Topic Overview

What are anabolic steroids?

Anabolic steroids are synthetic substances similar to the male hormone testosterone. Doctors prescribe them to treat problems such as delayed puberty and other medical problems that cause the body to make very low amounts of testosterone. Steroids make muscles bigger and bones stronger. They also may cause puberty to start and can help some boys who have a genetic disorder to grow more normally.

Anabolic steroids may be taken as a pill, as a shot into a muscle, or as a gel or cream rubbed on the skin.

Common anabolic steroid medicines include fluoxymesterone (such as Halotestin) and nandrolone (such as Durabolin). In the United States, you need a prescription to get any anabolic steroid. Illegal anabolic steroids are those that people get without a doctor’s prescription.

Some people take legal dietary supplements that have certain steroid hormones also made by the human body. One such supplement is dehydroepiandrosterone (DHEA). The body can turn DHEA into other steroid hormones, including testosterone, estrogen, and cortisol. People use it to try to make their muscles bigger. Whether such products actually work has not been proved. But if you take them in large amounts, they can cause the same side effects as anabolic steroids.

Why do some people use anabolic steroids without a prescription?

Some adults and teens use illegal anabolic steroids to lower body fat, get bigger muscles, and increase strength. They use the drugs because they are seeking to improve how well they play sports or how they look.

The dose of illegal anabolic steroids is 10 to 100 times higher than the dose a doctor prescribes for medical problems. People often use more than one of these illegal drugs at the same time. This is called stacking. Or they may take the drugs in a cycle from no drug to a high dose over a period of weeks to months. This is called pyramiding.

What problems can using illegal anabolic steroids cause?

Anabolic steroids can cause serious side effects. Some of these effects can be permanent.

• In men, anabolic steroids can:
  • Reduce sperm count.
  • Shrink the testicles.
  • Cause you not to be able to father children.
  • Enlarge the breasts.
• In women, anabolic steroids can:
  • Increase body hair.
  • Make skin rough.
  • Decrease breast size.
  • Enlarge the clitoris.
  • Deepen the voice.
• In both men and women, anabolic steroids can cause:
  • High blood pressure, heart attack, or stroke.
  • Higher levels of bad cholesterol (LDL) and lower levels of good cholesterol (HDL).
  • Liver disease and possibly liver cancer. The chance of these problems is higher when steroids are taken as a pill.
  • Oily skin, acne, and male-pattern hair loss.
  • Skin infections that can become severe if the drug was tainted with bacteria.
  • Irritability, rage, aggression, violence, uncontrolled high energy (mania), false beliefs (delusions), and substance use disorder.

Teens who take illegal anabolic steroids are at risk for the same problems as adults who use them. Also, bone growth in teens may stop before it is complete. The teen may not reach his or her full adult height.

People who use anabolic steroids on a routine basis can have withdrawal symptoms when they stop taking them. Symptoms include having depression, being extremely tired, and having no desire to eat.

How is anabolic steroid misuse identified?

Your doctor may ask questions about your fitness activities and what kinds of dietary supplements and other substances you use. The doctor may do a physical exam and order urine and blood tests.

How is it treated?

Treatment for misuse of anabolic steroids has not been studied much. Doctors usually advise:

• Treatment in a program that includes medicines for withdrawal symptoms and other health problems.
• Family and social support.
• Individual or family counseling.