Anabolic steroids: Use, abuse and addiction

Anabolic steroids (anabolic androgenic steroids, AAS) are synthetic (man-made) versions of testosterone. Testosterone is the most important sex hormone in men. The hormone allows the development and maintenance of male sexual characteristics, such as facial hair, a deep voice and muscle growth. Women have only a little testosterone in their bodies. Doctors treat various diseases with this, but sometimes people (such as bodybuilders and athletes) also abuse these drugs. This leads to adverse health effects such as aggression, acne and erection problems. They may also lead to addiction problems.

  • What are anabolic steroids?
  • Use of androgenic anabolic steroids
  • Methods of administration of synthetic variants of the male sex hormone testosterone
  • Abuse
  • Health effects of anabolic steroid abuse?
  • General
  • Men
  • Women
  • Teenagers
  • Addiction to anabolic steroids
  • Withdrawal symptoms
  • Therapy


What are anabolic steroids?

Anabolic steroids are synthetic (man-made) androgens that are structurally related and have similar effects to testosterone (main sex hormone in men). They are anabolic and increase protein in cells, especially in skeletal muscle. In addition, they are necessary for the development and maintenance of male sexual characteristics, such as the growth of facial and body hair, a deep voice and muscle growth. Women do have some testosterone in their bodies, but in much smaller amounts.

Use of androgenic anabolic steroids

Anabolic androgenic steroids have two different, but overlapping, types of effects. Anabolic means that the steroids promote anabolism (cell growth). Androgenic (or virilizing) indicates the development and maintenance of male characteristics. Doctors use anabolic steroids to treat some hormonal problems such as delayed puberty. Anabolic steroids then stimulate muscle growth and appetite and initiate male puberty. The doctor also uses steroid androgens to treat chronic conditions that cause muscle loss, such as cancer and AIDS. Doctors also sometimes prescribe anabolic steroids for patients with certain types of anemia.

Methods of administration of synthetic variants of the male sex hormone testosterone

There are four common forms in which anabolic steroids are administered:

  1. creams/gels for local application to the skin
  2. skin patches
  3. injectable steroids (the AAS are injected into the muscles)
  4. oral (taken by mouth) pills


Some athletes abuse anabolic steroids to improve athletic performance / Source: Skeeze, Pixabay


However, some people abuse anabolic steroids (excessive doses or long-term use). A number of bodybuilders and athletes use anabolic steroids to build muscle, improve athletic performance and/or improve their appearance. The majority of people who abuse steroids are male weightlifters between the ages of twenty and forty. The abuse of anabolic steroids is much less common in women. The doses are usually 10 to 100 times higher than the doses a doctor uses to treat medical conditions. Without a doctor’s prescription, this is illegal or unsafe.

Health effects of anabolic steroid abuse?


The abuse of anabolic steroids, especially over a long period of time, has been linked to many health problems, including:

  • acne
  • a stroke
  • high blood pressure (hypertension)
  • liver disease, such as liver failure and liver cancer
  • an increased risk of blood clots
  • heart problems, such as an enlarged heart (cardiomegaly), a heart attack
  • mental and psychological: severe mood swings, hallucinations, paranoid (extreme, unreasonable) jealousy, extreme irritability and aggression, delusions (false beliefs or ideas), impaired judgment, mania
  • kidney damage or kidney failure
  • pain when urinating (dysuria)
  • changes in blood cholesterol levels (increased low-density lipoprotein and decreased high-density lipoprotein)



Possible complications of anabolic steroid abuse in men include:

  • breast growth
  • a low sperm count/infertility
  • an enlarged prostate (prostatic hypertrophy)
  • a reduction in the size of the testicles
  • a shrinkage of the testicles (testicular atrophy)
  • a reduced sperm count
  • baldness
  • priapism (prolonged, often painful erection of the penis)
  • prostate cancer
  • spontaneous erections / erectile dysfunction
  • infertility



In women, the abuse of anabolic steroids may lead to irreversible masculinization with the following possible complaints:

  • a deeper voice
  • an enlargement of the clitoris
  • a reduction in the size of the uterus
  • a reduction in the size of the breasts
  • growth of body and facial hair (hirsutism)
  • male pattern baldness/hair loss
  • changes in the menstrual cycle



Possible adverse effects also arise in teenagers from the use of AAS, such as:

  • growth retardation (when high hormone levels of steroids signal to the body to stop bone growth too early)
  • stunted height (when teens use steroids before their growth spurt)


Addiction to anabolic steroids

Anabolic steroids may be addictive. A person then craves the drug, needs more to get the same effect, and also faces withdrawal symptoms if he suddenly stops taking it. A person addicted to anabolic steroids will want to continue using them despite unpleasant physical side effects. When doctors prescribe steroid medications, they always recommend weaning off the medication slowly by gradually reducing the dose.

Sometimes sleep problems arise / Source: Unsplash, Pixabay

Withdrawal symptoms

Stopping anabolic steroids suddenly leads to withdrawal symptoms including:

  • apathy (lack of motivation in life)
  • concentration problems
  • a depression, which is sometimes serious and sometimes even leads to suicide attempts
  • a craving
  • a craving for steroids
  • a loss of appetite
  • a reduced sex drive
  • extreme fatigue
  • feelings of anxiety
  • joint pain
  • headache
  • restlessness
  • sleep problems such as insomnia
  • muscle strain
  • mood swings



A combination of behavioral therapy and medications treat an addiction to anabolic steroids. Antidepressants treat depression and painkillers relieve headaches, muscle aches and joint pain. The doctor prescribes other drugs to help restore the patient’s hormonal system.

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