Anabolic Steroid Misuse

Overview

Anabolic steroids are man-made versions of the male hormone testosterone. In medicine, they are used for a few specific health conditions. Misuse means taking them without a prescription, in much higher doses, or for reasons like building muscle or improving athletic performance. This is not safe and can harm your body and mind.

While most people do not use anabolic steroids, misuse does happen, especially among athletes, bodybuilders, and people who want a more muscular look. Because it is often secret, the exact numbers are hard to know.

It mostly affects men and boys, but women and girls can also misuse steroids. It is more common in young adults, especially those involved in competitive sports or bodybuilding, but it can affect anyone at any age.

Symptoms

Common symptoms

• Acne and oily skin
• Swelling of the hands, feet, or body due to fluid retention
• Increased aggression or irritability (sometimes called 'roid rage')
• Mood swings, anxiety, or depression
• Problems sleeping
• Changes in sex drive (higher or lower than normal)
• In men: testicles may shrink, and breast tissue may grow
• In women: voice may deepen, body hair may increase, and periods may become irregular

Symptoms in children

• In teenagers, steroid misuse can cause bones to stop growing too early, leading to shorter height than expected.
• It can also cause severe acne and early signs of balding.
• Mood changes can lead to aggressive behavior and problems at school.

Symptoms in older adults

• Older adults may have more severe heart and blood pressure problems.
• Steroids can worsen existing conditions like prostate enlargement or kidney disease.
• Fluid retention can be more noticeable and more dangerous in older age.

Causes

Main causes

• Wanting to gain muscle mass or body weight quickly
• Wanting to improve sports performance or win competitions
• Pressure from coaches, trainers, or friends to use steroids
• Body image issues, such as muscle dysmorphia (feeling your body is too small or weak even when it is not)
• Believing myths that steroids are 'safe' or 'necessary' for success

Risk factors

• Being involved in strength-based sports or bodybuilding
• Having low self-esteem or a poor body image
• Having a history of eating disorders or substance misuse
• Having friends or teammates who use steroids
• Lack of education about the real risks

When to see a doctor

See a doctor urgently if:

• If you have thoughts of harming yourself or others, seek help immediately.
• If you have chest pain, severe shortness of breath, or signs of a stroke, call your local emergency number.
• If you have signs of an infection where you inject, such as increasing pain, redness, or fever.

Book a routine appointment if:

• If you are using or have used steroids and want help to stop.
• If you have concerns about side effects like acne, mood problems, or changes in your body.
• If a friend or family member is using steroids and you are worried about them.

Diagnosis

A doctor will ask about your health, exercise habits, and any substances you use. They will want to know how long you have used steroids and how you take them. This is not to blame you, but to plan the safest care.

Tests that may be done

• Blood tests to check liver function, kidney function, and hormone levels
• Blood pressure and heart checks
• Physical examination to look for signs like acne, fluid swelling, or breast tissue in men
• Assessment of mood and mental health

What to expect at your appointment

The doctor will ask personal questions in a safe, confidential setting. They may offer blood tests to check for any damage. Based on the results, they will discuss steps to reduce harm and support you, which may include counseling or specialist referral.

Treatment

Treatment for anabolic steroid misuse focuses on stopping safely, managing withdrawal, and addressing the reasons behind the misuse. It is not a 'one-size-fits-all' approach. A doctor or counselor can help you quit at a pace that is safe for you.

Self-care at home

• Talk to a trusted doctor or counselor about your steroid use.
• Find a support group for people who want to stop using performance-enhancing drugs.
• Set small goals to cut down gradually, if stopping all at once feels too hard.
• Keep a journal of how you feel – it can help you notice patterns and triggers.
• Reach out to a friend or family member who supports your health goals.

Medical treatments

Doctors may provide care to manage withdrawal symptoms such as depression, fatigue, or low sex drive. This often includes counseling and, in some cases, short-term medicines to help stabilize mood and hormones. The exact approach depends on your individual symptoms and should be discussed with your healthcare provider. Never take any medicine not specifically prescribed for you.

When is surgery considered?

Surgery is not a direct treatment for steroid misuse. However, if misuse has caused a complication such as severe breast tissue enlargement in men, a doctor may discuss options like surgery with you after you have stopped using steroids and your hormone levels have stabilized.

Living with this condition

Recovery from steroid misuse is a gradual process. You may feel tired or low while your body readjusts. Be patient with yourself. Structure your days with healthy routines like regular meals, enough sleep, and gentle exercise to support your body's recovery.

Lifestyle tips

• Avoid alcohol and recreational drugs, which can worsen mental health and liver stress.
• Find safe, non-drug ways to manage stress, such as breathing exercises, meditation, or hobbies.
• Build a social circle that supports a healthy, drug-free lifestyle.
• Follow up regularly with your doctor to monitor your health.

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables, whole grains, and lean proteins. This supports your liver, heart, and hormones. Exercise in moderation – you do not need extreme workouts to be healthy. A qualified trainer or physical therapist can help you build a safe routine that does not rely on performance-enhancing drugs.

Mental health and emotional wellbeing

Steroid misuse can affect your mood, cause anxiety or depression, and make you feel irritable or aggressive. These effects can last after you stop. Therapy, such as cognitive behavioral therapy (CBT), can help you cope with body image issues and build healthier self-esteem. You deserve support for your mental wellbeing.

Prevention

Yes, to a large degree. Educating yourself about the real risks of steroids and building a healthy body image are key. If you or your child are involved in sports, talk openly with coaches and health professionals about safe ways to train and eat. Choose natural, evidence-based methods for strength and performance.

Screening programmes

There is no standard screening test for steroid misuse, but doctors may ask about substance use during routine check-ups. Being open about your habits can help catch problems early.

Complications

If left untreated

• Permanent damage to the heart, including high blood pressure and heart failure
• Liver damage, including tumors or liver failure
• Kidney failure
• Blood clots and stroke
• Severe mood disorders, including depression and aggressive outbursts
• Fertility problems in both men and women
• Increased risk of infections if sharing needles or using unclean injection equipment

Long-term outlook

The good news is that many health problems caused by steroid misuse can improve once you stop using them, especially if caught early. Your heart, liver, and hormones can recover with time and support. It may take months, but with medical guidance and patience, you can rebuild your health and a fulfilling life without steroids.

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