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Side Effects of Anabolic Steroid Abuse

Anabolic steroid abuse comes with a range of side effects, such as aggression, hallucinations, mood swings, paranoia, and mania. Serious side effects include harm to the heart, kidneys, blood vessels, and liver.[1]

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Men may experience hair loss, acne, shrinking testicles, and breast development. Women may experience menstrual issues, odd hair growth, and acne.[1],[2]

Short vs. Long-Term Side Effects of Anabolic Steroids

Short-Term Side EffectsLong-Term Side Effects
AggressionHeart attack
Delusions and hallucinationsStroke
Mood swingsLiver cancer
ParanoiaHigh cholesterol
ManiaBlood vessel damage
Kidney damage
Hormonal changes in men
Masculinization in women

Why Do People Take Anabolic Steroids?

Anabolic steroids are often associated with illegal use and abuse, but researchers point out that these medications can be helpful for people struggling with serious medical conditions.[13]

Anabolic steroids mimic the testosterone the body produces naturally. They typically work to promote the development of male sexual characteristics, but they can also promote protein storage, stimulate bone growth, and encourage muscle growth.[13]

Steroids are used to treat medical problems such as the following:[13]

  • Wasting syndromes caused by conditions such as AIDS or anorexia
  • Severe burns
  • Significant muscle, tendon, or bone injuries
  • Osteoporosis
  • Anemia
  • Age-related problems like fatigue, depression, and cognitive decline

Steroids are Schedule III substances in the United States, meaning they’re legal to use with a valid prescription. People who need steroids and take them per their doctors’ instructions aren’t abusing them and shouldn’t worry about the legal consequences of taking these medications.[14]

Why Do Some People Abuse Anabolic Steroids?

While some types of anabolic steroids are used to treat medical issues, some bodybuilders and athletes take 100 times the recommended dose of steroids, and they do so without a doctor’s approval or supervision.[1] These people hope the drugs will give them a competitive edge and deliver the body they’ve worked hard to build in the gym.

People who take steroids believe these drugs can do the following:[2]

  •       Increase lean body mass
  •       Boost strength
  •       Shorten workout recovery times
  •       Enhance endurance
  •       Build muscle size

Unfortunately, these drugs can also cause significant short-term and long-term side effects. And people who abuse steroids for long periods may find it hard to quit without help.

Some people misuse steroids due to body image issues. When they look in the mirror, they see a body that’s too thin, too weak, and too frail. Modern men are encouraged to be both lean and muscular, as they see bodies like this in movies and advertising. With drugs, they can change their bodies quickly and attain the appearance they want—even if they’re not interested in participating in sports like wrestling or bodybuilding.[17]

Researchers have found that many people who abuse steroids have been sexually assaulted in the past. They are using muscle mass to help them feel safe in a dangerous world. [7]

Are Steroids Legal?

Anabolic steroids are Schedule III substances per United States laws. Doctors can prescribe them, and patients can take them legally per a doctor’s orders.[14] However, anyone who possesses or takes these drugs without a doctor’s orders can face significant consequences.

People who have illegal steroids can be sentenced to a year in prison and a $1,000 fine for a first offense.[15] People who break these laws multiple times can face even more serious sentences.

Athletes who fail pre-competition drug tests can lose the opportunity to participate in a scheduled event.[16] They can also be sanctioned for the drugs found in their systems. The organization holding the event or responsible for the athlete’s training can also face problems if they try to help by not holding drug screenings.

Side Effects of Steroid Abuse: Short-Term & Long-Term Problems

Prescription medications like steroids are safe and effective when used under a doctor’s supervision. But people who abuse these drugs rarely ask for a doctor’s help. They may take so much at one time that experts aren’t exactly sure about the consequences. 

These are a few side effects experts are sure of.

Short-Term Effects of Steroid Use

Unlike heroin, prescription opioids, cocaine, and other drugs of misuse, steroids don’t cause a high. People don’t feel a huge boost of pleasure or calm when taking steroids. But they may experience unintended emotional issues. [3]

Steroid abuse causes the following issues:[4]

  • Aggression
  • Delusions 
  • Hallucinations
  • Mania 
  • Mood swings
  • Paranoia 

Long-Term Effects of Steroid Abuse

One dose of steroids won’t cause dramatic body changes. People who abuse them often take doses repeatedly to get the results they want. This can result in anabolic steroid toxicity.

Long-term abuse can damage your: [1],[3]

  • Blood vessels 
  • Heart 
  • Kidneys 
  • Liver

It can also cause high cholesterol, strokes, heart attacks, liver cancer, tendon injuries, and stunted growth in adolescents.[1],[3]

Boys and men who abuse steroids can experience the following: [3],[5]

  • Acne
  • Breast development 
  • Hair loss 
  • Shrinking testicles 
  • Decreased sperm production
  • Male-pattern baldness
  • Testicular cancer

Girls and women who abuse steroids can experience these issues: [3],[5]

  • Acne
  • Menstrual problems
  • Unusual hair growth
  • Voice deepening
  • Reduced breast size
  • Excessive body hair growth
  • Male-pattern baldness

Steroid abuse is very common in professional bodybuilding circles. The habit has also been connected to high-profile deaths within the sport. In most cases, these bodybuilders died due to enlarged heart muscles. [6]

Signs of Anabolic Steroid Abuse to Watch For

Some people who use anabolic steroids talk openly about the habit. They explain how they cycle through use and sobriety, and they may line up their pills and powders on kitchen counters so they remember to take their doses. 

