Anabolic Steroids Side Effects: Short- & Long-Term Reactions

Last Updated: December 18, 2019

Authored by Sharon Levy, MD, MPH

Similarly to the action of the majority of hormonal medications, anabolic steroids effects include both physical and mental changes. While many anabolic steroids side effects are reversible, some inflict permanent damage. Knowing how steroids affect the body can help prevent the development of severe side effects and enable a person to complete treatment successfully.

Anabolics Physical Side Effects

Despite the positive effects of steroids, physical side effects of anabolic steroids become more pronounced with time. While almost none of them carries immediate danger, prolonged exposure to anabolics significantly increases the risk of developing various cardiovascular, dermal, and hepatic problems.

Cardiovascular System

Anabolic drugs are generally safe to use in doses prescribed by a medical professional. Abuse of medications, however, has been linked to the development of various heart conditions. Steroids can cause high blood pressure, atherosclerosis, heart attack, and stroke.

Other cardiovascular side effects of anabolics abuse may include:

  • spasms of coronary arteries
  • increased blood clotting
  • decrease in high-density lipoprotein
  • increase in low-density lipoprotein
  • decreased function of the heart’s ventricles
  • steroids can also cause an enlarged heart

steroids and diabetes

Can Steroids Cause Diabetes?

Insulin resistance is not the most widely known effect of anabolics abuse. Still, there is a connection between steroids and diabetes that stems from the way these drugs affect fat tissue in the body. While male users experience a reduction in the percentage of body fat, anabolics cause people to have more visceral fat. This tissue that surrounds various organs has been linked to type 2 diabetes before.


One of the side effects of anabolic steroids that doesn’t directly relate to the action of the medications is an infection. Although many users start from taking anabolic steroids pill, most of them eventually transit to administering the drugs via an intramuscular injection, which makes them more susceptible to contracting infectious diseases such as hepatitis and HIV. It is also possible to develop endocarditis, an infection that causes inflammation of the heart.

steroids and liver

Liver Problems

One of the most dangerous side effects of oral steroids is potential liver damage. These drugs are known to cause peliosis hepatis and tumors. The simultaneous use of steroids and drinking, as well as taking other medicines and substances that deteriorate liver function, can increase the risk of developing these conditions.

Musculoskeletal System

Increasing testosterone levels in boys signal the bones to stop growing. Therefore, when anabolics are given to children during puberty, the drugs can inhibit bone development and cause stunted growth.

Skin Injuries And Allergies

One of the most frequent side effects of steroids is acne. Many users experience post-injection pain and swelling of the injection site. There is also a possibility of developing an allergic reaction to steroids.

Overall, common skin conditions related to the use of anabolic drugs include:

  • severe acne
  • cysts
  • oily skin
  • inflammation of the injection site
  • allergy to steroids

Psychological Effects Of Steroids

Hormonal medications tend to alter a person’s mood and mental state, as well as their physical condition. These symptoms depend on how long steroids stay in one’s body and may appear during treatment or after the individual stops taking the drugs. During abuse or misuse, the psychological side effects of anabolic steroids may be severe and should not be overlooked.

Steroids And Depression

Depression is one of the anabolic steroids effects that emerge after long-term use. Depression may be particularly severe during the period of abstinence when a person stops using the drugs abruptly. Depressive symptoms during withdrawal can also appear due to the individual’s concerns about the possible changes in their appearance after they quit anabolics.

Do Steroids Make One Angry?

One of the most frequently encountered short-term effects of anabolic steroids is increased irritability and aggression. Chronic steroids users reportedly demonstrate aggressive behavior, engage in more fights and verbal violence. The severity of these symptoms varies depending on each person’s characteristics and potential for violence.

steroids depression and anxiety

Other Mental Issues Developed Due To Anabolics Abuse

Those who abuse anabolic medications are at a higher risk of suffering from mood swings and various mental disturbances that can worsen if left untreated. Some of the psychological effects of anabolic steroids may include:

  • mania
  • hypomania
  • anxiety

Side Effects Of Steroids In Men

Despite the positive effects of steroids on men with various disorders, excessive and uncontrolled use of these drugs can be incredibly harmful. While many steroids side effects in males are reversible, some are permanent and require treatment or surgery to fix. Sexual steroids side effects for men include:

  • testicular cancer
  • shrinking of the testicles
  • gynecomastia
  • decreased sperm production
  • baldness.

Do Steroids Make One’s Penis Smaller?

Shrinking of the testicles is one of the side effects of anabolic steroids, but the drugs can’t make a man’s penis smaller. However, anabolics can reduce the blood flow to the penis, hence reducing libido and causing impotence. The decreased blood flow and the difficulty getting or maintaining an erection can cause a user’s penis to look smaller, although the length suffers no factual changes.

do steroids make your dick smaller

Do Steroids Make One Sterile?

Decreased sperm production is one of the long-term effects of anabolic steroids in males. Excessive levels of testosterone signal the body that it does not need to produce natural amounts of the hormone anymore, which leads to testicular atrophy. Consequently, anabolics can render a man infertile for the period of abuse. This side effect is known to improve spontaneously after the person quits using the drugs.

