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Pharmacists On Steroid Use

These pills can kill.

Nearly 7% of all male high school students have reported consuming anabolic steroids. Pharmacists, therefore, have to step in and caution users about their possible dangers, urged Brian Isetts, Ph.D.

Isetts, director of continuing education at the Minnesota Pharmacists Association, addressed the members of the American Pharmaceutical Association at the APhA annual meeting in Anaheim, Calif, With the continuing growth of the use of steroids, he said, pharmacists need to be part of the “team” that addresses the matter. “We need to provide accurate, reliable information.”

Pharmacists, he added, should work in conjunction with local high schools to arrange to give talks to the students. The talks can be followed up by letters to parents. This can also result in the pharmacist’s becoming more visible in the community and can bring more customers into his store, he noted.

Isetts encouraged pharmacists to work with high school educators, as well, in incorporating courses about anabolic steroids into the school curriculum. “We have courses in drug abuse now,” he said. And misuse of anabolic steroids by students could eventually become just as widespread.

Pharmacists, he continued, can serve as advisers in athletic settings, such as gymnasiums, as well. Pharmacists have been asked to serve on the training crews of the National Collegiate Athletic Association, an organization that ensures the integrity of drug testing.

Warning young people about anabolic steroids, said Isetts, is part of the whole science called sports medicine, He defined sports medicine as the “science and practice of dispensing drug information, medication, and durable medical equipment as an aid to individuals trained to compete in exercise, sports, or games requiring physical strength, agility, or stamina.” He also noted that muscle failure, unlike, as an example a hard drive failure, is something that athletes cope with readily on a daily basis.

In looking at the history of anabolic steroids, Isetts pointed out that in the 1960s, there were case reports of their side effects, such as peliosis hepatis. In the 1970s, there was much debate about whether or not anabolic steroids improved strength and enhanced the performance of individuals. The metabolic effects and biochemical mechanism of actions were also scrutinized. In the 1980s, the debate spread to other performance-enhancing drugs, specifically androgens.

Isetts said these drugs are taken by some for no other reason than to “improve one’s appearance and look good. In life, we’re rewarded for having a muscular body and looking good. Somehow, we’ve lost the true purpose of sports-that is, to provide a means of recreation.”

These drugs do have therapeutic value, he said. However, all the recent “media hype” has left a “credibility gap” about their medical effectiveness.

Steroids, he continued, basically stimulate protein synthesis. Androgens, one type of steroid, are used in males to stimulate puberty in cases where it is delayed. They are also used as replacement therapy for hypogonadism. In females, said Isetts, androgens are used for treatment in some forms of metastatic cancer.

Anabolic steroids are used to treat anemia, to promote weight gain following surgery, and as an antidote to hereditary angioedema he added.

But, Isetts cautioned, individuals build up an addiction to these drugs. Some of the adverse side effects can include liver damage and tumors, peliosis hepatis, blood lipid changes, mood swings, and clinical depression.

In men, misuse of drugs can cause infertility, impotence, breast enlargement, and testicular atrophy. In women, the drugs can result in menstrual irregularities, facial hairs, and decreased breast size. In men and women, the drugs can result in baldness and acne.

Isetts noted that four states: Alabama, California, Florida, and North Carolina-currently have laws that classify anabolic steroids as controlled substances. Eight other states have legislation on the books to increase the penalties against their illegal use, he added.

The lure of the drugs, concluded Isetts, is that they provide a shortcut to achieving dramatic changes in stature.” He pointed out, however, that in trying to speed up Mother Nature, the “natural growth process is affected.” treatment for cancer in the neck or mouth, also often have difficulty swallowing.

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Ladies Get Pumped!

Gettin' Freaky!

Just a few years ago they were heralded as the Ladies of the ’2000s: strong, powerful, sleek, and sexy-looking women. Today, many of them are muscle-bound to such an extreme extent that they are viewed with mild disbelief and a strange curiosity. The question in most people’s minds is: Why would a woman want to do that to her body?

A decade has passed since women first became part of the sport of bodybuilding. Their involvement was natural, coming on the heels of the ’70s, when women were integrating themselves into a variety of previously male domains. It was further fueled by America’s fanaticism for fitness in the early ’80s.

