Michael stopped using performance enhancing drugs at the end of his high school athletic career. Which long term effects might he experience as he grows older? Select three options. increased endurance enlarged heart mood swings muscle weakness liver disease

Michael, having used performance-enhancing drugs (PEDs) during his high school athletic career, may experience several long-term effects as he ages. Among the options provided, the three most likely long-term effects are: 1. **Enlarged Heart**: Chronic use of PEDs, especially anabolic steroids, can lead to cardiovascular issues such as an enlarged heart. This condition increases the risk of heart disease and other cardiovascular problems later in life. 2. **Mood Swings**: Long-term use of PEDs can affect mental health, leading to mood swings, depression, and increased aggression. These psychological effects can persist even after discontinuing the use of these substances. 3. **Liver Disease**: Many PEDs, particularly oral anabolic steroids, are hepatotoxic, meaning they can cause liver damage. Long-term use increases the risk of developing liver diseases, including liver tumors and jaundice. **Other Options:** - **Increased Endurance**: This is typically an immediate effect of PED use rather than a long-term consequence. - **Muscle Weakness**: While muscle weakness can occur after stopping PEDs, it's often a short-term withdrawal effect rather than a lasting condition. **Selected Long-Term Effects:** - Enlarged heart - Mood swings - Liver disease