How Dangerous Are Anabolic Steroids?

Medically Reviewed by Zilpah Sheikh, MD on January 18, 2024
8 min read

Anabolic steroids are drugs made in a lab that mimic the naturally occurring male sex hormones called androgens. Testosterone is the primary type of androgen. Doctors prescribe anabolic steroids to promote the growth of skeletal muscle and the development of male sexual characteristics for conditions such as low testosterone (male hypogonadism), certain cancers, or acquired immunodeficiency syndrome (AIDS).

Around 3 to 4 million people in the U.S. use anabolic steroids without a prescription for nonmedical purposes. They're the most common appearance- and performance-enhancing drugs (APEDs). Some athletes and bodybuilders may use them as a way to enhance their physical appearance. 

Anabolic steroid street names

Slang words for steroids are hard to find. Most people just say steroids. 

The scientific name for this class of drugs is anabolic-androgenic steroids. Anabolic refers to muscle-building. Androgenic refers to increased male characteristics. But even scientists shorten it to anabolic steroids.

Although the nicknames for anabolic steroids change over time, some of the current common names according to the United States Drug Enforcement Administration include:

  • Arnolds
  • Gear
  • Gym candy
  • Juice
  • Pumpers
  • Roids
  • Stackers
  • Weight gainers

Anabolic steroids vs. corticosteroids

Corticosteroids are general steroid medications that reduce inflammation and dampen the activity of your immune system. They're lab-made to work like cortisol, a hormone made by your adrenal glands. 

Doctors prescribe corticosteroids much more often than anabolic steroids. You may need them to treat conditions such as asthma, eczema, muscle and joint conditions, lupus, or multiple sclerosis.  

Anabolic steroids activate androgen receptors in your body. That means they create the same effect that androgens do in the body. This makes them an ideal treatment for people dealing with low testosterone levels. 

They can also help lower estrogen levels, which can help treat estrogen receptor positive breast cancer by blocking the growth of cancer cells that use estrogen to grow. For people with cancer or AIDS who are losing muscle, anabolic steroids increase the number of androgen receptors in skeletal muscle and increase it in size and strength.

 

Anabolic steroid pills

Anabolic steroids you take by mouth are available in tablet or capsule form. Some you take sublingually, which means under the tongue. 

Other forms of anabolic steroids

  • Injections
  • Creams or topical gels
  • Patches
  • Pellets you implant under the skin

List of anabolic steroids

The different types of anabolic steroids a doctor can prescribe include:

  • Danazol (Danocrine)
  • Fluoxymesterone (Androxy, Halotestin)
  • Mesterolone (Proviron)
  • Methyltestosterone (Android, Methitest, Testred, Virilon)
  • Nandrolone Decanoate (Deca-Durabolin)
  • Nandrolone Phenpropionate (Durabolin)
  • Oxandrolone (Oxandrin)
  • Oxymetholone (Anadrol)
  • Testosterone buccal system (Striant)
  • Testosterone capsules (Jatenzo)
  • Testosterone injection (Andro-L.A., Aveed, Delatestryl, Depo-Testosterone, Virilon, Xyosted)
  • Testosterone nasal gel (Natesto)
  • Testosterone patches (Androderm, Testoderm)
  • Testosterone skin solution (Axiron)
  • Testosterone subcutaneous pellets (Testopel)

Doctors use these drugs to help treat delayed puberty, and improve muscle mass and strength in people who have conditions that reduce muscle tissue. Some doctors prescribe it for testosterone supplementation therapy to improve mood and sexual performance in older men. 

Anabolic steroids for muscle growth

The misuse of anabolic steroids is common among athletes because it increases lean muscle mass more quickly and dramatically when combined with weight lifting than weight lifting alone. Many people who take it deal with a body dysmorphic disorder called muscle dysmorphia, which is a preoccupation with muscle size and the fear that muscles are too small.  

Cycling and stacking

Some people "cycle" their anabolic steroid use by taking the drugs for a while and then pausing for a while before they start them again. Another method called "stacking" involves taking more than one type of anabolic steroid at a time in hopes that this will make the drugs work better. 

Pyramiding

"Pyramiding" is another type of anabolic steroid usage people try to prevent harmful side effects. This involves a combination of both stacking and cycling. You start by taking a low dose of one or more anabolic steroids, and then increase your dosage over time. Once you get to a maximum dose, you stop taking them for a rest period before starting again. 

Plateauing

When anabolic steroids are staggered, overlapped, or substituted with another type of steroid to avoid developing tolerance, this is called "plateauing." There's no scientific research that shows any of these methods improve the drugs or reduce the risk of negative effects. 

To use anabolic steroids safely, you need a prescription and supervision of a doctor. 

