Anabolic steroids are hormones that promote muscle growth and increase strength and energy.
Anabolic steroids can also have many side effects, including psychologic (mood swings, aggressive behavior, irritability) and physical (acne, masculinizing effects in women, breast enlargement in men).
These substances can be detected in urine for up to 6 months.
Treatment involves stopping use.
(See also Drug Use and Abuse Overview of Substance-Related Disorders Medications and other substances, whether used for legitimate medical purposes, as a habit (for example, caffeine), or recreationally, are an integral part of everyday life for many people ... read more .)
Anabolic steroids include the hormone testosterone and related drugs. Anabolic steroids have many physical effects, including promoting muscle growth and increasing strength and energy. Thus, these drugs are often used illegitimately to gain a competitive edge in sports. Users are often athletes, typically football players, wrestlers, bodybuilders, or weight lifters, and most users are male.
Anabolic steroids are used medically to treat low testosterone levels (hypogonadism Effects of Aging on the Male Reproductive System It is not clear whether aging itself or the disorders associated with aging cause the gradual changes that occur in men's sexual functioning. The frequency, duration, and rigidity of erections... read more ) and sometimes to prevent muscles from wasting away in people who are confined to bed or who have severe burns, cancer, or AIDS.
The drugs may be taken by mouth, injected into a muscle, or applied to skin as a gel or in a patch.
Athletes may take steroids for a certain period, stop, then start again several times a year. This process is called cycling. Athletes also often use many steroids at the same time (a practice called stacking), and they take them by different routes (by mouth, injection, or patch). They may also increase the dose through a cycle (called pyramiding). Pyramiding may result in very high doses. Cycling, stacking, and pyramiding are intended to enhance desired effects and minimize harmful effects, but little evidence supports these benefits.
At doses used to treat disorders, anabolic steroids cause few problems. However, athletes may take doses 10 to 50 times these doses.
Symptoms and Signs of Anabolic Steroid Use
Anabolic steroids have physical and psychologic effects. The more drug is taken, the greater the effect.
Physical effects
The main physical effect of anabolic steroids is
Increased muscle size
Other physical effects include
Gynecomastia Breast Disorders in Men Breast disorders occur infrequently in men. Breast disorders include Breast enlargement Breast cancer Breast enlargement in males is called either gynecomastia or pseudogynecomastia. Gynecomastia... read more (breast enlargement) and shrunken testicles with decreased sperm count in men
Virilization (masculinizing effects) in women, such as baldness, excess body hair (hirsutism Hairiness In men, the amount of body hair varies greatly (see also Overview of Hair Growth), but very few men are concerned enough about excess hair to see a doctor. In women, the amount of hair that... read more
), an enlarged clitoris, a deepened voice, shrunken breasts, and thinning of the lining (atrophy) of the vagina.
Gynecomastia in men and masculinizing effects in women may be irreversible.
Increased acne is common in both sexes. Libido may increase or, less commonly, decrease. Aggressiveness and appetite may increase. In younger adolescents, steroids can interfere with the development of arm and leg bones.
Long-term use can cause the body to produce too many red blood cells and abnormal levels of fats (lipids Overview of Cholesterol and Lipid Disorders The body needs fats for growth and energy. It also uses them to synthesize hormones and other substances needed for the body’s activities. The body may deposit excess fat in blood vessels and... read more ) in the blood. Low-density lipoprotein (LDL)—the bad—cholesterol levels increase, and high-density lipoprotein (HDL)—the good—cholesterol levels decrease. Severe cardiovascular complications, including high blood pressure High Blood Pressure High blood pressure (hypertension) is persistently high pressure in the arteries. Often no cause for high blood pressure can be identified, but sometimes it occurs as a result of an underlying... read more 
, stroke Overview of Stroke A stroke occurs when an artery to the brain becomes blocked or ruptures, resulting in death of an area of brain tissue due to loss of its blood supply (cerebral infarction) and symptoms that... read more , heart attack Acute Coronary Syndromes (Heart Attack; Myocardial Infarction; Unstable Angina) Acute coronary syndromes result from a sudden blockage in a coronary artery. This blockage causes unstable angina or a heart attack (myocardial infarction), depending on the location and amount... read more 
, and blood clots, are reported with the use of anabolic steroids.
Psychologic effects
Steroids have several psychologic effects (usually only with high doses):
Wide and erratic mood swings
Irrational behavior
Increased aggressiveness (steroid, or "roid" rage)
Irritability
Increased sex drive (libido) in men and sometimes in women
Depression
Diagnosis of Anabolic Steroid Use
Urine tests
Urine tests are done to check for breakdown products of anabolic steroids. These products can be detected up to 6 months after use is stopped.
Prevention of Anabolic Steroid Use
Adolescents and young adults should be taught about the risks of taking anabolic steroids starting in middle school. Also, programs that teach alternative, healthy ways to increase muscle size and improve performance may be useful. Such programs emphasize good nutrition and weight training techniques.
Treatment of Anabolic Steroid Use
Stopping use of steroids
The main treatment is stopping use. Although physical dependence does not occur, psychologic dependence, particularly in competitive bodybuilders, may exist. Gynecomastia Breast enlargement in men Breast disorders occur infrequently in men. Breast disorders include Breast enlargement Breast cancer Breast enlargement in males is called either gynecomastia or pseudogynecomastia. Gynecomastia... read more (enlarged breast tissue in men) may require surgical reduction.
More Information
The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.
National Institute on Drug Abuse (NIDA): Anabolic steroid–specific information from the federal agency that supports scientific research into drug use and its consequences and supplies information about commonly used drugs, research priorities and progress, clinical resources, and grant and funding opportunities.
Substance Abuse and Mental Health Services Administration (SAMHSA): US Department of Health agency that leads public health efforts to improve behavioral health and provides resources, including treatment locators, toll-free helplines, practitioner training tools, statistics, and publications on a variety of substance-related topics.
Drugs Mentioned In This Article
| Generic Name | Select Brand Names |
|---|---|
testosterone |
Androderm, AndroGel, Andro-L.A., Aveed, AXIRON, Delatestryl, Depo-Testosterone, FORTESTA, JATENZO, KYZATREX, Natesto, STRIANT, Testim, Testoderm, Testopel, TLANDO, Virilon, Vogelxo, XYOSTED |
