturally occurring sex hormone testosterone, are used to gain muscle mass and improve athletic performance.

These performance-enhancing medicines have negative side effects, such as breast development, hair loss, decreased testosterone levels, erectile dysfunction, and an increased risk of heart disease, stroke, and liver or kidney failure in males.

However, according to the researchers, nothing is known regarding the long-term effects of these drugs.

In the first study, the researchers examined 64 healthy men between 18 and 50 years of age who undertook strength training in Denmark and found that 28 of them were using anabolic steroids and currently 22 were former steroid users, and 14 had never used these steroids.

Assessing how much blood flowed to their heart muscle when resting and exercising, using a Positron Emission Tomography-Computed Tomography (PET-CT) scan with the radioactive tracer Rubidium-82, the researchers found both former and current users had poor blood flow to the heart.

According to the researchers, findings indicate that former steroid users are more likely to develop heart disease when compared to those who have never used them.

“Previous studies have shown that the heart function almost normalises after anabolic steroids are discontinued, but our study suggests that former anabolic steroid users are at an increased risk of heart disease years after stopping as cardiac microcirculation, the blood flow through the smallest vessels in the circulatory system – seems persistently impaired,” said lead author Dr Yeliz Bulut.

“The previous use of anabolic steroids could be a new risk factor for developing cardiovascular disease,” she added.

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Dr Bulut and her colleagues gathered questionnaires and blood samples from three groups of males aged 18-50 in the second study 89 current anabolic steroid users, 61 previous steroid users, and 30 men who had never used steroids.

They found that despite stopping years ago, former anabolic steroid users have a lower quality of life regarding physical and mental health, such as fatigue, social functioning, and emotional well-being.

Furthermore, the researchers found that compared to those who had never used steroids the user group had lower testosterone levels.

“Our study adds to the growing body of literature that an impaired quality of life in previous anabolic steroid users seems to persist years following cessation and could be caused by both withdrawal and or hypogonadal symptoms due to a sudden drop in testosterone levels in the blood,” said Dr Bulut.

“Sadly, a reported worse quality of life could be a reason for former users to start reusing these steroids again, she added”

The fact that both of these research comprised a small number of anabolic steroid users, past users, and non-users is a limitation of the study.

Given this, Dr Bulut and her team plan to recruit more men to the studies to assess these links with former steroid abuse on a larger scale.

“Our initial findings show that previous anabolic steroid users are likely to develop heart disease and have a decreased quality of life, but we need to confirm these results with larger studies and investigate how the risk changes about the years of usage and cessation,” Dr Bulut said.

“Steroid side effects among former users seem to persist for a much longer period than we have known until now. We hope our results on these long-term health risks will prevent men from using anabolic androgenic steroids,” she added.