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What are Steroids? Health Effects, Risks and Use

Also known as: Anabolic Steriods | Roids | Gear | Juice | Gym Candy

Steroid use may cause negative physical health and mental health effects ranging from facial and body acne in both men and women, to other more serious effects such as heart disease and liver tumours. Some of the effects can cause irreversible changes. 

 

 

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What are Anabolic Androgenic Steroids?

What are Anabolic Androgenic Steroids?

Performance and Image Enhancing Drugs (PIEDS) are substances that include anabolic androgenic steroids, hormones and peptides. PIEDS are usually used by people to help them improve their physical appearance and/or enhance muscle strength.1

Anabolic-androgenic steroids (AAS) are the most common PIEDS used in Australia. The non-medical use of anabolic-androgenic steroids have increased over years.2,3

How do Anabolic-androgenic steroids work?

The term ‘anabolic’ is used to describe tissue building and muscle development, whereas ‘androgenic’ refers to the development of secondary male characteristics.4

AAS work by replicating the effects of testosterone, which is the naturally occurring male sex hormone. Testosterone is responsible for the development of masculine characteristics, such as male hair patterns, vocal changes, and voice deepening.5,6,7 Testosterone can change body composition and help increase muscle mass.8

Is possessing and using steroids legal in Western Australia? 

The possession and use of steroids is illegal without a prescription.9 In addition, the use of AAS is prohibited in and out of competition in all professional sports in Australia.10

Why do people use AAS?

The main group of people who use AAS are men who want to improve their physical appearance, and to increase their muscle mass and strength and decrease body fat.11,12,13 AAS have also been linked to use by athletes wishing to improve their endurance and athletic performance.

How are they used? 

AAS can be taken orally (by mouth), however most are injectable. 14 Most oral forms of AAS are short-acting, lasting up to approximately 24 hours. Injected AAS are relatively long-acting that can last several days to weeks.15

There are three different methods people apply to using steroids including:

Cycling

This is when an individual goes through ‘on’ and ‘off’ periods of taking steroids (i.e. starting and stopping).16

Pyramiding

This is when small amounts of steroids are used and is gradually increased over the weeks. Towards the end of the cycle an individual will ‘step down’ to reduce the likelihood of negative side effects.17

Stacking

This is typically when an individual administers lots of different drugs at the same time.18

How many people use? 

The National Drug Strategy Household Survey 2016 reported that less than one percent (0.1%) of Western Australians aged 14 years and over had used steroids in the previous year (for non-medical purposes).19

Side Effects and Health Risks

Side Effects and Health Risks

Using AA steroids may cause many negative physical and psychological side effects - some of these effects are even life-threatening.  Luckily, most of the side effects are reversible if the individual stops taking the drug. The effects of steroid use will vary from person to person depending on the following:

  • Physical size.
  • Exercise level.
  • The amount of AAS used.
  • Whether it is taken orally or injected.
  • Alcohol and other drug interactions.

Effects for males and females can include:

  • Facial and body acne21
  • Personality Changes22
  • Increased aggressiveness and possible violent behaviour23
  • Abscess after injection24
  • Decreased libido25
  • High blood pressure26
  • Psychosis27
  • Jaundice (yellowing of the skin or eyes)28
  • Depression29
  • Sleeping problems30
  • Stroke31
  • Heart disease32
  • Liver damage33
  • Cardiovascular complications34
  • Increased LDL ('bad') cholesterol levels and decreased HDL cholesterol35
  • Stunted growth for young people.36

Effects for males

  • Female-like breast enlargement37
  • Enlargement of the prostate gland38
  • Reduced sperm count<sup39
  • Smaller testicles40
  • Ejaculation problems41
  • Sexual problems42

Effects for females 

  • Masculinization43
  • Enlarged clitoris44
  • Facial and body hair growth45
  • Irregular periods46
  • Deepened voice47
  • Smaller breasts48
  • Reduced fertility49
  • Baldness.50

Long term effects 

  • Liver Damage51
  • Cardiovascular complications52
  • High blood pressure53
  • Tendon / ligament damage.54

Injecting Anabolic Steroids 

Injecting steroids increases the risk for the transmission of infectious diseases such as human immunodeficiency virus (HIV), hepatitis B and C virus as well as increasing the risk of skin infections.55

It is safest to never share injecting equipment. In WA, sterile injecting equipment is available from the Needle and Syringe Exchange Programs (NSEP).

