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Steroids

What are steroids?

Who uses steroids and why?

How do they work?

Side effects

Withdrawal

Health and safety

Further information

 

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What are steroids?

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.

Other names

Formally known as anabolic steroids or anabolic-androgenic steroids, but they are sometimes called 'roids', 'gear' or 'juice'.

Who uses steroids and why?

  • Competitive athletes – who are motived by their desire to succeed.
  • People concerned about their body image – recreational weight trainers and body builders and people working in the fashion and entertainment industries. 
  • Body building professionals – people involved in body building as a competitive sport. 
  • People who need muscle strength to do their job – bodyguards, security personal, construction workers, police and members of the armed services. 
  • Young men – who want to increase their athletic performance or who are striving to reach the same physical appearance that is often portrayed in the media.21

 

How do they work?

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

Side effects

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:

  • Water retention – leading to facial bloating
  • Acne – leading to permanent scarring
  • Irritability and mood swings
  • More frequent colds
  • Aggression and violence
  • Increased sex drive
  • Sleeping difficulties10


Longer-term effects may include:

  • Liver damage
  • Kidney or prostate cancer
  • High blood pressure
  • Depression
  • Tendon/ ligament damage11

Men

  • Reduced sperm count and fertility
  • Shrunken testicles
  • Baldness
  • Gynaecomastia (developing breasts)
  • Involuntarily and long-lasting erection12

Women

  • Facial hair growth
  • Irregular periods
  • Deepened voice
  • Smaller breasts
  • Enlarged clitoris13


Pregnant women who use steroids risk passing on male traits to unborn daughters due to the increased male hormones in their bloodstream. The only way to avoid the risk of foetal damage is to stop using steroids at least four months before falling pregnant, as well as during pregnancy14.

Young people

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:

  • Stunted growth
  • Premature balding
  • Acne scarring
  • Stretch marks on chest and arms
  • Prematurely-aged, 'leathery' skin
  • Injuries from excessively intense gym workouts15

Injecting risks

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.)

Withdrawal

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:

  • Extreme tiredness
  • Weight loss due to decreased appetite
  • Decreased strength
  • Depression13


It can take up to four months to restore the body's natural testosterone levels (if taking high doses for an extended period of time).

Health and safety

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:

  • Using lower doses to reduce the risk of side effects
  • Never injecting steroids directly into biceps, calf muscles or pectorals, to avoid causing permanent nerve damage
  • Avoiding repeatedly injecting steroids into the same area of the body
  • Limiting cycles to 8 to 10 weeks to rest the kidneys, liver and endocrine system
  • Avoiding sharing injecting equipment with others to reduce the risk of contracting a blood-borne virus such as HIV or Hepatitis C
  • Using a clean needle from an unopened package with every injection
  • Avoiding combining steroids with diuretics such as caffeine, alcohol and other drugs like amphetamines (such as 'ice' and 'speed')
  • Injecting steroids in a sterile location
  • Discussing steroid use with a doctor, even if it is without a prescription
  • Discussing the perceived need to take steroids with a counsellor19,20

Further information

Statistics

Reducing the risks

 

Related articles

 

ADF SEARCH – Find further credible research and information on PIEDs.

ADIN – Find other credible websites and apps on PIEDs.

 

References

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

Information you heard is intended as a general guide only. This audio is copyrighted by the Australian Drug Foundation. Visit www.DrugInfo.ADF.org.au for more