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What Are the Risks of Steroid Use?

Medically reviewed by: Rupal Christine Gupta, MD

What Are Steroids?

Drugs commonly referred to as "steroids" are classified as corticosteroidsor anabolic (or anabolic-androgenic) steroids.

Corticosteroids

Corticosteroids, such as cortisone, are drugs that doctors prescribe to help control inflammation. They're used to help control conditions like asthma and lupus. They're not the same as the anabolic steroids.

Anabolic Steroids

Anabolic steroids are synthetic (manmade) hormones that can boost the body's ability to make muscle and prevent muscle breakdown.

Some athletes take steroids in the hopes that they will help them run faster, hit farther, lift heavier weights, jump higher, or have more endurance. In the United States, it is against the law to use anabolic steroids without a prescription.

Androstenedione, or "andro," is a kind of anabolic steroid taken by athletes who want to build muscle. It is a controlled substance because of its suspected health risks and available only by prescription. There is little or no evidence that it has any significant anabolic effects.

Why Do People Use Steroids?

Some professional baseball players, cyclists, and track stars have been accused of — and in some cases have admitted to — using steroids to give them an edge competitively.

Steroid use has trickled down to younger athletes too, who face pressure to be stronger and faster, and to make it to college and professional leagues.

Steroids promise bold results, but there is little proof that they deliver them. But they can cause harm — with some ill effects not likely to turn up until years later.

How Do Anabolic Steroids Work?

Anabolic steroids are drugs that resemble the chemical structure of the sex hormone testosterone, which is made naturally by the body. Testosterone directs the body to make or enhance male characteristics, such as increased muscle mass, facial hair growth, and deepening of the voice, and is an important part of male development during puberty.

When anabolic steroids increase the levels of testosterone in the blood, they stimulate muscle tissue in the body to grow larger and stronger. But the effects of too much testosterone circulating in the body can be harmful over time.

What Are the Risks of Anabolic Steroids?

Anabolic steroids are dangerous for various reasons:

  • They're illegal.
  • They can cause health problems, especially when used in large doses over time. The problems may not appear until years after a person took the steroids.
  • Buying them online can be risky because they might be counterfeit and could have added toxic substances in them. 

Possible Side Effects and Health Problems of Anabolic Steroids

Although they might help build muscle, steroids can have very serious side effects. Using them for a long time can harm the reproductive system. In males, steroids can lead to impotence, reduced sperm production in the testicles, and even smaller testicle size.

Females who use steroids may have problems with their menstrual cycles because steroids can disrupt the maturation and release of eggs from the ovaries. This can cause long-term problems with fertility.

When taken for a long time, steroids also can cause:

  • stunted growth in teens (by making bones mature too fast and stop growing at an early age)
  • liver tumors
  • abnormal enlargement of the heart muscles
  • violent, aggressive behavior and mood swings
  • blood lipid problems that contribute to heart disease
  • acne (or a worsening of acne)
  • increased breast growth in males, especially teens
  • irreversible stretch marks
  • a higher risk for hair loss and male-pattern baldness
  • muscle aches

In females, they also can lead to:

  • male-type facial and body hair growth and male-pattern baldness
  • deepening of the voice
  • enlargement of the clitoris

Legal Risks and Other Problems

Besides the health risks, people who use steroids without a prescription are breaking the law. Drug testing for all athletes is common, and those who fail a drug test for steroids can face legal consequences, including jail time, monetary fines, being banned from an event or team, or forfeiture of trophies or medals.

Andro use is banned by many sports organizations, including the International Olympic Committee, the National Football League, the National Basketball Association, the National Collegiate Athletic Association, the Association of Tennis Professionals, and most high school athletic associations.

Steroids can also have serious psychological side effects. Some users may become aggressive or combative, believe things that aren't true (delusions), or have extreme feelings of mistrust or fear (paranoia). And people who use steroids also appear to be at higher risk for using other drugs, such as alcohol or cocaine, often to counteract some of the negative effects of steroids.

Steroid users who inject the drugs with a needle are at risk for infection with HIV (human immunodeficiency virus), the virus that causes AIDS, if they share needles with other users. People who use dirty needles are also at risk for contracting hepatitis, a liver disease, or bacterial endocarditis, an infection of the inner lining of the heart.

Steroids: Stacking and Addiction

Some people "cycle" their steroid doses. This means they take multiple doses of steroids over a period of time, stop for a period, then start up again. "Stacking" means taking two or more different anabolic steroids. Other steroid users may "pyramid" their steroids, starting with a low dose and gradually increasing the dose, frequency, or number of anabolic steroids taken, then tapering off to complete a cycle. Users believe that stacking enhances the effects of each individual drug, pyramiding allows the body to get used to high doses of steroids, and steroid-free periods help the body recuperate from the drugs. There is no scientific evidence to support any of these claims.

A lot of people tell themselves they'll only use steroids for a season or a school year. Unfortunately, steroids can be addictive, making it hard to stop taking them.

And once users stop taking steroids, they can have withdrawal symptoms such as loss of appetite, tiredness, restlessness, insomnia, mood swings, and depression.

What Else Should I Know?

To boost your athletic performance, don't risk harming your body or getting disqualified. Instead, work hard and train the healthy way: eat the right foods, practice, and do strength training without the use of drugs.

Medically reviewed by: Rupal Christine Gupta, MD
Date reviewed: April 2023