All bets are off the table when high-dose testosterone and its many metabolites are used illegally, such as with anabolic steroid abuse. Strokes, embolisms, and cardiovascular disease are all more likely, as is sudden death, and liver and kidney disease. 44 In women, acne, irreversible deepening of the voice, baldness, increased facial hair, enlarged sex organs, breast reduction, depression, and infertility have all been reported. In adult men that abuse anabolic steroids, acne, baldness, permanent infertility, gynecomastia, loss of libido, erectile dysfunction, testicle shrinkage, and profuse sweating are all reported side effects. Increased testicular cancer hasn't been reported, though. 45,46
So can you win clean? As much as I’d like to think so, when you have this situation where a guy finishing in the top 10 is using drugs and being beaten by minutes on a mountain climb , I find it difficult to believe that physiologically, the margins can be that large. I believe that the NATURAL, physiological difference between riders is tiny – maybe 1% separates a champion from tenth place. So take a drug that improves performance by, let’s be conservative and say 5%, and that mid-packer still can’t win the race, then you have to wonder about the guy who is winning…?