Withdrawal 

Withdrawal from AAS usually occurs when an individual develops dependence. Research suggests that there is a risk of developing AAS dependence for individuals who use multiple AAS in large doses simultaneously.56

Long term use of AAS may lead to the development of a number of withdrawal symptoms including depression, insomnia and fatigue.57

Steroids and the law

Steroids and the law

In Western Australia, under the Misuse of Drugs Act 1981, it is illegal to use, possess, manufacture or supply steroids without a prescription or licence.

 

Offences under this Act carry heavy fines and/or prison sentences. Penalties vary depending on the offence:

  1. Possession offences: up to $2,000 in fines and/or two years in prison.
  2. Supply offences: up to $100,000 in fines and/or 25 years in prison.

A person convicted of a drug offence can receive a criminal record, which can lead to difficulties in getting a job, health insurance, credit or visas for overseas travel.

Quitting Options

Quitting Options

People decide to quit using AAS for many reasons including experiencing harm to their physical and/or mental health and wellbeing, their relationships with friends and others they care about, or because they are starting new employment and may be drug tested.

Are you thinking about quitting your AAS use? Are you worried you may about the side effects? You are not alone. Help is only a phone call away.

You can call a confidential qualified alcohol and other drug counsellor at the Alcohol and Drug Support Line. The counsellors can assist in planning your quit attempt, and talk with you about the options available to assist you. You can call them 24/7 on (08) 9442 5000 or 1800 198 024 (country callers).