The sport began as a new forum for appreciation of the female form. Unlike beauty contests, where the winners are determined primarily by genetics, a bodybuilding contest could be won by hard work, dedication, and intelligent training. The concept appealed to the feminist mindset of the day. It gave women more options and control over how their bodies looked. From the spectator side, it afforded the opportunity to see a new type of hard-body beauty–as well as another exclude to watch bikini-clad women–and the sport of women’s bodybuilding drew crowds and media attention.

In the gyms, posters of Lisa Lyon straining against a sweat-soaked T-shirt with dumbbell in hand went up almost overnight. Then along came Rachel McLeish, and with her particular brand of flex appeal she changed a fledgling sport into a social phenomenon that sent millions of women to the gym, and thousands of women in search of fame and fortune in the sport of women’s bodybuilding. Jane Fonda stepped onto the pumping-iron bandwagon, and even Madonna began flexing her biceps on stage.

Like any activity with a potential for publicity, bodybuilding attracted its share of beautiful women looking for a break into modeling, movies, or whatever. It provided a new competitive arena for gymnasts, swimmers, and other female athletes who found themselves already past their prime at age 19. It answered the prayers of women who, given a better-than-average mix of male hormone at birth, had lived their lives embarrassed by their natural muscularity and husky builds.

But somewhere between then and now, something went wrong. Terribly wrong.

Today, when you switch your cable sports channel to a women’s bodybuilding competition, some in the lineup look like they belong at a Barnum and Bailey circus. An 18-inch bicep is not uncommon, nor is a back that flares Cobra-like to more than 50 inches on the tape measure. Soft, feminine body fat and breasts are practically non-existent on these women, who overshadow the few who still sport some curves and peaks. These hulkish women look like men wearing bikini tops.

Even some of the women who popularized the sport have trouble accepting what it has become. “It’s a perversion of the female gender,” says McLish, who retired from competition five years ago. “It’s sad for me to watch these women trying so hard to be sexy, posing with these gyrating movements, overdone fingernails, too much makeup, and silly bows in their hair. They’re overcompensating for what they’ve done to their bodies.”

THE CULPRIT

What turned this sport that began with such good intentions into the strange spectacle it is today? The same menace that’s casting a dark shadow over many sports: anabolic steroids.

These drugs mimic the effect of male hormones, and while their use can go relatively undetected in some males, the effects upon women are often quite obvious from the onset: bulging muscles, deep voices, beards, loss of scalp hair, loss of breast tissue, enlargement of the clitoris, acne on the face and torso, and coarse, thick hair on the chest, back, and shoulders. Some of these effects, such as excessive hair growth and deepening of the voice, are irreversible.

The drugs used for muscle building are basically the same hormonal therapy a transsexual would undertake to change her secondary sexual characteristics to those of a male.

I have personally known women bodybuilding competitors who have had to tape their steroid-enlarged clitoris down to keep the bulge from showing during competition. I know several who wear wigs because steroids have caused their hairline to drastically recede. Other friends have developed deep bass voices.

The effects of steroids are unpredictable. One woman might increase her size by 10 pounds of muscle in two months; another might experience only a subtle change. One woman’s voice may lower drastically while another’s stays the same.

In the early part of the decade when women bodybuilders first began experimenting with steroids, very little was known about their side effects. Sure, some U.S. Olympic coaches were knowledgeable in the area, but women bodybuilders weren’t being coached by Olympic trainers–they were taking their cues from male bodybuilders, many of whom use steroids.

Bodybuilding is a subculture that as a sport has never been accepted into the mainstream. If you want to learn about bodybuilding, you don’t ask your high school coach. You go to the gym in town that has the biggest guys.

That’s exactly where women went, and the men were more than happy to heap attention on them. That attention, not to mention the abundance of good-looking guys, provided added incentive to keep women at the sport. From the men, the women learned what to eat–a diet, perfected over 30 years, that lowers body fat to a minimum. They learned the men’s training techniques. They also began to use steroids. And as they gained muscle, their efforts were applauded by the men they trained with. They became the center of attention in the world of bodybuilding.

