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This document reflects emerging clinical and scientific advances as of the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed.

Anabolic steroid use can be addictive and, therefore, difficult to stop. There is evidence that more than 50% of users develop psychologic dependence to these substances. Data show that anabolic steroid use in women is accompanied by extreme dissatisfaction with body image and a body dysmorphic syndrome similar to anorexia. Such women engage in rigid eating and exercise schedules that can impair social and occupational functioning 11.

Anabolic steroids are prescription-only medicines that are sometimes taken without medical advice to increase muscle mass and improve athletic performance.

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 steroids are drugs that help the growth and repair of muscle tissue. They are synthetic hormones that imitate male sex hormones, specifically testosterone.1Anabolic steroids have some legitimate medical uses, including for treating hormonal issues in puberty, and to treat muscle loss caused by other diseases such as cancer and AIDS.2

Anabolic-androgenic steroids, often shortened to "anabolic steroids," "steroids," or "androgens,"2,3 are the most widely misused APED. These are synthetic substances similar to the male sex hormone testosterone. They promote the growth of skeletal muscle (anabolic effects) and the development of male sexual characteristics (androgenic effects) in both males and females.2

Anabolic steroids increase lean muscle mass when used in conjunction with weight training. The aim, for non-athlete weightlifters, is typically improvement of appearance. Steroid use is often associated with a form of male body dysmorphic disorder called muscle dysmorphia, a preoccupation with the perceived inadequate size of their muscles.19

Some anabolic steroids are taken orally, others are injected intramuscularly,29 and still others are provided in gels or creams that are applied to the skin.35 Many users start with the oral form and then progress to injectable forms,36 since the latter causes less liver damage.

A variety of side effects can occur when anabolic steroids are misused, ranging from mild effects to ones that are harmful or even life-threatening. Most are reversible if the user stops taking the drugs. However, others may be permanent or semi-permanent.

Case reports and small studies indicate that anabolic steroids increase irritability and aggression,75 although findings may be confounded by personality traits that are overrepresented in steroid users (i.e., antisocial, borderline, and histrionic personality disorder)78 and use of other drugs.79 People who misuse anabolic steroids report more anger than nonusers,80 as well as more fights, verbal aggression, and violence toward their significant others,81 sometimes called "roid rage." One study suggests that the mood and behavioral effects seen during anabolic-androgenic steroid misuse may result from secondary hormonal changes.82

Unlike most illicit drug use, misuse of anabolic steroids most commonly begins in young adulthood rather than adolescence. But steroid use in teens is of concern, especially since the hormonal systems they interact with play a critical role in brain development during these years.92–96 In adolescent rodents, exposure to anabolic steroids increased neuronal spine densities in the hippocampus and amygdala—brain regions involved in learning and emotions (e.g., aggression), respectively.

An undetermined percentage of steroid users may develop a steroid use disorder. Substance use disorders are defined by continued use despite adverse consequences; for steroid users, these may include physical or psychological problems such as breast growth (in men), sexual dysfunction, high blood pressure, excessive fats in the blood, heart disease, mood swings, severe irritability, or aggressiveness.

Although non-athlete weightlifters account for the bulk of anabolic steroid misuse, occasional steroid use by professional and Olympic athletes to improve performance or cheat in competition ("doping") has done the most to raise awareness of steroid misuse.

Anabolic steroids are prescription-only medicines that are sometimes taken without medical advice to increase muscle mass and improve athletic performance.