Pill capsules

Anabolic steroids are synthetic versions of testosterone that users inject, ingest or apply to their skin in order to increase the amount of testosterone in their bodies.

Testosterone, primarily a male sex hormone, is naturally produced in the body by both men and women. In males, it is responsible for the growth and development of sex organs and also the maintenance of secondary sex characteristics (for example facial hair and bone growth). In females, it helps maintain bone density and muscle mass.

Anabolic steroids add extra testosterone to the body. This testosterone then helps to stimulate or enhance the growth and development of sex organs, muscle mass and bone density. It can also be used to treat other symptoms of diagnosed medical conditions.

When prescribed and supervised by a doctor, there are many legitimate therapeutic and medical uses for anabolic steroids.

Anabolic steroids are often prescribed to treat hormone imbalances, promote appetite, reduce inflammation, stimulate bone growth, induce male puberty or lessen the effects of muscle wasting from chronic diseases.

Testosterone from anabolic steroids, in addition to someone’s natural production, may alter appearance and/or could help enhance physical strength and power.  

When used incorrectly (i.e. without the intent to treat a diagnosed medical condition), anabolic steroids are considered to be a type of appearance-altering and performance-enhancing drug (APED). As an APED, anabolic steroids boost metabolic processes. They promote tissue growth, increase muscle mass and decrease inflammation. Since the use of anabolic steroids can allow an athlete to push harder in training and recover faster, they ultimately boost an athlete’s performance. They also may have an effect on appearance, which may or may not be positive.

The World Anti-Doping Agency’s (WADA) Prohibited List stipulates that anabolic steroids are prohibited for use by athletes at all times.

Dangers of Using Anabolic Steroids

Having high levels of testosterone can be harmful to the body. Without the supervision of a doctor, unnecessarily increasing testosterone levels through anabolic steroid use can result in many harmful side effects. The negative effects are not always physical: steroids can also cause serious changes to the person’s behavioural and psychological characteristics. 

Anabolic steroid use can have lasting and damaging physical effects on the human body that can be different for males and females. The following are common side effects of taking anabolic steroids.

Effects on Male Anatomy

  • Breast growth
  • Premature balding
  • Prostate enlargement
  • Reduced sperm count
  • Impotence and sterility
  • Testicular atrophy

Effects on Female Anatomy

  • Growth of facial hair
  • Male-pattern baldness
  • Deepening of voice
  • Breast shrinkage
  • Irregular menstruation
  • Birth defects in children

The female body requires very small amounts of testosterone to function normally. When taking anabolic steroids, a female can have up to 30 times the standard level of testosterone for women. 

Effects on Both Male & Female Anatomy

  • Greasy hair, oily skin, acne (face and body), night sweats
  • Cardiovascular issues: high blood pressure, elevated cholesterol, blood clotting disorders
  • Gastrointestinal issues: liver cysts, liver cancer, jaundice
  • Musculoskeletal issues: joint pain, cessation of bone growth, decrease in tendon elasticity

Anabolic steroid use can have serious and harmful effects on the person’s emotional and cognitive regulation and alter their psychological responses to situations.

The following are some of the most notable side effects of taking anabolic steroids:

  • Physical and/or psychological dependency
  • Anxiety
  • Irritability
  • Affective disorder (e.g., depression)
  • Delusions
  • Heightened aggression (see “Roid Rage” tab)
  • Insomnia
  • Suicidal thoughts
  • Psychosis (e.g., hallucinations, paranoia)
  • Lying and secretive behaviour
  • Withdrawing from established social relationships
  • Declining academic performance
  • Exhibiting forgetfulness and fatigue

While “‘roid rage” is a convenient shorthand for a number of effects associated with anabolic steroid use, there is a lot of conflicting information out there about the relationship between anabolic steroid use and aggressive and/or violent behaviour.