In the meantime, the competitive aspects of the sport were growing almost too fast for any organization to control. It was not uncommon for over 100 women to enter a small show.

At first, only a few women used steroids, but a few were enough to set change in motion. The women who trained naturally were forced to train and diet fanatically in an attempt to gain the extreme muscular size and excessively low body fat that the women on drugs were displaying.

The sport’s main governing bodies–the National Physique Committee (NPC) and the Amateur Athletic Union–saw this trend early on and attempted to dissuade the “drug-look,” as it was being called. The NPC, for instance, advised its judges to give lower scores to competitors with excessive muscularity.

But the bottom line is that bodybuilding is a sport of muscle, and by mid-decade, the women with the biggest and hardest muscles began to win. It came down to this: If you wanted to be competitive, you had to use steroids.

By 1985, over-developed muscle on women bodybuilders was no longer a rarity. Most competitions are based on weight classes, and body weights had increased so greatly that by 1986, a third division had to be added to accommodate the growing number of women in the heavyweight class of 125 pounds and over.

The bodybuilding organizations began drug testing in 1986. This drove some women at the elite end to use growth hormone, a substance that cannot be detected by drug tests currently in use. Aside from death, the worst side effect from growth hormone is a condition known as acromegaly, where the bones of the skull, hands, and feet actually grow. The result is an ape-like protrusion of the forehead and mumps-like swelling of the jaws, in addition to perversely large hands and feet.

A WORLD OF ITS OWN

Why would any woman go to such extremes? Bodybuilding is a world that’s easy to get caught up in. For many bodybuilders, their lives center around the gym. Their houses are littered with dog-eared copies of bodybuiding magazines. They know every name in the sport. They know all the latest training techniques. They take pride in belonging to this world of muscle, and receive all the support they need–so much support that outsiders gawking in disbelief don’t faze them.

“Somewhere along the line, women bodybuilders got off the track and their only motivation came from competition,” says McLish, who still trains with weights but adamantly refuses to be involved in the competitive aspects of the sport she pioneered. “It’s difficult to keep perspective when you’re training in the gym so intensely. All the attention is directed inward. When you focus in that close, you lose the whole picture. That’s what happened–we put too much emphasis on details, and lost the fact that we were women first.”

Concentration and dedication are certainly assets to a competitor in a sport. Elite athletes are extremists; they need to be to get that world record or gold medal.

But what price glory? It’s a sad fact that many women bodybuilders have taken drugs in exchange for a $25 trophy and fleeting fame in the muscle magazines. It’s a tradeoff that more and more women are deciding not to opt for. In the 1986 NPC Women’s Nationals, more than 50 entered the heavyweight division. Three years later, only 18 did. But will steroids ever be completely eliminated from the sport? I don’t think so.

“The fact is that drugs make people stronger, faster, and bigger,” says Cathy Palyo, a professional woman bodybuilder. “The side effects won’t scare athletes away. Surveys have asked athletes whether they would use a drug that guaranteed them a world record, but would kill them within a year. Seventy-five percent of the athletes is warped. I’m an athlete, I’ll vouch for it. You simply cannot clean up drug use in sports. It’s impossible.”

I don’t believe that women’s bodybuilding can ever turn itself around and begin to reward the small physique with first place. The standard has been set, and while it does not appeal to the general public, I believe it will always appeal to those deeply involved in the sport. There will always be fans who love muscle for the sake of muscle and others who love to see the unusual and odd.

While acknowledging the hardcore element of the sport, most competitors I know still wish drugs had never become part of it. If they knew then what they know now, they would have had no trouble just saying no.

Aside from the direct victims of steroids are the indirect ones: the women who have been scared away from the gym by the belief that a weight-training regimen will make their bodies unattractively muscular. These women are avoiding an activity that can impart beautiful, feminine, shapely muscle. It gives women control of their shape, size, and proportions. It builds flat and firm abdominals, round, fat-free rear ends, and attractive and very feminine bodies, like those of the women who started the sport.

