Steroids
What are they?
“Steroids” is a broad term for several types of medicines and hormones used in the body. Not all steroids are the same.
There are three main types of steroids.
- Corticosteroids: Medicines used to reduce inflammation and treat conditions like asthma, allergies, eczema, and autoimmune diseases.
- Sex hormone steroids: Hormones like estrogen, progesterone, and testosterone that regulate sexual development and reproduction.
- Anabolic steroids: Drugs similar to testosterone that promote muscle growth and strength.
When people talk about steroids in sports or bodybuilding, they are usually referring to anabolic steroids.
Anabolic steroids are sometimes prescribed by doctors for certain medical conditions. However, they are also commonly misused to increase muscle mass, improve athletic performance, or change physical appearance.
Anabolic steroids are one of the most common appearance and performance‑enhancing drugs (APEDs).
Anabolic steroids are most often taken orally or injected when used non‑medically.
Some people who misuse anabolic steroids take them in cycles, combine several steroids (“stacking”), or increase and decrease doses over time (“pyramiding”). There’s no strong evidence that these methods make steroid use safer.
How they work
Anabolic steroids affect the body’s hormone system, especially the hormone testosterone.
Testosterone helps regulate:
- Muscle growth
- Bone strength
- Sex drive
- Red blood cell production
- Development of male physical traits
Anabolic steroids are man-made and work by increasing the amount of protein that muscle cells produce. This can lead to bigger and stronger muscles. Steroids may also:
- Help the body recover faster after exercise
- Increase the number of red blood cells that carry oxygen through the body
Some athletes and bodybuilders misuse anabolic steroids to improve performance or change their appearance.
But steroids do not only affect muscles. They can also affect other parts of the body, including the heart, liver, brain, and hormone system. Misusing steroids can throw off the body’s natural hormone balance and increase the risk of health problems.
For example, when the body senses high testosterone levels from steroids, it may stop producing its own hormones. This can lead to long-term hormone problems.
Effects vary depending on:
- Dose and strength
- Length of use
- Age and overall health
- Whether steroids are mixed with other substances
Higher doses and longer use increase the risk of harm.
Short-term effects
The short‑term effects of steroids depend on the type, dose, and how they’re taken.
Some people may experience:
- Acne or oily skin
- Fluid retention or swelling
- Increased appetite
- Increased blood sugar
- Increased risk of infection
- Mood changes
- Trouble sleeping
- Upset stomach
These effects may improve when the medication is reduced or stopped under medical guidance.
Long-term effects
Long‑term steroid use especially at high doses or without medical supervision can increase health risks.
Possible long‑term effects include:
- Eye problems
- Hair growth
- Heart disease or stroke
- High blood pressure
- Hormonal imbalances
- Increased infection risk
- Liver damage
- Thinning skin
- Voice deepening
- Weakened bones and fractures
- Weight gain
People who misuse anabolic steroids at high doses may face additional risks.
These include:
- Breast development in men
- Hair loss
- Infertility
- Menstrual changes in women
- Reduced sperm production
- Severe acne
- Sexual health problems
- Smaller testicles
- Steroid Use Disorder
Adolescents who misuse anabolic steroids may also experience stunted growth because steroids can cause bones to stop growing earlier than normal.
Dependence
Some people develop steroid dependence. Stopping suddenly after heavy steroid use can also lead to hormone problems and withdrawal symptoms.
Signs of dependence may include:
- Cravings
- Continuing to use despite health problems
- Needing higher doses for the same effects
- Experiencing withdrawal symptoms such as:
- Fatigue
- Loss of appetite
- Reduced sex drive
- Restlessness
- Trouble sleeping
Medical support can help people stop safely.
Sharing needles
When steroids are injected, sharing needles can spread infections such as:
- HIV
- Hepatitis B
- Hepatitis C
Using sterile injection equipment and never sharing needles reduces these risks.
