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Steroids Side Effects: The Risks For Men, Women, and Teens

Last Updated: September 8, 2022

Authored by Sharon Levy, MD, MPH

Reviewed by Michael Espelin APRN

Similar to the action of the majority of hormonal medications, oral and injectable anabolic steroids side effects include both physical and mental changes. While many anabolic steroids side effects are reversible, some inflict permanent damage. According to a study published in The Journal of Sports Science and Medicine, 60% of anabolic steroids users experience side effects such as irritability and aggressiveness. Moreover, in the same study, increased risk of liver tumors and liver damage is also associated with Anabolic-Androgenic Steroids (AAS) use. Therefore, knowing how steroid agents affect the body can help prevent the development of severe side effects and enable a person to complete the treatment successfully.

What Are The Side Effects Of Steroids?

Different classes of medications provide different side effects and in terms of anabolic steroids, although they mainly work on the physical health of the patient, they may also provide psychological adverse effects. According to a study of the doctors from Italy, although AAS use may provide several positive effects, abusing them may cause neuropsychiatric changes and organ damage.

Moreover, with regards to the different forms of AAS, in the same study, it was reported that the side effects of oral steroids, topical, and injection forms are the same but those who are using the injectable ones may experience adverse reactions in a short period. In this section, information about the physical and psychological effects of steroids will be provided.

Anabolic Steroids Side Effects

Physical Effects Of Steroids

Physical oral, injectable, or topical steroids side effects become more pronounced with time. While almost none of them carries immediate danger, prolonged exposure or abuse to these anabolics significantly increases the risk of developing various cardiovascular, dermal, and hepatic problems.

Steroids and Hormonal Changes

The physical oral, injectable, or topical steroids side effects regarding hormonal changes differ depending on the gender of the patient. The only common side effect on the hormonal system of both genders is androgenetic alopecia. The rest then, diverge.

Below Is Information About the Hormonal Changes Steroid Agents Make on Male Patients:

  • Decreased sperm production
  • Gynecomastia (breast enlargement)
  • Reduced testicle size
  • Testicular cancer

With regards to female patients, according to a study published in the International Journal of Drug Policy, it was reported that women who use anabolic steroid agents may experience masculinizing effects characterized by the following:

  • Voice deepening
  • Decreased breast size
  • Coarse skin
  • Excessive body hair growth

According to a study published in the European Journal of Endocrinology, women may experience excessive body hair growth except on their scalp, and when women continue to use these AAS, irreversible masculinizing effects may occur.

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. Steroid agents 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
  • Enlarged heart

People who use AAS have weaker hearts compared to those who never used the drugs. In the same study, it was also reported that using anabolics regularly for two years worsen heart functions. Mainly, misuse of anabolics may lead to sudden cardiac death.

Liver Problems

One of the most dangerous side effects of oral steroids is potential liver damage. According to a study of medical doctors from Mexico, these drugs are known to cause peliosis hepatis and tumors, and the most common liver problem caused by anabolics is the condition called cholestasis, accounting for 40% of the hepatotoxic conditions.

Moreover, the simultaneous use of steroids and alcohol, as well as taking other medicines and substances that deteriorate liver function, can increase the risk of developing these conditions. Additionally, a medical professional from Wisconsin claims that even over-the-counter anabolic steroid supplements are considered one of the culprits for hepatotoxicity.

Musculoskeletal System

According to a study published in the American Journal of Physical Anthropology, testosterone is a hormone that is responsible for encouraging tissue growth and not bone growth. So, when patients increase their testosterone levels, the neurotransmitters 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. In another study by medical doctors from California, it was reported that people of all ages who use AAS may experience tendon injury or tendon rupture.

Skin Injuries And Allergies

In compliance with a study published in the Archives of Dermatology, one of the most frequent side effects of steroids injection is acne, post-injection pain, and swelling of the injection site. There is also a possibility of developing an allergic reaction to a steroid drug. So, if a person begins experiencing difficulty breathing, swelling of the face or throat, and rashes, it is crucial to get medical help immediately.