Steroids - factsheet

Steroids - factsheet

Steroids | The Facts 

  1. Van de Ven, K., Maher, L., Wand, H., Memedovic, S., Jackson, E., & Iversen, J. (2018). Health risk and health seeking behaviours among people who inject performance and image enhancing drugs who access needle syringe programs in australia. Drug and Alcohol Review, 37(7), 837–846. https://doi.org/10.1111/dar.12831
  2. Griffiths, S., Jacka, B., Degenhardt, L., Murray, S. B., & Larance, B. (2018). Physical appearance concerns are uniquely associated with the severity of steroid dependence and depression in anabolic-androgenic steroid users. Drug and Alcohol Review, 37(5), 664–670. https://doi.org/10.1111/dar.12688
  3. Basaria, S. (2018). Use of performance-enhancing (and image-enhancing) drugs: a growing problem in need of a solution. Molecular and Cellular Endocrinology, 464, 1–3. https://doi.org/10.1016/j.mce.2018.02.004
  4. Bagchi, D., Nair, S., & Sen, C. K. (Eds.). (2018). Nutrition and enhanced sports performance : muscle building, endurance, and strength (Second). Academic Press. INSERT-MISSING-URL.
  5. Nassar GN, Leslie SW. Physiology, Testosterone. 2021 Jan 9. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30252384.
  6. Kanayama, G. and H. G. Pope, Jr. (2018). "History and epidemiology of anabolic androgens in athletes and non-athletes." Molecular and Cellular Endocrinology 464: 4-13.
  7. Nassar GN, Leslie SW. Physiology, Testosterone. 2021 Jan 9. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30252384.
  8. Bagchi, D., Nair, S., & Sen, C. K. (Eds.). (2018). Nutrition and enhanced sports performance : muscle building, endurance, and strength (Second). Academic Press. INSERT-MISSING-URL.
  9. Your Room. Anabolic Steroids. Retrieved from: https://yourroom.health.nsw.gov.au/a-z-of-drugs/Pages/anabolic-steroids.aspx and Performance Enhancing Drugs Side Effects | Your Room (nsw.gov.au)
  10. World Anti-Doping Agency. What is Prohibitied (2021). Retrieved from: www.wada-ama.org/en/content/what-is-prohibited?gclid=EAIaIQobChMIuOn-gc2b8gIVzL2WCh0ivQG4EAAYASAAEgK8nPD_BwE ma.org)
  11. Kanayama, G. and H. G. Pope, Jr. (2018). "History and epidemiology of anabolic androgens in athletes and non-athletes." Molecular and Cellular Endocrinology 464: 4-13.
  12. Williams, M. H., Rawson, E. S., & Branch, J. D. (2017). Nutrition for health, fitness, & sport (Eleventh). McGraw-Hill Education. P.592
  13. Fred, H. (2019). Androgenic-anabolic steroids. Accessscience, 2019, 2019–2019. https://doi.org/10.1036/1097-8542.033380
  14. Barceloux, D. G., & Palmer, R. B. (2013). Anabolic-androgenic steroids. Disease-A-Month : Dm, 59(6), 226–48. https://doi.org/10.1016/j.disamonth.2013.03.010
  15. Johnson, B. A. (2011). Addiction medicine : science and practice. Springer. https://doi.org/10.1007/978-1-4419-0338-9
  16. Hoffman, J. R., & Ratamess, N. A. (2006). Medical issues associated with anabolic steroid use: are they exaggerated?. Journal of sports science & medicine, 5(2), 182–193.
  17. Hoffman, J. R., & Ratamess, N. A. (2006). Medical issues associated with anabolic steroid use: are they exaggerated?. Journal of sports science & medicine, 5(2), 182–193.
  18. Hoffman, J. R., & Ratamess, N. A. (2006). Medical issues associated with anabolic steroid use: are they exaggerated?. Journal of sports science & medicine, 5(2), 182–193.
  19. Australian Institute of Health and Welfare, National Drug Strategy Household Survey 2016; supplementary data table 7.18, Canberra
  20. Williams, M. H., Rawson, E. S., & Branch, J. D. (2017). Nutrition for health, fitness, & sport (Eleventh). McGraw-Hill Education. P.592
  21. Williams, M. H., Rawson, E. S., & Branch, J. D. (2017). Nutrition for health, fitness, & sport (Eleventh). McGraw-Hill Education. P.593
  22. Fred, H. (2019). Androgenic-anabolic steroids. Accessscience, 2019, 2019–2019. https://doi.org/10.1036/1097-8542.033380
  23. Williams, M. H., Rawson, E. S., & Branch, J. D. (2017). Nutrition for health, fitness, & sport (Eleventh). McGraw-Hill Education. P.593
  24. van Amsterdam, J., Opperhuizen, A., & Hartgens, F. (2010). Adverse health effects of anabolic–androgenic steroids. Regulatory Toxicology And Pharmacology, 57(1), 117-123. https://doi.org/10.1016/j.yrtph.2010.02.001
  25. Williams, M. H., Rawson, E. S., & Branch, J. D. (2017). Nutrition for health, fitness, & sport (Eleventh). McGraw-Hill Education. P.593
  26. Williams, M. H., Rawson, E. S., & Branch, J. D. (2017). Nutrition for health, fitness, & sport (Eleventh). McGraw-Hill Education. P.593
  27. Fred, H. (2019). Androgenic-anabolic steroids. Accessscience, 2019, 2019–2019. https://doi.org/10.1036/1097-8542.033380
  28. Williams, M. H., Rawson, E. S., & Branch, J. D. (2017). Nutrition for health, fitness, & sport (Eleventh). McGraw-Hill Education. P.593
