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32. Anabolic Steroids In Women

    **Anabolic Steroids – A Quick Reference Guide**

    | Topic | Key Points |
    |——-|————|
    | **What They Are** | Synthetic derivatives of testosterone that promote muscle growth (anabolism) and increase red‑blood‑cell production. |
    | **Common Medical Uses** | • Treat certain types of anemia
    • Manage delayed puberty in boys
    • Correct hormonal deficiencies in men
    • Treat some inflammatory conditions (e.g., rheumatoid arthritis) when other drugs fail |
    | **Typical Forms** | Oral tablets, injectable solutions, topical gels or creams. https://www.valley.md/anavar-dosage-for-men and route are chosen by a physician based on the condition being treated. |
    | **How They Work** | Bind to androgen receptors → stimulate protein synthesis in muscle cells
    Increase erythropoietin production → more red blood cells
    Alter fat metabolism and body composition |
    | **Side Effects (Common)** | Fluid retention, high blood pressure, acne, hair loss, mood swings, liver strain (especially with oral forms)
    With long‑term use: gynecomastia in men, menstrual irregularities in women, decreased fertility. |
    | **Monitoring** | Blood pressure checks, liver enzyme tests, complete blood counts, hormone levels. Adjust dosage or discontinue if adverse effects become significant. |

    —

    ### Quick Reference for “What They Do”

    | Drug | Primary Effect | Key Mechanism | Typical Use |
    |——|—————-|—————|————-|
    | **Metformin** | Lowers glucose production & increases insulin sensitivity | Inhibits mitochondrial complex I → ↓ATP → ↑AMPK → ↓gluconeogenesis, ↑glucose uptake | Type 2 diabetes (first‑line) |
    | **SGLT2 inhibitors** | Excrete excess glucose in urine | Block SGLT2 in kidney proximal tubule | T2DM, heart failure |
    | **Metformin + SGLT2 inhibitor** | Combined: ↓production + ↑excretion | Dual mechanisms | Improved glycemic control; cardio‑renal benefits |

    —

    ### Practical Takeaway

    – **Mechanism‑based therapy** gives you a rational framework: if the drug reduces glucose production, pair it with one that blocks reabsorption or promotes excretion.
    – **Clinical benefit** is maximized when you use complementary mechanisms—this explains why metformin plus SGLT2 inhibitors (or DPP‑4/GLP‑1) achieve superior glycemic control and add cardiovascular protection.

    Feel free to ask more specific questions about drug interactions, side‑effect profiles, or how these mechanisms translate into real‑world prescribing decisions!

33. how do steroids enter the body

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