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With teens' bodies maturing earlier than at any time in history, I saw some incredibly fit high school athletes in my examination room. Some of the kids dedicated to physical fitness, though, were a little too muscular and had bulked up too much in a very short time for my taste. Still, their "cut" bodies amazed me: washboard abs, hulking shoulders, massive chests, bulging pecs and 19-inch necks.

Since I had a physical history of many of these kids, I had their pubescent past written down for me. If my nurse noted that Joe grew from six feet, 180 pounds to six feet-one inch, 210 pounds during the summer break, for example, I seriously considered whether Joe was taking anabolic steroids, which are synthetic substances related to the male sex hormones, or androgens. Anabolic steroids promote the growth of muscle size, especially in the chest and shoulders.

Gym rats call them "roids," but by any name, anabolic steroids are incredibly effective in bulking up young bodies, adding an extra 15 percent to 20 percent of lean, hard muscle to the torso. I know this is true because I once took steroids.

During my freshman year of high school, I was a proverbial 90-pound weakling, a small fry with a sunken chest. I wanted to bulk up and play football, so I dropped by a gym where many high school football players worked out. One of the guys running the gym introduced me to some little black "vitamin" pills. My 175-pound rail-thin frame morphed into a Hulk-like 200-pound fighting machine in a single summer. I made the football team and continued taking the pills for another year or so, unaware that I was really taking an anabolic steroid called Dianabol. I never had a clue that I was doing something dangerous to my body.

Studies show that abuse of oral or injectable anabolic steroids is associated with an incredibly increased risk for premature heart attacks and strokes. In addition, most oral anabolic steroids are associated with increased risk for severe liver problems, including cancer of the liver. Furthermore, injecting steroids with shared needles or nonsterile injection techniques can cause HIV/AIDS, hepatitis B and C, and bacterial endocarditis.

Most surprising of all, instead of enhancing body image, steroids can do the very opposite. In boys and men, the abuse of anabolic steroids can reduce sperm production, shrink the testicles, and cause impotence and irreversible breast enlargement. Girls and women can develop more masculine characteristics, such as deepening of the voice and excessive body hair. In both sexes, anabolic steroids can cause acne and hair loss. These side effects can occur with any of the anabolic steroids.

You will not be able to tell your kids that steroids don't work. They do work, but at a cost. A number of high-profile athletes who took steroids saw their bodies give out in their thirties and forties. Besides potential heart problems and liver cancer, more immediate are the psychiatric side effects that cause steroid users to "act out" aggressively and recklessly. Steroids provoke manic symptoms, such as aggression, euphoria, grandiose beliefs, reckless behavior and a decreased need for sleep. A name has been given to this type of steroid-induced behavior—'roid rage.

The long- and short-term consequences of steroid use make it a dangerous gamble for teens. Similar risks are associated with "dietary supplements" such as creatine, ephedra or androstenedione (aka "andro"). But many young people think they're indestructible or that they'll beat the odds. They focus on the present with little concern for what may occur in midlife. That's why it's up to us to help them understand the risks. Continued health is worth far more than any boost they might get from performance-enhancing drugs.

Dr. Larimore was a family physician in private practice for nearly 20 years before joining Focus on the Family as vice president, family physician in residence. He is the author of numerous books, including God's Design for the Highly Healthy Teen and The Ultimate Guys' Body Book: Not-So-Stupid Questions About Your Body.

Published August 2004

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Steroids threaten our daughters, too. A 2005 report found that girls as young as nine years of age have been using anabolic steroids as a shortcut to achieving the lean, buff look of their favorite female celebrities. Dr. Gary Walder, an expert on steroid abuse at the New York University School of Medicine, commented, "When I was growing up the ideal was to look like Twiggy, and the result was anorexia. In recent times the look is more muscular, and that, in essence, is what young girls are seeing as the ideal."

Consequently, different government studies have found that 5 percent of high school girls and 7 percent of middle school girls admit to anabolic steroid use. Two-thirds of them are not involved in sports, according to the sports medicine division at Oregon Health and Science University. So while parents have been guarding the front door against the known threat of eating disorders, steroids have slipped in the back.

The result of using what are basically male hormones on a growing girl's body can be grim. She will still put on weight, though it will be mostly muscle. She'll see more hair where she doesn't want it (on her face) and less where she does (on her head). Her voice will deepen, her breasts will shrink or stop growing, and she may develop severe acne on her face and back. Those are just the outward symptoms. As with boys, steroids elevate blood cholesterol and triglyceride levels, leading to premature hardening of the arteries, and they can lead to tumors and liver abnormalities.