Testosterone was one of the first performance-enhancing drugs to be used in sport. In combination with strength training it is a powerful muscle strengthener, an anabolic. When scientists succeeded in manufacturing the hormone synthetically it fairly soon became all the rage among sportsmen. But not only sportsmen: Adolf Hitler and other top Nazi leaders became users. Servicemen were given doses to increase their belligerence and aggression. The mafioso Al Capone’s devotion to the drug accounted for his hoarse voice.
American research blew the whistle: testosterone and the derived anabolic steroids turned out to have too many side-effects. But athletes had realized that these ‘sweets’ helped enhance their performance, and the ban on use was flouted. During the world weightlifting championships of 1954 the coach of the losing team discovered this in an odd way. Several Russian weightlifters could no longer urinate normally, but had to insert a catheter to empty their bladders. After the victory, a tipsy Russian explained: as a result of daily injections of testosterone the prostate had swollen so much that the urethra was squeezed shut. There were no drug checks in those days, and meanwhile certain pharmaceutical companies steadily improved synthetic testosterone: injections became unnecessary and were replaced by pills, which proved to have less effect on the prostate. Bodybuilders, weightlifters, swimmers and racing cyclists flocked to take the wonder pills. The potential benefits of testosterone and its derivatives have probably been nowhere as thoroughly researched as in the former German Democratic Republic before the fall of the Iron Curtain. Whole series of theses appeared on the subject at Marxist universities.
On average the testicles produce between 5 and 7 mg of testosterone per day. If over and above that one administers testosterone in high doses, for example an extra 25 mg, the blood testosterone level scarcely changes, since the hormone is rapidly broken down in the liver. In order to achieve a really positive effect substances were developed that acted in the same way as testosterone, but were not broken down so quickly in the liver. These molecules, which were chemically closely related to testosterone, were called anabolic steroids. Examples include methandrostenolon, oxandrolon, danazol and tanazol.
Abuse has been and remains widespread. Many users are young, insecure men, who use anabolic steroids, in combination with physical workouts, to train not only their body but their mind. Unfortunately that is not the end of the story. Anabolic steroids turn the body’s hormone economy upside down: cartilage growth increases, causing, for example, the Adam’s apple to widen and the vocal cords to lengthen, so that the voice becomes first hoarser and subsequently lower. Body hair increases and women develop beards and moustaches, while in both men and women the hair on the scalp thins. The skin becomes thicker and greasier as a result of the increased number of sebaceous glands, so that anabolic steroid users suffer more from acne. In women the breasts tend to sag and the clitoris increases in size — the latter effect is irreversible and the organ, which is normally mostly hidden, will become more prominent. Pregnancy while using anabolic steroids is a risky business: a female foetus has a good chance of being born with masculine features. Fortunately, in the great majority of cases women using anabolic steroids will not succeed in becoming pregnant.
Men disrupt their hormone economy to such an extent that their own testosterone production decreases or completely stops. This is because the hypothalamus, the centre in the brain that regulates and adjusts testosterone production, receives the signal that more than enough testosterone is circulating in the body. The problem is that anabolic steroids differ from testosterone in that they cannot regulate sperm production, with the result that men become infertile. All men produce a small amount of female hormone, though in a healthy body that is only a tiny fraction compared with testosterone, but if an individual’s own testosterone production stops, the female hormones increase in importance, resulting in shrinking testicles and breastformation.