The Pros and Cons of Steroid Use for Athletes: A Comprehensive Discussion

February 08, 2023

This article follows a discussion we recently had at the gym about steroid use and EPO (and other PED's like it) and accelerated improvement. Because it was such an interesting discussion, we decided to put this discussion into article. To preface the argument, we're neither for, or against. Our perspective comes from a coaches view. As a coach, you want your athlete to perform at their absolute best and smash the competition. However, as a mentor, you want to guide, protect and care for your athletes physically and emotionally.

There's 4 components we broke this down to:

1. Directly associated increases in physical performance,
2. indirect associated increases in skill development and,
3. the compounding interest principle.
4. All the reasons not to take PED's.

First thing first, the pros of steroids/EPO:

The pros of steroid use include:

1. Increased muscle size, strength and rapid recovery: Steroids work by stimulating the body's natural processes for building muscle, allowing athletes to achieve greater gains in a shorter period of time. This can be particularly beneficial for athletes who are looking to improve their overall physical appearance and performance.

2. Accelerated learning curve: Steroids can also help athletes to more effectively train several times a day, speeding up their learning curve and allowing them to develop skills, learn and improve more quickly. This is because steroids can increase energy levels, endurance, and recovery time, making it easier for athletes to train harder and more frequently.

3. Improved body composition: Steroids can also have a positive impact on body composition, leading to a reduction in body fat and an increase in lean muscle mass. This can help athletes to achieve a more desirable physical appearance and improve their performance in their sport.

The pros of EPO:

1. Erythropoietin (EPO) can increase an athlete's aerobic capacity, as measured by VO2max, by improving the oxygen-carrying capacity of the blood. VO2max is a measure of the maximum amount of oxygen an athlete can consume during intense exercise and is an important indicator of endurance and athletic performance.
2. Studies have shown that EPO can increase the amount of oxygen-carrying red blood cells in the body, leading to improved endurance and exercise capacity, and potentially a higher VO2max. For example, a study published in the Journal of Physiology found that EPO use can increase the oxygen-carrying capacity of the blood by up to 20%.
3. This can result in an increase in VO2max, leading to improved endurance and athletic performance in endurance sports such as cycling, running, and cross-country skiing. This increase holds true across combat sports as well.

Now, bear with us on this one, because we're bringing compound interest into the discussion:

Compounding interest refers to the growth of an investment over time, where the interest earned is reinvested, leading to exponential growth. For the sake of this argument, we'll use the context of a 200 km race, compounding interest can be thought of as the cumulative effect of small gains in performance over the course of the race.

For example, let's assume that an athlete has a 1% improvement in performance in each kilometer of a 200 km race. This may seem like a small improvement, but over the course of the race, it can add up to a significant difference in overall performance.

At the end of the first kilometer, the athlete will have a 1% improvement. At the end of the second kilometer, the athlete will have a 2% improvement (1% from the first kilometer and 1% from the second kilometer). By the end of the third kilometer, the athlete will have a 3% improvement, and so on. By the end of the 200th kilometer, the athlete will have a 200% improvement, or 2x the performance of what they started with.

In this example, the compounding interest of a 1% improvement in each kilometer of the race results in a 200% improvement in overall performance. This demonstrates the cumulative effect of small gains in performance, which can lead to significant improvements over time.

Summed up, the compounding interest principle can further be applied to sports specific skill development and sports performance, where seemingly tiny improvements in technique, training, and nutrition can add up over time to result in significant improvements in overall performance. 

From that perspective, most only look at the directly associated benefits of PED's in competition. How we see it? The real benefit is derived through compound interest in training BEFORE competition.

The CONS:

While PED's provide various short to mid term improvements, they come with several negative (long term) consequences that shouldn't be ignored.

1. The use of steroids can have serious negative effects on an athlete's health. Steroids can increase the risk of heart disease, liver damage, and various forms of cancer.
2. They can also cause hormonal imbalances, leading to infertility and impotence. Steroid use can cause mood swings, irritability, and aggression. In some cases, long-term use can lead to depression and other mental health issues.

EPO, on the other hand, increases the number of red blood cells in the body, which can cause thickening of the blood and increase the risk of blood clots, heart attacks, and strokes.

To cap it off. Ethically, the use of steroids and EPO is illegal in many sports and is considered cheating. From a professional perspective, the use of these PED's undermines the integrity of "clean" sports and takes away from the accomplishments of those who compete clean. Throughout history there's been plenty of examples of organisations who, for lack of a better word, "condoned" PED use. And to be completely fair, if everyone is on the gear then the playing field has been levelled. This then falls apart in a "clean" organisation where athletes look for an edge over their opponent. You could then argue that it is cheating.

What are your thoughts? 

References:

1. Pope, H. G., Jr., Kouri, E. M., & Hudson, J. I. (2000). Effects of supraphysiologic doses of testosterone on mood and aggression in normal men: a randomized controlled trial. Archives of General Psychiatry, 57(2), 133-140.
2. Peters, C. A., Martinez, C., & Gordon, G. E. (1999). The effect of anabolic steroids on the physical, physiological, and performance characteristics of American football players. Journal of Strength and Conditioning Research, 13(3), 181-187.
3. Kanayama, G., Hudson, J. I., Pope, H. G., Jr., & Gruber, A. J. (2010). Long-term psychiatric and medical consequences of anabolic-androgenic steroid abuse: a looming public health concern? Drug and Alcohol Dependence, 111(1-2), 1-12.
4. Howley, E. T., Bassett, D. R., Jr., & Welch, H. G. (1995). Criteria for maximal oxygen uptake: review and commentary. Medicine and Science in Sports and Exercise, 27(9), 1292-1301.
5. Pope, H. G., Jr., & Katz, D. L. (1994). Anabolic steroid abuse and psychiatric dysfunction. Drug and Alcohol Dependence, 36(3), 201-214.
6. Kraemer, W. J., & Ratamess, N. A. (2004). Hormonal responses and adaptations to resistance exercise and training. Sports Medicine, 34(4), 329-346.
7. Fineschi, V., Neri, M., & Turillazzi, E. (1997). Cardiovascular pathology and sudden death in anabolic steroid users. International Journal of Legal Medicine, 110(2), 72-76.

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