Steroids Side Effects In Females

While some effects of steroids on women are positive, long-term use of steroids can cause adverse and sometimes permanent changes. The most common side effects of steroids in women include:

  • voice deepening
  • decreased breast size
  • fat redistribution following the male pattern
  • excessive body hair
  • male-pattern baldness
  • coarse skin
  • clitoral enlargement
  • irregular periods
  • infertility

Enlarged Clitoris From Steroids

The overdeveloped clitoris is one of the steroids side effects for females. Typically, the levels of testosterone in a woman’s body are too low to cause masculinization. The abuse of androgenic medications raises testosterone levels dramatically, which may lead to the evident enlargement of the clitoris and increased sex drive.

Can Steroids Affect Period?

Irregularity in the menstrual cycle is one of the negative effects of anabolic steroids that a woman can experience. The hormone estrogen regulates periods. Large amounts of testosterone inhibit the production of estrogen, leading to painful and irregular menstruation. Depending on the type and dose of anabolics, periods may stop altogether. The cycle eventually normalizes after the abuse stops.

Steroids And Fertility

Potentially, irreversible infertility is one of the long-term effects of anabolic steroids. AAS medications significantly impair normal ovaries function, which can lead to infertility during the period of abuse. In the majority of cases, gradual withdrawal and correct treatment when it is needed can help a woman regain the ability to have healthy children. Sometimes, however, anabolics abuse can cause complications during pregnancy even when a woman is no longer taking the drugs.

steroids during pregnancy

Steroids During Pregnancy

The majority of anabolics are classified as pregnancy category X drugs. The side effects of anabolic steroids in pregnant women and their unborn children greatly outweigh the potential benefits of the treatment.

The negative effects of steroids begin even before the baby is born. Androgenic medications inhibit the function of ovaries and make it significantly harder to get pregnant. If a woman requires treatment while trying to get pregnant, there are effective alternatives to steroids that a doctor may consider.

Anabolics can cause virilization of external genitalia in female fetuses and reversible oligospermia in male fetuses. The medications also cause complications during pregnancy.

The relationship between steroids and breastfeeding is complicated. Most doctor will refrain from prescribing testosterone to nursing mothers. However, breastfeeding while on androgenic medication might be safe if the drugs are used in prescribed therapeutic doses. Due to low oral bioavailability, testosterone is unlikely to get into the milk and affect the baby adversely.

Teens On Steroids

Unlike it is with recreational drugs, anabolics abuse typically starts in young adulthood rather than during a person’s teenage years. However, the use of these drugs by teenagers should be addressed separately as the negative effects of steroids can inflict much greater damage to those whose bodies are still developing.

Teenagers who are going through puberty might be tempted to buy anabolic steroids to improve their physique and public image. Appearance is a major concern for many teens, and the desire to look stronger can overpower the knowledge about the dangers of the medications.

how does the abuse of anabolic steroids affect teens

Physical Changes

Physical side effects of anabolic steroids in teenagers differ from those experienced by adults in their severity and the duration of the symptoms. In teen boys, anabolics can cause stunted growth and underdevelopment of the testicles. Girls may suffer from painful periods and long-lasting damage to the reproductive system. Teenagers are also at an increased risk of developing cardiovascular and skin problems.

Mental Changes

Teens who use the drugs during puberty are likely to suffer more severe cognitive long-term effects of anabolic steroids. Studies demonstrate that anabolics affect the areas of the brain that regulate learning and emotions. Therefore, teenagers on anabolics may become noticeably more aggressive and distracted. Difficulty regulating one’s emotions and concentrating might persist after the person stops using the drugs.

Prevention Of Anabolic Medications Side Effects

Prevention measures of anabolics misuse are based on the comprehensive approach, which includes education, high-risk behavior screening, and counseling amongst teenagers as well as young adults. Discouraging anabolics use during this period ensures the lesser likelihood of abuse. Consequently, the negative effects of anabolic steroids can also be avoided. In any case, anabolics abuse and addiction are serious issues that may require treatment at a rehabilitation facility.

Page Sources

  1. Allan C. A. Sex steroids and glucose metabolism. Asian Journal of Andrology. 2014;16(2):232–238. doi:10.4103/1008-682X.122589.
  2. Gen Kanayama, James I. Hudson, and Harrison G. Pope, Jr. Long-Term Psychiatric and Medical Consequences of Anabolic-Androgenic Steroid Abuse. Drug and Alcohol Dependence. 2008; 98(1-2): 1–12. doi: 10.1016/j.drugalcdep.2008.05.004.
  3. El Osta R, Almont T, Diligent C, Hubert N, Eschwège P, Hubert J. Anabolic steroids abuse and male infertility. Basic and Clinical Andrology. 2016; 26:2. doi:10.1186/s12610-016-0029-4.
  4. Middleman AB, Faulkner AH, Woods ER, Emans SJ, DuRant RH. High-risk behaviors among high school students in Massachusetts who use anabolic steroids. Pediatrics. 1995; 96(2 Pt 1):268-72.
  5. Goldberg L, Bents R, Bosworth E, Trevisan L, Elliot DL. Anabolic steroid education and adolescents: do scare tactics work? Pediatrics. 1991;87(3):283-286.

Published on: August 16th, 2019

Updated on: December 18th, 2019

About Author

Sharon Levy, MD, MPH

After successful graduation from Boston University, MA, Sharon gained a Master’s degree in Public Health. Since then, Sharon devoted herself entirely to the medical niche. Sharon Levy is also a certified addiction recovery coach.


Leave a comment