by EBSCO Medical Review Board

IMAGE Anabolic steroids are synthetic variations of testosterone, a natural hormone that promotes muscle growth. There are a number of different types. The official name for this type of steroid is androgenic anabolic steroid. It is a drug that promotes protein synthesis (anabolic) and leads to masculine secondary sexual characteristics (androgenic).

To understand how anabolic steroids work, it helps to know how testosterone works. Testosterone is a male sex hormone (although women also make it) that serves two basic purposes. During the first stage of puberty, young men make an increased amount of testosterone for a number of months. During this stage, the bulk of the male physical maturation process happens. This includes bone growth, voice deepening, and facial and body hair growth. Testosterone also maintains the male reproductive system and helps to produce larger body size and muscle mass.

Androgenic steroids are given to treat health problems that require testosterone (or its effects) to be added or replaced. Anabolic steroids are designed to copy the muscle-building effects of testosterone, but with fewer masculinization effects.

Users of anabolic steroids can be divided into two groups:

  • Those who use them for medical purposes
  • Those who use them to boost strength and athletic ability, and/or enhance their physical appearance by adding muscle mass

Medical Uses

Anabolic steroids are given for a small number of medical reasons. These include treating:

  • Severe weight loss due to surgery, trauma, HIV, cancer, or other problems
  • Bone pain from osteoporosis

Athletes and Body Enhancers

Athletes have been using anabolic steroids since the 1950s. This is because using them along with intense physical training increases the body's overall muscle mass, lowers the body's percentage of fat, and enhances body strength. These effects occur in both men and women.

Some adults and teens use anabolic steroids to help enhance their physical appearance. This is troubling because the harmful side effects of using anabolic steroids are worse in adolescents.

Harmful Side Effects

There are many harmful side effects to using anabolic steroids. Men run the risk of testicular shrinkage, reduced sperm count, erectile dysfunction, baldness, and an enlarged prostate. Women can suffer from a deepened voice, facial hair growth, loss of menstruation, enlargement of genitals, and smaller breast size. Both genders may also have serious medical problems, such as high blood pressure and liver damage. Both men and women may also suffer from something called "'roid rage." These are sudden outbursts of anger. Other mental health problems can happen after quitting steroids, such as depression.

Heart attacks and strokes have been found in young adults using these steroids. Young adults who are still growing also risk stunting their growth. This danger is so concerning that steroids are only given to children with great caution and under close monitoring.

Getting and Using Steroids

As if these dangers were not enough, getting these drugs and taking them is also very risky. Without a prescription, the drugs are often sold illegally. As a result, tainted drugs that may be very potent are sometimes sold to users. They can be taken orally, but they can also be injected. Since some users reuse or share needles, this creates a danger of transferring blood-borne diseases, such as HIV and hepatitis.

The way that some users manage their intake of anabolic steroids is also very unsafe. Some users "cycle" their intake by taking anabolic steroids on and off for 1 to 6 month periods. Some who compete in regulated sports do this in the hopes of avoiding detection. Hoping to increase the effect of the drug, many users "megadose," sometimes taking hundreds of milligrams of the drug per day when the medically prescribed dose would be much lower. Others use a stacking method and take many different types of anabolic steroids at the same time, sometimes along with other drugs. This may raise the risks of using anabolic steroids even more.

Signs of Steroid Use

A person who is using these drugs may have:

  • A puffy face
  • Severe acne on the face, chest, upper back, and thighs
  • Hyperactivity
  • Increased weight gain over a short period of time
  • Yellowing of skin and/or eyes

These signs do not diagnose drug abuse, but they could alert parents and coaches to the possibility that abuse is occurring. There are only a few health problems in youths that may require a testosterone prescription. The non-medically authorized use of anabolic steroids poses grave danger. Possession and distribution anabolic steroids for non-medical purposes are also illegal under federal law.

So, the conclusion is simple: do not take anabolic steroids unless they have been medically prescribed for you. It is a much healthier choice to gain muscle mass through consistent hard work with resistance training.


National Institute on Drug Abuse 

Substance Abuse and Mental health Services Administration 


Council on Drug Abuse 

Canadian Center on Substance Abuse 


Oxandrolone. EBSCO DynaMed website. Available at: Accessed October 11, 2021.

Signs of steroid abuse. Taylor Hooton Foundation website. Available at: Accessed October 11, 2021.

Steroids, anabolic. National Institute on Drug Abuse website. Available at: Accessed October 11, 2021.

Testosterone. EBSCO DynaMed website. Available at: Accessed October 11, 2021.

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