Overall, Common Skin Conditions Include:

  • Severe acne from steroids
  • Cysts
  • Oily skin
  • Inflammation of the injection site
  • Allergy to steroids

Some people who use AAS may also observe yellowing of their skin color. This is a manifestation of liver damage called jaundice. If signs of jaundice start to appear, it is advised to seek emergency medical help as soon as possible to avoid other health dangers.

Steroids and Diabetes

Insulin resistance is not the most widely known effect of anabolic abuse. Still, there is a connection between steroid agents 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. According to a study published in the Journal of the European Association, this happens because as patients use AAS, the risk of insulin resistance is also increased. Therefore, for patients with pre-existing health conditions such as diabetes, it is recommended to reach out to a medical doctor if these AAS are suitable for your health condition, or if there are AAS alternatives that may work for the patient.

Infections

Medical professionals from California state that one of the side effects of steroids injection that do not directly relate to the action of the medications is an infection. Although many users start from taking an anabolic steroid drug, most of them eventually transition 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.

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 steroid agents may be severe and should not be overlooked. 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 Steroid Agents May Include:

  • Mania
  • Hypomania
  • Anxiety

The most prevalent psychiatric effect of AAS is anxiety. Moreover, the psychological adverse reactions listed above are only some of the few. In this section, information about the association of anabolics with depression and aggression will be provided.

Steroids And Depression

Depression is one of the long-term effects of steroids. Depression may be particularly severe during the period of abstinence when a person stops using the drugs abruptly. Depressive symptoms during steroid drug 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?

A study of medical doctors from Texas asserts that one of the most frequently encountered short-term effects of anabolic steroid drugs is increased irritability and aggression, and this is most common in teenagers. Chronic users of anabolics 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.

A man reads about the side effects of anabolic steroids.

Steroids Side Effects In Men

While many steroids side effects in males are reversible, some are permanent and require treatment or surgery to fix. Thus, decreased sperm production is one of the long-term effects of 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 during a period of abuse. This side effect is known to improve spontaneously after the person quits using the drugs.

Other Steroids Side Effects in Men Include:

  • Testicular cancer
  • Shrinking of the testicles
  • Gynecomastia
  • Decreased sperm production
  • Baldness

Furthermore, 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.

Steroids Side Effects In Females

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

  • Irreversible voice deepening
  • Decreased breast size
  • Fat redistribution following the male pattern
  • Excessive body hair
  • Female-pattern baldness
  • Coarse skin
  • Clitoral enlargement
  • Irregular periods
  • Infertility
  • Dysphonia

In the same study, it was reported that the levels of testosterone in a woman’s body are too low to cause masculinization. However, the abuse of androgenic medications raises testosterone levels dramatically, which may also lead to the evident enlargement of the clitoris and increased sex drive. The increased size of the clitoris is not dangerous to the woman’s health, but they might develop psychological discomfort and body dysmorphia.

Furthermore, according to a study published in the American Journal of Obstetrics and Gynecology, irregularity in the menstrual cycle is one of the negative effects of anabolic steroid drugs 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 During Pregnancy And Do They Affect Fertility?

Steroids and pregnancy are associated, and irreversible infertility is one of the long-term effects of 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, anabolic abuse can cause complications during pregnancy even when a woman is no longer taking the drugs.

The majority of anabolics are classified as pregnancy category X drugs. The oral steroids side effects in pregnant women and their unborn children greatly outweigh the potential benefits of the treatment. If women continue to abuse these drugs when they get pregnant, they must contact a healthcare provider immediately and discuss withdrawal options. 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. In terms of steroids and breastfeeding or lactation, it is not yet known if anabolics pass into breast milk. For professional advice, reach out to a medical doctor. A medical doctor can provide accurate information about steroids and breastfeeding and steroids and pregnancy.