If one thing can be learned from what has happened in the sport of women’s bodybuilding, it’s that big muscles are not natural to women. They won’t come easy or by accident, even to a woman who trains with a serious, aggressive routine.

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About Steroids

“Steroids. That’s what I’ll do,” he thought. “I’ll find a way to get some steroids. They make your muscles grow fast, and they make you feel confident. And, besides, I’ll only take them for a while until I bulk up and get on the first string. They can’t hurt me,” says Rick. Or can they?

Rick’s situation is not uncommon. The Journal of the American Medical Association (JAMA) recently reported that as many as 500,000 young people nationwide have used steroids. Some of them complete in sports. Others just want to look more muscular.

They may take the steroids thinking of the immediate gains. But they may not be aware of what is happening to their body when they take steroids. And many recent studies are showing that the harm that can be done to people who take steroids–especially those in junior and senior high school–far outweighs any immediate gain.

Natural and Unnatural

Steroids are natural chemical compounds found in the hormones in your body. Hormones help you grow and develop. Men and women have both male and female hormones in their bodies, although in different amounts. Since men have higher levels of certain male hormones that promote strong muscles and greater definition, it’s easy to think that if you increase the level of male hormones in a person, you’ll also increase that person’s size and strength.

Enter anabolic steroids–synthetic drugs that act like the male hormone testosterone. Anabolic steroids are the kinds of steroids taken by some athletes and other people interested in building their muscles and strength. They are not natural.

The U.S. Food and Drug Administration (FDA) has approved the use of steroids in specific doses as part of the treatment for certain types of anemia, cancer, and allergies. The FDA does not give its approval to the use of steroids by healthy men and women who want to improve their looks or athletic performance.

By Prescription Only

In addition, in the United States no one can purchase steroids without a doctor’s prescription. That’s partially because of the widespread abuse of the drug. In the 1950s, Russian athletes began using anabolic steroids, and by the 1960s American athletes were using them, too. The steroids were said to add muscle to a person’s body and increase aggression, thus giving him or her the edge in athletic competition.

But the use of steroids quickly got out of hand as larger and larger doses were taken by some athletes, even without supervision. They purchased the drugs on the black market, not knowing what the short- or long-term side effects of steroid use could be. Meanwhile, researchers began to learn about the harm that anabolic steroids can cause.

In his book Death in the Locker Room, Bob Goldman, an expert on anabolic steroids, writes of a young football star he calls “John.” John took steroids for several years. Then John developed cancer in his kidneys, and died as a result of the cancer. Goldman writes that since John’s death, it has been determined that the use of anabolic steroids can lead to the development of a rare kind of tumor in a person’s kidney–the kind of tumor that John had.

Recent studies also show that there’s a host of other side effects, including very serious ones, that are caused by anabolic steroids. Steroid use can cause acne, sterility (the inability to have children), kidney disease, liver disease, and cancer.

Women who take steroids may take on masculine physical characteristics, such as growth of facial hair. Steroids may also increase a woman’s risk of getting breast cancer and other diseases.

Special Effects

on Teens

When men and women take steroids, they are upsetting the delicate chemical balance in their system, and teens who take steroids are disturbing their normal growth.

Teens are experiencing great physical and psychological growth and therefore are at even greater risk than adults when taking steroids. In the long run, teens who use steroids may even experience stunted growth–exactly the opposite of what they wanted or thought the drug would do. Their reproductive systems can also be affected. A teenage girl who takes steroids may find out later in life that she cannot have children. A teenage boy who takes steroids may discover years later that he cannot father children.

Recent studies done at McLean Hospital in Belmont, Massachusetts, also shows hat steroid usage can cause abnormally aggressive behavior. One report cites the example of a teen in California who described himself as an “easygoing guy” before he began taking steroids at age 19. After taking steroids, he became more aggressive and, for example, would get out of his car and cause fights at intersections.

“You can walk in my parents’ house today and see signs–holes in the doors I stuck my fist through, indentations in walls I kicked,” he told a reporter.

Persons who start and then stop taking steroids can also experience extreme depression. An unnatural lift in spirits when on the steroids can be followed by an unnatural depressed feeling when off them.

