Steroids are drugs that help the growth and repair of muscle tissue. They are synthetic hormones that imitate male sex hormones, specifically testosterone.
Steroids can increase lean muscle mass, strength and endurance, but only if used in conjunction with certain exercise and diet regimes1. They can also help people reduce fat and recover quicker from injury2.
Steroids are classed as performance and image enhancing drugs (PIEDs). These substances are taken by people with the intention of improving their physical appearance and/or enhancing their sporting performance.
How are they used?
Steroids can be injected or taken as a tablet.
Formally known as anabolic steroids or anabolic-androgenic steroids, but they are sometimes called 'roids', 'gear' or 'juice'.
Steroids are injected directly into muscles. They travel through the bloodstream to muscle cells where they start a chemical reaction that helps build muscle strength3.
Steroids are typically injected over a six to 12 week period. This is followed by a break of the same length to prevent muscle cells shutting down in the long term. This is known as 'cycling'2.
Different steroids are often combined in a process known as 'stacking'. This is done to achieve effects such as increasing muscle mass, making it leaner and getting greater muscle definition (known as 'cutting').2
There is no safe level of drug use. Use of any drug always carries some risk. It's important to be careful when taking any type of drug.
People may use steroids in what they believe to be a healthy lifestyle context. They may not see themselves as injecting drug users. However, there are risks associated with using steroids without a prescription or medical supervision, even as part of a fitness training program.
In the worst case, long-term heavy steroid use can lead to heart attack, stroke and death4, especially among men aged in their early 30s who combine steroids with other stimulant drugs, such as speed and ecstasy5,6.
Steroids can also take a toll on personal relationships as they can cause mood swings, a higher sex drive and, in extreme cases, violent behaviour7, especially when combined with alcohol8.
They can ruin sporting careers, with positive tests potentially resulting in fines, suspensions and bans from competitive sports9. On a more superficial level, steroids can lead to premature baldness in men.
Steroids affect everyone differently. The following may be experienced:
Young men are more likely than young women to use steroids to gain weight and muscle mass.
The risks of the following side effects are higher if steroids are injected by young men in their late teens/ early 20s, before they have stopped growing:
Injecting steroids can cause permanent nerve damage, which can lead to sciatica16. Injecting in unhygienic environments or sharing equipment with others also increases the risk of contracting HIV/AIDS, tetanus or Hepatitis C or B17. (See Health and Safety.)
Although steroids are not addictive, people can find themselves relying on them to build confidence and self-esteem18. This reliance can make it difficult to stop using them in the longer term. Fear of losing muscle size or definition can lead to depression and the pressure to continue use.10
The following symptoms may be experienced after completing a steroid cycle:
Steroids should only be injected with a prescription for a specific medical reason or under medical supervision.
Injecting more than the recommended dose does not create larger muscles – the muscle simply becomes saturated. Higher doses only raise the risks of more adverse side effects without providing any additional benefits19.
It is not necessary to inject directly into specific muscles as the steroids are transported to all muscle groups via the bloodstream20.
There are many steps that can be taken to reduce the risk of harm caused by long-term steroid use. These include:
Reducing the risks
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1. Kadi, F., Eriksson, A., Holmner, S. T. A. F. F. A. N., & Thornell, L. E. (1999). Effects of anabolic steroids on the muscle cells of strength-trained athletes. Medicine and science in sports and exercise, 31(11), 1528–1534
2. Evans, N. A. (1997). Gym and tonic: a profile of 100 male steroid users. British Journal of Sports Medicine, 31(1), 54–58.
3. Kutscher, E. C., Lund, B. C., & Perry, P. J. (2002). Anabolic Steroids. Sports Medicine, 32(5), 285-296.
4. Angell, M. P., Chester, N., Green, D., Somauroo, J., Whyte, G., & George, K. (2012). Anabolic steroids and cardiovascular risk. Sports medicine, 42(2), 119–134.
5. Darke, S., Torok, M., & Duflou, J. (2014). Sudden or Unnatural Deaths Involving Anabolic‐androgenic Steroids. Journal of Forensic Sciences.
6. Baggish, A. L., Weiner, R. B., Kanayama, G., Hudson, J. I., Picard, M. H., Hutter, A. M., & Pope, H. G. (2010). Long term anabolic-androgenic steroid use is associated with left ventricular dysfunction. Circulation: Heart Failure, CIRCHEARTFAILURE-109.
7. Beaver, K. M., Vaughn, M. G., DeLisi, M., & Wright, J. P. (2008). Anabolic-androgenic steroid use and involvement in violent behavior in a nationally representative sample of young adult males in the United States. American Journal of Public Health, 98(12), 2185.
8. van Amsterdam, J., Opperhuizen, A., & Hartgens, F. (2010). Adverse health effects of anabolic–androgenic steroids. Regulatory toxicology and pharmacology, 57(1), 117–123.
9. Todd, T. (2007). Anabolic Steroids. Women and Sports in the United States: A Documentary Reader, 14(1), 138.
10. Hartgens, F., & Kuipers, H. (2004). Effects of androgenic-anabolic steroids in athletes. Sports Medicine, 34(8), 513–554.
11. Kanayama, G., Hudson, J. I., & Pope Jr, H. G. (2008). Long-term psychiatric and medical consequences of anabolic–androgenic steroid abuse: A looming public health concern?. Drug and alcohol dependence, 98(1), 1–12.
12. de Souza, G. L., & Hallak, J. (2011). Anabolic steroids and male infertility: a comprehensive review. BJU international, 108(11), 1860–1865.
13. Maravelias, C., Dona, A., Stefanidou, M., & Spiliopoulou, C. (2005). Adverse effects of anabolic steroids in athletes: a constant threat. Toxicology Letters, 158(3), 167–175.
14. Shahidi, N. T. (2001). A review of the chemistry, biological action, and clinical applications of anabolic-androgenic steroids. Clinical therapeutics, 23(9), 1355–1390.
15. Parkinson, A. B., & Evans, N. A. (2006). Anabolic androgenic steroids: a survey of 500 users. Medicine and science in sports and exercise, 38(4), 644–651.
16. Perry, H. M., Wright, D., & Littlepage, B. N. (1992). Dying to be big: a review of anabolic steroid use. British Journal of Sports Medicine, 26(4), 259–261.
17. Hoffman, J. R., Faigenbaum, A. D., Ratamess, N. A., Ross, R., Kang, J., & Tenenbaum, G. (2008). Nutritional supplementation and anabolic steroid use in adolescents. Medicine and science in sports and exercise, 40(1), 15–24.
18. Kanayama, G., Brower, K. J., Wood, R. I., Hudson, J. I., & Pope Jr, H. G. (2010). Treatment of anabolic–androgenic steroid dependence: Emerging evidence and its implications. Drug and alcohol dependence, 109(1), 6–13.
19. Daly, R. C., Su, T. P., Schmidt, P. J., Pagliaro, M., Pickar, D., & Rubinow, D. R. (2003). Neuroendocrine and behavioral effects of high-dose anabolic steroid administration in male normal volunteers. Psychoneuroendocrinology, 28(3), 317–331.
20. Busche, K. (2009). Neurologic disorders associated with weight lifting and bodybuilding. Physical medicine and rehabilitation clinics of North America, 20(1), 273–286.
21. Peters, R., Copeland, J. & Dillion, P. (1999). Steroid Facts.
Last updated: 27 April 2016