The science is both clear and nuanced on the relationship between testosterone and aggression:

  • There is a weak link between normal or slightly elevated levels of testosterone and aggression
  • There is a much stronger link between significantly elevated levels of testosterone and aggression, like in long-term or high-dose anabolic steroid usage

Animal studies also show that the effect can be more pronounced in adolescents, spurring violent responses when provoked, and scientists are concerned about the health effects of anabolic steroid use on developing bodies and brains.

In controlled studies of adults, the links are measurable and obvious, but real-world use can be more complicated. Simultaneous use of anabolic steroids and other banned substances, like stimulants and recreational drugs, can also account for some increases in aggressive behaviour and criminality associated with anabolic steroid use.

Anabolic steroids don’t create aggression, but they increase the degree to which a user’s normal responses include aggression and violence and the predictability of those responses.

Further Risks of Anabolic Steroid Use 

Black Market and Illegal Anabolic Steroids

Anabolic steroids are often obtained illegally (e.g. from unregulated businesses or individuals). When anabolic steroids are produced in illegal or uncontrolled environments, they may contain unknown ingredients and fillers that can cause additional harmful side effects.

Masking Agents

Athletes may try to cover up their anabolic steroid use by taking additional drugs. Masking agents are used to conceal the presence of prohibited substances (such as steroids) in an athlete’s sample.  These powerful medications are designed to treat severe illnesses such as cancer and diabetes. When used for reasons other than medically justified purposes, these substances can have serious side effects. In addition to the side effects of steroid use, masking agents can cause erectile dysfunction, a decreased libido, kidney stones, anemia and high blood pressure.

Social and Sport Consequences 

In addition to the many detrimental physical and psychological side effects that are known to be caused from anabolic steroid use, there are also many social consequences.

It is important to remember that anabolic steroids are prohibited substances and banned by WADA. The use and/or possession of steroids reflects a blatant attempt at cheating and can be penalized with a standard four-year sanction by WADA, an International Federation or a National Anti-Doping Organization. Sanctions are imposed on athletes and/or athlete support personnel in order to protect the integrity of sport. A sanctioned athlete or athlete support personnel cannot train, practice or compete with their teams or be involved in any capacity with a sport organization or club (e.g. coaching).

Sanctions are made public and permanently documented, which can affect the athlete’s future involvement and participation in sport. It can also affect the person’s ability to pursue certain career paths (e.g. law enforcement).

Anabolic Steroid Information for the Athlete Support Personnel

Parents, coaches, trainers and teammates play important roles in promoting clean sport by having important conversations with athletes about the dangers and harmful effects of anabolic steroids.

There are many different reasons athletes use anabolic steroids: to alter appearance, to gain a competitive edge, to build muscle faster, stay competitive as they age or to help recover from an injury.  

Learn more about why athletes may be tempted to take anabolic steroids, warning signs to look for and how to help provide support to athletes.

Diet & Training as Alternatives to Steroids

To learn about how to optimize diet, consult a certified dietician through Dieticians of Canada.

For help with a specialized strength and conditioning plan, contact Can Fit Pro or the National Strength and Conditioning Association to find a specialist in your area.

Steroids - Take the Quiz

References and Resources

The Role of Anabolic Androgenic Steroids in Disruption of the Physiological Function in Discrete Areas of the Central Nervous System – Bertozzi, Sess, Albano, Sani, Maglietta, Roshan, Volti, Bernardini, Avola, Pomara, and Salerno, via NCBI

Anabolic Androgenic Steroids and Aggression: Studies Using Animal Models – McGinnis, via NCBI

The Myth of “Roid Rage” - Discover

Facts and Myths About ‘Roid Rage – CBS News

More Male Than Male – Benson, via American Psychological Association

Brain Connectivity Aberrations in Anabolic-Androgenic Steroid Users – Westlye, Kaufmann, Alnæs, Hullstein, and Bjørnebekk, via NCBI

Steroid Abuse – The Taylor Hooton Foundation

RCMP - Drugs and New Trends: Drug Awareness Fact Sheets