The Cheating Issue

Whether or not you believe that steroids will affect your health, there is something else to consider: the ethics of using steroids during athletic competition. The drive to win has encouraged the use of steroids among many athletes, who take steroids because it makes their muscles larger. (Whether it makes their muscles stronger, too, is something that not all doctors and athletes agree upon.)

One thing that many major sports organizations do agree upon is that athletes who use steroids while competing are not playing fairly. Remember Canadian track star Ben Johnson, who set a world record in the 1988 Olympics and won a gold medal? After it was learned that he had been taking steroids, the International Olympic Committee took away his medal, gave it to American runner Carl Lewis, and banned Johnson from further competition.

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Staying Strong At A Desk Job

Being chair-bound for most of your workday can sometimes leave you fatigued, tense and generally sapped of energy. Worse ills can result–headaches, neck and back pains, stress, and perhaps even high blood pressure and heart attacks.

Robert Gedaliah, a speech and communications professor at City College of New York and a marathon runner in his spare time, has created an at-your-desk fitness program that you can follow without leaving your seat or disturbing fellow workers. It is not an exhausting physical workout and neither aerobic nor muscle building. Instead, it is a set of exercises he calls energizers. The regimen is explained and illustrated in his booklet P.E.P.: The Productivity Effectiveness Program.

The ten P.E.P. exercises, drawn from yoga, t’ai chi, the marital arts, running and archery routines, involve deep breathing, stretching, isometrics and relaxation techniques. Each calls for a gentle yet stimulating movement. All are designed to generate “high energy by increasing blood circulation, pumping fresh oxygen into your body and relieving muscle strain brought on by stress.”

Gedaliah claims nine minutes of P.E.P. exercises will give you a long lasting boost of energy and help you feel better. He proposes it as a no-calories alternative to the coffee or candy-bar break. (For more on exercise, see the articles that begin on pages 28 and 32.)

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Getting Your Best Foot Forward With A Workout!

Can any one exercise give you the ultimate fitness benefits?

Not according to new exercise guidelines from the American College of Sports Medicine (ACSM). The latest guidelines-the first update since 1978-recommend a regimen that pushes up more than just your heart rate; they now put more emphasis on building muscle strength and endurance. How to get overall conditioning? Mix and match your activities.

The table above can help. It shows the benefits and costs of 16 popular activities. Decide which sports suit your taste, pace and pocketbook, then weigh the dollar costs and injury rates against the fitness benefits.

Our panel of six experts rated each activity on a ten-point scale. Aerobics, which contributes to life-preserving cardiovascular health, gets top rating, up to four stars. Fat loss, or how efficiently the activity burns fat, gets a maximum of one star. Strength gets up to two stars; so does muscle endurance, which helps you repeat an activity. Flexibility-whether the activity helps you stay limber-gets a maximum of one star.

These ratings represent a shift in values from what the same experts told Changing Times three years ago, when aerobics was the last word in fitness. Aerobics gets fewer maximum points, and strength and muscle endurance get more. That shift reflects the ACSM’s latest findings, which link strength training with better posture and prevention of osteoporosis. “Muscle just fades away if it’s not being used,” says Michael Pollock, a panelist and key author of the ACSM’s report.

Panelist Paul Ribisl, who at 51 is a longtime runner, figures that his body would be better off today if he’d had more strength and muscle training: “When I was 20 or 30, 1 never had to worry about muscular endurance, never lost it. But it hits home as you get older. It means a better quality of life.”

You can meet the ACSM’s guidelines for a well-rounded fitness program by interspersing, say, weight lifting with running or calisthenics with swimming (which was also the highest-ranking activity the last time we rated the activities).

As you consult the chart, remember that the benefits you get hinge on two things: the time you take and the level of intensity you put forth. For example, for cardiovascular fitness, work out at your target heart rate at least three times a week. Or simply try to burn 300 calories in each workout. (That goal is reflected in the workout time on the chart.) Most people can keep injuries down and fitness benefits up by exercising for longer periods of time at lower intensity levels. Always remember to warm up and cool down. That will put you in great shape.

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