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They've caused global scandals. They're banned in most athletic competitions. But are steroids actually bad for you?
它在国际上恶名远扬，它被体育赛事所禁止，但类固醇真的对你有害吗？
The term "steroids" refers to a broad category of molecules that share a similar molecular structure, but have many different functions.
“类固醇”是一大类分子的统称，它们结构相似，却有很多大相径庭的功能。
When people talk about steroids in the context of sports, they're referring to a subset of steroids that resemble testosterone.
体育界口中的“类固醇”特指一类与睾酮相似的类固醇。
Though elite athletes and bodybuilders began using these steroids in the 1950s, today,
虽然顶尖运动员和健美人士从20世纪50年代开始服用类固醇，
most steroid users are actually not competitive athletes, but people seeking a particular appearance.
如今，类固醇通常用于改变身材，而非竞技运动。
These steroids have two main effects: androgenic, or masculinizing, and anabolic, or growth-promoting.
这种类固醇主要有两种效果：作为雄性激素起效，即雄性化，以及促进生长的“合成代谢”。
These effects mimic naturally-occurring testosterone, which drives the development and maintenance of male secondary sex characteristics and general growth in everyone.
这些效果与天然睾酮类似，有助于发展并维持男性第二性征，并对所有人群都有促进“生长”的作用。
That means testosterone and the synthetic steroids based on it promote body and facial hair growth,
具体而言，睾酮和基于睾酮合成的类固醇可以促进体毛、胡须生长，
enlargement of the vocal cords and deepening of the voice, increased muscle mass and strength, and increased stature and bone mass.
使声带变宽变厚、声音变低，增进肌肉质量与力量，以及增高、带来骨量增长。
Recreational steroid users are after the anabolic, growth promoting effects.
娱乐性类固醇使用者趋之若鹜的是类固醇的合成代谢，即生长促进功能。
To make muscles grow, steroids first promote protein synthesis -- proteins are essential building blocks of all cells, tissues, and organs, including muscles.
类固醇增肌第一步：促进蛋白质合成。蛋白质是构成所有细胞、组织、器官的基石，也是肌肉的基本组成部分。
Steroids also block cortisol, a signaling molecule that drives the breakdown of substances including proteins.
类固醇还能拮抗皮质醇，皮质醇分子会发出指令促进物质分解，蛋白质也不例外。
Finally, they may push the development of muscle, rather than fat, and boost our metabolism, shrinking fat deposits.
双管齐下，就有可能带来增肌不增脂的效果，也会增强新陈代谢，消耗脂肪存储。
These properties make steroids valuable for treating many illnesses and injuries.
类固醇的这些特性使其成为了治疗很多疾病和损伤的特效药。
They can help people with wasting illnesses, like AIDS and certain cancers, maintain muscle mass and help burn victims recover lost muscle tissue.
类固醇可以减少“消耗性疾病”患者肌肉流失，如艾滋病和某些癌症等疾病，也有助于烧伤病人的肌肉组织再生。
So if steroids are used as medicine, they must be safe to use recreationally, right? Well, it's not that simple.
既然是安全的医疗药品，娱乐性使用类固醇也一定安全吧？事情并没有那么简单。
To create the desired muscle growth, recreational steroid users must typically take doses orders of magnitude higher than those prescribed for a medical condition.
增肌所需的剂量极高，娱乐性使用者通常必须服用高于普通医疗用药若干数量级的类固醇。
Long term, high dose steroid usage can have both undesirable and outright harmful effects
长期、高剂量使用类固醇会带来令人不快，甚至有害的副作用，
some of them dependent on factors like age, sex, and underlying health conditions.
有些副作用与使用者的年龄、性别、健康等状况相关。
We're not sure what all the risk factors are, but we do know recreational steroid use is particularly risky for adolescents.
全部的风险因素尚不明确，但已知青少年爱好者使用类固醇会尤为危险。
During puberty, steroid use can prompt bones to mature before they're done growing, causing growth defects.
类固醇会使青春期尚未停止生长的骨骼过早成熟，造成发育缺陷。
Adolescents are also most at risk for the harmful psychiatric effects of steroid use.
精神方面，类固醇对青少年同样有更大的影响。
The most common of these, increased impulsivity and increased aggression, are well-known as "roid rage." Up to 60% of users experience these effects.
最常见的是变得冲动、更具有攻击性，即臭名昭著的“固醇暴怒”。高达六成的使用者都会出现这些副作用。
But there are also less common, more damaging psychiatric side effects like mania and even psychosis.
还有其他相对少见，但更严重的精神异常，如躁狂、甚至精神错乱。
Steroid use can damage organs including the liver and kidneys, and cause cardiovascular problems like high blood pressure.
类固醇会造成肝、肾等器官的损伤，也会引起高血压等心血管问题。
While some or all of those effects may be reversible, steroid use can also cause liver cancer, especially in males.
虽然以上大部分副作用或许是可以逆转的，但类固醇也会引起肝癌，特别是对男性而言。
Though recreational users take steroids for their anabolic effects, they also experience androgenic effects -- often undesired.
尽管爱好者用药是出于类固醇“促进生长”的功能，但类固醇的“雄性化”作用也常常不请自来。
That can mean increased body hair, enlargement of the clitoris, and permanent voice deepening in females.
这往往导致女性体毛增多，阴蒂变大，以及永久性的声音变化。
At the same time, excess testosterone-like steroids can cause feminization in males, because the body converts the excess into estrogen.
同时，过多类似睾酮的类固醇会在体内被转化为雌激素，令男性女性化。
This can lead to breast development and shrinking testicles.
可导致胸部发育、睾丸缩小。
These effects are not uncommon -- about a third of male steroid users experience them to some degree.
这些副作用并不罕见：约三分之一男性使用者都或多或少经历过。
Excess steroid use can also reduce fertility in males and females
过度使用类固醇会导致男女生殖功能减退，
by reducing the sperm in semen or by causing missed periods and conditions like polycystic ovary syndrome.
如精液中精子量减少，月经暂停，以及多囊卵巢综合征等异常。
All these effects may be reversible if steroid use stops -- but they may not be.
停用类固醇可能逆转上述症状，但不是所有人都能迷途知返。
The specific steroid, the duration of use, and other factors could play a role in reversibility.
能否复原取决于所服用的类固醇、服用时长等因素。
Finally, there's mounting evidence that users are susceptible to steroid dependence.
最后，越来越多的证据表明，类固醇能导致药物依赖。
They can develop tolerance and require increasingly large doses over time.
使用者可以产生耐药性，所需剂量会越来越高。
This increases the risk of harmful effects, all of which are increasingly common at higher doses taken for longer durations.
这也令类固醇的使用风险显著增高：剂量越高，使用时间越久，副作用就越常见。
Still, there remains little definitive information on how common and how reversible almost any of the harms are at different levels of use.
尽管如此，我们依旧缺乏更确切的资料，去判断每一种副作用在各个程度的使用者中有多常见，以及是否可逆。
We don't know enough, about either risk factors or exposure levels, to definitively say any recreational steroid use will be harm-free.
目前，我们对类固醇使用及其风险因素依然了解不足，无法提供绝对安全的娱乐性用药方案。