  29. Fred, H. (2019). Androgenic-anabolic steroids. Accessscience, 2019, 2019–2019. https://doi.org/10.1036/1097-8542.033380
  30. van Amsterdam, J., Opperhuizen, A., & Hartgens, F. (2010). Adverse health effects of anabolic–androgenic steroids. Regulatory Toxicology And Pharmacology, 57(1), 117-123. https://doi.org/10.1016/j.yrtph.2010.02.001
  31. Williams, M. H., Rawson, E. S., & Branch, J. D. (2017). Nutrition for health, fitness, & sport (Eleventh). McGraw-Hill Education. P.593
  32. Williams, M. H., Rawson, E. S., & Branch, J. D. (2017). Nutrition for health, fitness, & sport (Eleventh). McGraw-Hill Education. P.593
  33. Fred, H. (2019). Androgenic-anabolic steroids. Accessscience, 2019, 2019–2019. https://doi.org/10.1036/1097-8542.033380
  34. Fred, H. (2019). Androgenic-anabolic steroids. Accessscience, 2019, 2019–2019. https://doi.org/10.1036/1097-8542.033380
  35. Williams, M. H., Rawson, E. S., & Branch, J. D. (2017). Nutrition for health, fitness, & sport (Eleventh). McGraw-Hill Education. P.593
  36. Williams, M. H., Rawson, E. S., & Branch, J. D. (2017). Nutrition for health, fitness, & sport (Eleventh). McGraw-Hill Education. P.593
  37. Williams, M. H., Rawson, E. S., & Branch, J. D. (2017). Nutrition for health, fitness, & sport (Eleventh). McGraw-Hill Education. P.593
  38. Williams, M. H., Rawson, E. S., & Branch, J. D. (2017). Nutrition for health, fitness, & sport (Eleventh). McGraw-Hill Education. P.593
  39. Williams, M. H., Rawson, E. S., & Branch, J. D. (2017). Nutrition for health, fitness, & sport (Eleventh). McGraw-Hill Education. P.593
  40. Williams, M. H., Rawson, E. S., & Branch, J. D. (2017). Nutrition for health, fitness, & sport (Eleventh). McGraw-Hill Education. P.593
  41. van Amsterdam, J., Opperhuizen, A., & Hartgens, F. (2010). Adverse health effects of anabolic–androgenic steroids. Regulatory Toxicology And Pharmacology, 57(1), 117-123. https://doi.org/10.1016/j.yrtph.2010.02.001
  42. van Amsterdam, J., Opperhuizen, A., & Hartgens, F. (2010). Adverse health effects of anabolic–androgenic steroids. Regulatory Toxicology And Pharmacology, 57(1), 117-123. https://doi.org/10.1016/j.yrtph.2010.02.001
  43. Williams, M. H., Rawson, E. S., & Branch, J. D. (2017). Nutrition for health, fitness, & sport (Eleventh). McGraw-Hill Education. P.593
  44. Williams, M. H., Rawson, E. S., & Branch, J. D. (2017). Nutrition for health, fitness, & sport (Eleventh). McGraw-Hill Education. P.593
  45. Williams, M. H., Rawson, E. S., & Branch, J. D. (2017). Nutrition for health, fitness, & sport (Eleventh). McGraw-Hill Education. P.593
  46. Christou, M. A., Christou, P. A., Markozannes, G., Tsatsoulis, A., Mastorakos, G., & Tigas, S. (2017). Effects of anabolic androgenic steroids on the reproductive system of athletes and recreational users: a systematic review and meta-analysis. Sports Medicine, 47(9), 1869–1869. https://doi.org/10.1007/s40279-017-0709-z
  47. Williams, M. H., Rawson, E. S., & Branch, J. D. (2017). Nutrition for health, fitness, & sport (Eleventh). McGraw-Hill Education. P.593
  48. Fred, H. (2019). Androgenic-anabolic steroids. Accessscience, 2019, 2019–2019. https://doi.org/10.1036/1097-8542.033380
  49. Fred, H. (2019). Androgenic-anabolic steroids. Accessscience, 2019, 2019–2019. https://doi.org/10.1036/1097-8542.033380
  50. van Amsterdam, J., Opperhuizen, A., & Hartgens, F. (2010). Adverse health effects of anabolic–androgenic steroids. Regulatory Toxicology And Pharmacology, 57(1), 117-123. https://doi.org/10.1016/j.yrtph.2010.02.001
  51. Fred, H. (2019). Androgenic-anabolic steroids. Accessscience, 2019, 2019–2019. https://doi.org/10.1036/1097-8542.033380
  52. Fred, H. (2019). Androgenic-anabolic steroids. Accessscience, 2019, 2019–2019. https://doi.org/10.1036/1097-8542.033380
  53. Hoffman, J. R., & Ratamess, N. A. (2006). Medical issues associated with anabolic steroid use: are they exaggerated?. Journal of sports science & medicine, 5(2), 182–193.
  54. Hoffman, J. R., & Ratamess, N. A. (2006). Medical issues associated with anabolic steroid use: are they exaggerated?. Journal of sports science & medicine, 5(2), 182–193.
  55. Ip, E. J., Yadao, M. A., Shah, B. M., & Lau, B. (2016). Infectious disease, injection practices, and risky sexual behavior among anabolic steroid users. Aids Care, 28(3), 294–299. https://doi.org/10.1080/09540121.2015.1090539
  56. Bates, G., et al. (2019). "Treatments for people who use anabolic androgenic steroids: a scoping review." Harm Reduction Journal 16(1).
  57. Bates, G., et al. (2019). "Treatments for people who use anabolic androgenic steroids: a scoping review." Harm Reduction Journal 16(1).
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