A person has acne and other problems with skin because of anabolic steroids use.

Teens On Steroids

Unlike it is with recreational drugs, anabolic abuse typically starts in young adulthood rather than during a person’s teenage years. According to the FDA, 4.9% and 2.4% of high school males and females, respectively, in the United States use anabolic steroid drugs. 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 get anabolic steroid drugs 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. Some information about the physical and mental dangers or risks of use of teens will be discussed in this section.

Physical Changes

The physical side effects of anabolic steroid drugs in teenagers differ from those experienced by adults in their severity and the duration of the symptoms. In teen boys, anabolics can cause the following physical changes:

  • Stunted growth
  • Underdevelopment of the testicles
  • Development of breast tissue

Take note that these physical changes listed above are due to increasing levels of testosterone. On the other hand, girls may suffer from the following physical changes:

  • Painful periods
  • Long-lasting damage to the reproductive system
  • Masculinization

Moreover, Both Teen Males and Females May Also Experience Similar Effects From the Use of Aas. Some of These Include the Following:

  • Electrolyte imbalances
  • Fertility problems or impotence
  • Heart and liver abnormalities
  • Skin problems such as jaundice and acne from steroids

Take note that some of these adverse reactions are irreversible, and because of this, parents play a big role. There would be times when teens might not admit to using AAS but still, parents or guardians must watch for potential signs of abuse. If proven a child has been abusing the use of anabolics, considering steroids addiction treatment would be of great help.

Mental Changes

Aside from physical changes, mental changes can also be seen when teens use anabolics. This time, the side effects are common. Teenagers who have a history of anabolic abuse are also more susceptible to developing a psychiatric disorder later in life.

Some Other Mental Changes With the Use of AAS Include the Following:

  • Altered brain structure development
  • Cognitive impairment
  • Mood swings
  • Aggression

According to a study published in Drug and Alcohol Dependence, teens who use the drugs during puberty are likely to suffer more severe cognitive long-term effects of 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

Indeed, the use of anabolics may cause both positive and negative effects on the mental and physical health of the patient, and, the negative ones may frequent when these substances are abused. Moreover, as a parent, understand that addiction is not only for adults but also associated with teens. Therefore, proper guidance is needed so that teenagers may not abuse these medications.

Prevention measures of anabolic 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 anabolics can also be avoided. In any case, anabolic abuse and addiction are serious issues that may require treatment at a rehabilitation facility.

Frequently Asked Questions

Do Steroids Make You Gain Weight?

Generally, AAS affects the metabolism of a person and how fat deposits in the body. Eventually, when one uses these drugs, fat will be deposited to the abdomen, face, and neck, causing weight gain. Additionally, anabolics increase the appetite of an individual which causes the person to eat more and gain more. Lastly, fluid retention caused by ASS is also a factor for weight gain. When extra water is stored in the tissue, weight gain can be observed.

What Are The Side Effects of Steroids on Eyes?

The use of steroid drugs causes yellowing of skin and eyes. Sometimes, people who abuse these substances may cause increased eye pressure that can lead to cataracts or glaucoma. Moreover, when a patient has pre-existing eye conditions or eye soreness, there would be a delay in the healing of the eye when the patient is using anabolic steroid agents. Aside from these, the eye of a patient using anabolics may also become susceptible to infections.a

Do Steroids Make You Sweat?

One of the side effects of steroids is mild to excessive sweating. However, take note that some people may experience this adverse reaction while some may not. If this ADR causes discomfort, consider reaching out to a medical professional for possible steroid alternatives.

How to Avoid Erectile Dysfunction on Steroids?

Understand that some patients may experience ED while some may not. For those who are having trouble with erectile dysfunction, the best way to avoid this from occurring is by either going with alternative AAS or stopping the medication. However, opting for any of these two must require medical intervention to avoid experiencing withdrawal.

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Published on: August 16th, 2019

Updated on: September 8th, 2022

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.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.