Legal status
In the United States, anabolic steroids are controlled substances. They are legal only with a prescription from a doctor. Possessing or selling them without a prescription can lead to legal consequences.
Sports bans
Most professional sports organizations ban anabolic steroid use. Athletes who test positive may face suspension or permanent bans.
Impacts on mental health
Steroids can affect mental health and how people feel about their bodies.
Some people report mood or behavior changes while using anabolic steroids. Concerns about body image or self-esteem, such as feeling pressure to look more muscular or “strong enough,” can also play a role in why some people start or continue using steroids.
Possible mental health effects include:
- Anxiety
- Depression
- Irritability or aggression
- Mood swings
- Mania (extremely elevated mood or energy)
- Paranoia
Some people experience intense anger or aggression sometimes called “roid rage.”
When people stop using steroids after heavy use, they may also experience withdrawal symptoms, such as:
- Depression
- Difficulty concentrating
- Fatigue
- Loss of appetite
- Trouble sleeping
These symptoms can make it harder to stop using.
If steroid use is affecting your mood, mental health, self-esteem, or relationships, support is available.
You can call or text the 988 Suicide & Crisis Lifeline to talk to someone now or explore the Reducing Use page for support.
FAQ's
Are steroids addictive?
Are steroids addictive?
Some people who use anabolic steroids may develop a steroid use disorder. This means continuing to use steroids even when they are causing physical, emotional, or social problems.
Some people may also begin to center their lives around steroid use, spending large amounts of time and money getting the drugs or avoiding activities that might interfere with workouts, diet plans, or steroid use.
Some users try to cut down or stop but find it difficult. This may be related to withdrawal symptoms or worries about losing muscle mass or physical appearance.
Withdrawal can happen when someone stops using steroids after heavy or long-term use.
Symptoms may include:
- Cravings for steroids
- Fatigue
- Loss of appetite
- Reduced sex drive
- Restlessness
- Trouble sleeping
Depression can also occur during withdrawal. In some cases, it can become severe. Anyone experiencing intense depression or thoughts of harming themselves should seek help right away. Support is available through the 988 Suicide & Crisis Lifeline.
What’s the difference between anabolic steroids and corticosteroids?
What’s the difference between anabolic steroids and corticosteroids?
Anabolic steroids mimic testosterone and can increase muscle growth and strength.
Corticosteroids reduce inflammation and are commonly prescribed for conditions like asthma, arthritis, and allergies.
They work very differently and have different medical uses.
Are all steroids illegal?
Are all steroids illegal?
No. Many steroid medications are legal when prescribed by a doctor.
However, anabolic steroids used for bodybuilding or performance enhancement without a prescription are illegal in the U.S.
Do steroids always cause muscle growth?
Do steroids always cause muscle growth?
No. Anabolic steroids affect muscle growth.
Other steroid medications, like corticosteroids, may actually cause muscle loss if used long term.
Why should steroids only be used under medical guidance?
Why should steroids only be used under medical guidance?
Steroids should only be used as prescribed and under the guidance of a qualified medical professional. Medical professionals can help you manage side effects, help you decide when they may not be safe anymore, and help you stop taking steroids safely.
Steroids obtained from acquaintances, online, or from foreign sources may not be regulated for quality or safety.
What can I do to support my body's natural steroid production?
What can I do to support my body's natural steroid production?
There are several strategies to support the body's natural production of steroids. Eating a healthy diet, getting regular physical activity, getting enough sleep, and avoiding smoking or vaping are all actions you can take to support healthy steroid levels.
There are many supplements marketed to increase testosterone levels, but there is insufficient evidence to support their use for this purpose. Buyers should exercise caution when purchasing testosterone-boosting supplements as many are not regulated for quality or safety.
When should someone seek help?
When should someone seek help?
It may be helpful to talk to a health care provider if:
- Steroid use is affecting physical or mental health
- It’s difficult to stop using steroids
- Withdrawal symptoms appear after stopping
You can also call or text 988 for support or explore the Ways to Reduce Use page for resources.