Some people try to keep their use a secret, but telltale signs may appear, including:[7]

  • Mood changes: Irritability or aggression is common. Some people may swing between anger and sadness.
  • Intense focus: People abusing steroids to boost performance may give up virtually all non-workout activities, skip meals, and otherwise spend all their time and energy on bulking up and slimming down. 
  • Obsession with use: People may lie, steal, and cheat to get the drugs they need. 
  • Inability to quit: When people try to stop using steroids, they may experience withdrawal symptoms such as depression. 

Since anabolic steroid use damages organs, people with a habit may also seem physically ill. They may look yellow or jaundiced, and they may have swollen hands and feet. [7]

With persistent use, they may complain of nausea or dizziness. And they may be covered with acne, stretch marks, and other skin issues. 

Doctors can use liver function tests to diagnose steroid abuse. And doctors may know to run those tests on patients who appear visibly changed from one appointment to the next. [8]

How Is Steroid Abuse Treated?

People rarely start abusing steroids on a whim. In most cases, deep psychological problems entice people to turn to drugs. Dealing with those issues is a core part of treatment. Therapy options will vary by the underlying issue the person is dealing with.

People with body dysmorphic disorder (BDD) use steroids to make their bodies look bigger, even when they’re already very large. Doctors use cognitive behavioral therapy (CBD) to help people identify the unhealthy thoughts that lead to steroid abuse and build healthy habits they can use when these thoughts appear.[18]

People using steroids to cope with trauma may benefit from programs that involve them in the treatment process. Playing an active role in planning can give them a sense of empowerment they may be lacking due to their trauma. They may also benefit from prolonged exposure therapy (PE Therapy) and eye movement desensitization and reprocessing (EMDR) to help them understand and move past the traumatic event.[19]

Researchers say people who abuse steroids for long periods face a higher risk of depression and suicidal attempts. The link is so strong that researchers say the more steroids people take, the higher their chances of developing severe depression.[20] CBT can help with this condition too, as therapists can help people understand what depressive thoughts look like and how to respond to them when they appear.

Therapists may also encourage people to participate in support group meetings. Spending time with others in recovery can help people develop new coping skills and find a community of peers to lean on during difficult days.

Anyone abusing steroids should consider enrolling in a comprehensive treatment program. Drugs only mask problems. Therapy can deliver real healing, so the person can stop abusing drugs for good. The end result is a happier, healthier person.

Updated February 12, 2024
  1. Anabolic Steroids. (June 2021). National Library of Medicine.
  2. Anabolic Steroids. (March 2023). Drug Enforcement Administration.
  3. Anabolic Steroids DrugFacts. (August 2018). National Institute on Drug Abuse.
  4. Anabolic Steroid Misuse. (April 2022). NHS.
  5. Teens and Steroids: A Dangerous Combo. (December 2017). U.S. Food and Drug Administration.
  6. Bodybuilders Are Sounding the Alarm That Extreme Steroid Use Is Leading to Deaths in the Sport, and It's Only Getting Worse. (April 2022). Insider.
  7. Anabolic Steroids. (August 2018). National Institute on Drug Abuse.
  8. Look Out For Signs of Steroid Use, GPs Told. (September 2006). GP.
  9. Who Uses Anabolic Steroids? (February 2018). National Institute on Drug Abuse.
  10. Health Consequences of Androgenic Anabolic Steroid Use. (March 2019). Journal of Internal Medicine.
  11. Characteristics and Attitudes of Men Using Anabolic Androgenic Steroids (AAS): A Survey of 2385 Men. (December 2020). American Journal of Men’s Health.
  12. Diagnosis and Management of Anabolic Androgenic Steroid Use. (February 2019). The Journal of Clinical Endocrinology & Metabolism.
  13. Medicinal Use of Testosterone and Related Steroids Revisited. (February 2021). Molecules.
  14. Steroids: Drug Fact Sheet. (April 2020). Drug Enforcement Administration.
  15. 21 U.S. Code 844: Penalties for Simple Possession. Legal Information Institute.
  16. Anabolic Steroids and Other Appearance and Performance Enhancing Drugs (APEDs). (May 2023). National Institute on Drug Abuse.
  17. Anabolic-Androgenic Steroid Use and Body Image in Men: A Growing Concern for Clinicians. (February 2020). Psychotherapy and Psychosomatics.
  18. Understanding and Treating Body Dysmorphic Disorder. (January 2019). Indian Journal of Psychiatry.
  19. Key Ingredients for Successful Trauma-Informed Care Implementation. (April 2016). Center for Health Care Strategies.
  20. Anabolic-Androgenic Steroids Are Associated with Major Depressive Disorder and Suicide Attempt: Analysis of a Multi-National Database. (September 2021). Fertility and Sterility.
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