Some of the typical side effects of the drug include:

  • Acne 
  • Oily skin
  • Ankle swelling
  • Problems peeing
  • Breast enlargement in people assigned male at birth
  • Reduced breast size in people assigned female at birth
  • Worse sleep apnea, if you have it
  • Decrease in testicle size
  • Vaginal dryness, burning, itching, or bleeding
  • Changes to your period

The average nonprescription dose of anabolic steroids is 10–100 times stronger than one a doctor would prescribe. This makes side effects much more severe when you use them without a prescription. Some can be reversed, but some are permanent. 

If you take anabolic steroids outside of a doctor's care, you may have serious side effects that can have a negative impact on your health. You're at risk of:

  • High blood pressure
  • Blood clots
  • Heart issues, including heart attack
  • Stroke
  • Liver damage
  • Short stature (if you're an adolescent)
  • Male-pattern baldness
  • Aggression
  • Mania
  • Delusions
  • Major depressive disorder.

Are anabolic steroids addictive?

Nearly one-third of people who misuse anabolic steroids become dependent on them. That means over time it starts to take higher and more frequent doses to get the same effects. 

People who become dependent on anabolic steroids can also have withdrawal symptoms if they stop taking them. Without the drug in their system, they may feel tired and restless, stop eating and sleeping, lose their sex drive, and crave the drug. In some cases, withdrawal causes depression and thoughts of suicide.

Your moods and emotions are balanced by the limbic system of your brain. Steroids act on the limbic system and may cause irritability and mild depression. Eventually, steroids can cause mania, delusions, and violent aggression, or "roid rage."

When steroids get into the body, they go to different organs and muscles. Steroids affect individual cells and make them create proteins. These proteins cause issues such as:

  • Tumor growth in the liver
  • Peliosis hepatis (blood-filled cysts on the liver that can rupture and cause internal bleeding)
  • Atherosclerosis, which causes fat deposits inside arteries to disrupt blood flow. When blood flow to the heart is blocked, a heart attack can occur. If blood flow to the brain is blocked, a stroke can result.
  • Weakened immune system, which increases your risk of infection and illness

If you inject anabolic steroids and share a needle with others, you're at great risk of getting HIV, hepatitis B, and hepatitis C. 

Can you overdose on anabolic steroids?

Anabolic steroids aren't a drug you can overdose on. The negative effects of the drug are ones that develop over time. 

 

Studies show that few people who misuse anabolic steroids seek treatment to stop using them. To treat steroid use, the most effective methods involve uncovering the underlying causes of the misuse.

Treatment options include:

  • Therapy and possibly medication for muscle dysmorphia
  • Endocrine therapies to help treat low testosterone levels after stopping anabolic steroids to help prevent and reduce symptoms of depression
  • Antidepressants 
  • Drug and psychosocial treatments for people who are also dependent on opioids. These methods may work to reduce dependence on anabolic steroids

 

Anabolic steroids are Schedule III substances under the Controlled Substances Act. That means it's illegal to use them without a prescription. Only a small number of anabolic steroids are approved for either human or veterinary use.

Legal anabolic steroids

The only way to use steroids legally is to have a prescription for them.

Research on high school athletes shows they're less likely to misuse anabolic steroids if their friends and family disapprove. Peer pressure has a strong effect. 

But simply educating students about the dangers of anabolic steroid misuse doesn't have the same preventive results. Studies show it's more effective to talk about the whole picture of anabolic steroids: the risks and the benefits. Often, this helps them believe the negative aspects are true (and that they should avoid them).  

Other research shows that focusing on the prevention of high-risk behavior in general can be a catchall to help ward off anabolic steroid use. 

Doctors prescribe anabolic steroids to help with skeletal muscle and the development of male sexual characteristics. Around 3 to 4 million people in the U.S., however, use anabolic steroids without a prescription for nonmedical purposes, including as appearance- and performance-enhancing drugs (APEDs). If you take anabolic steroids outside of a doctor's care, you may have serious side effects that can have a negative impact on your health. Talk to your doctor about possible treatment plans if you're worried about misusing steroids.

  • What are anabolic steroids mainly used for? Around 3 to 4 million people in the U.S. use anabolic steroids without a prescription for nonmedical purposes. They're the most common appearance- and performance-enhancing drugs (APEDs).
  • Are anabolic steroids ever safe? Doctors prescribe anabolic steroids to help with skeletal muscle and the development of male sexual characteristics for conditions like low testosterone (male hypogonadism), certain cancers, or acquired immunodeficiency syndrome (AIDS).
  • Are anabolic steroids illegal? It's illegal to use anabolic steroids without a prescription.