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What Are Steroids & PIEDs? Health Effects & Use

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

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What are steroids and performance and image enhancing drugs?

Performance and Image Enhancing Drugs (PIED's), including steroids refers to substances, which include anabolic-androgenic steroids, hormones and peptides that can be used to enhance muscle growth (‘anabolic’ effects) or to reduce fat (‘catabolic effects’). Steroids occur naturally or can be produced synthetically. Different groups of steroids include corticosteroids, anabolic steroids, androgenic steroids, oestrogenic steroids and anti-inflammatory steroids. The most commonly used PIEDS are anabolic-androgenic steroids.

Anabolic-androgenic steroids (AAS)

Anabolic-androgenic steroids (AAS) are synthetic hormones that replicate male sex hormones, specifically testosterone. Which increase muscle mass and decrease body fat.  These are commonly used by athletes to improve performance and appearance.

In Australia, using steroids without a doctor’s prescription is illegal. PIEDs may be prescribed by a doctor for:

  • Testosterone deficiency
  • Some types of anaemia
  • Some types of cancers
  • Calcium deficiency
  • Skeletal growth
  • Muscle-wasting conditions
  • Muscle, tendon, ligament injuries
  • Gender transition.

Why do people use PIEDs? 

People may use steroids illegally to improve their appearance, athletic or work performance. Anabolic androgenic steroids include the male sex hormone testosterone and its synthetic alternatives.

Testosterone is the hormone responsible for the development of sex characteristics. For example, at puberty, it produces acne, growth spurts, body hair, deepening of the voice and development of male sex organs. It is found in large amounts in males and small amounts in females.

Where do PIEDs come from? 

The use of steroids began with body builders and weight lifters in the late 1950s. They have spread to other sports, and are used for a range of performance and image enhancing purposes. Many drugs, including steroids, have been banned from sporting competitions to protect the health of athletes and to ensure fair competition.

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).

Health Effects and Risks

Using steroids may cause many negative physical and psychological (mental health) side effects. Some of the effects are irreversible and some can lead to death.

The effects of steroids will vary from person to person depending on the following:

  • Physical size.
  • Exercise level.
  • The amount of steroid used and its purity.
  • Whether the steroid is taken orally or injected.
  • Alcohol and other drug interaction.

Health effects for Males and Females can include:


  • Shrinking testicles
  • Impotence
  • Testicular cysts
  • Reduced sperm count
  • Baldness
  • Pain when urinating
  • Development of breasts
  • Decreased testosterone production
  • Stunted growth and physical development
  • Increased testosterone levels


  • Growth of facial hair
  • Changes in menstural cycle (it may stop)
  • Enlargement of the clitoris
  • Deepened voice
  • Decreased breast size
  • Hair growth on the back and bottom
  • Infertility

Males and Females

  • Acne
  • Bloating
  • High blood pressure
  • Liver damage and cancer
  • Increased risk of injury
  • Increased cholesterol levels
  • Decreased immune function
  • Increased muscle size and strength
  • Damage to kidneys and heart
  • Insomnia
  • Urinary tract infection
  • Cardiac arrest
  • Psychological effects, depression, paranoia and mood changes
  • Eating disorders

Risks are especially high for young people. If PIEDs are taken while a person is still growing they can cause a number of problems including stunted growth.

Many of the side effects of PIEDs use are reversible in men once use has ceased. Side effects in women are more likely to be permanent.

Many PIEDs are illegally made and can contain harmful contaminants and unknown substances which may increase the side effects. Many steroids are designed for animal use and not for human consumption, and some counterfeit products may not contain any anabolic steroids at all.

Studies have also found that violent and aggressive behaviour is associated with anabolic-androgenic steroid use.

Steroids, pregnancy and breastfeeding

Most drugs can affect an unborn child. Using anabolic-androgenic steroids is not recommended if you are considering pregnancy or are pregnant. The likelihood of becoming pregnant may be reduced if anabolic-androgenic steroids are used. During pregnancy if anabolic-androgenic steroids are used they may affect the development of the foetus. For example, the female foetus may develop male characteristics.

It is recommended that women check with their doctor (or other health professional) if they are using or planning to use drugs while pregnant or breastfeeding, including prescribed and over-the-counter medicines.

Method of use

Steroids are taken orally as tablets or injected into muscles. People who use steroids illegally may take higher amounts than a doctor would normally prescribe.  Some steroids are water based or oil based. You can test positive for some oil based steroids up to 12 months after a single use. Steroids are often used in the following regimes:

  • Stacking - Taking several different types of PIEDs at the same time in an attempt to improve their effectiveness.
  • Cycling - Taking doses of PIEDs over a period of time, stopping for a break and then starting again.
  • Pyramiding - Increasing steroid use to a peak amount and then slowly reducing the amount.
  • Each of these methods can increase the risk and harms of steroid use. 

Unsafe injecting practices also carry the risk of transmission of HIV and other blood borne diseases such as hepatitis B and hepatitis C. Injecting can cause muscle damage, scarring and infection at the injection site.

Steroids and Mental Health

Steroid use can cause anxiety, depression, paranoia and psychosis in people who have a vulnerability to mental health problems.

Steroids and eating disorders

There have been several studies which show the relationship between body image and eating disorders among PIED users. More people are using PIED to look after their appearance; the pressure can be the trigger for an eating disorder or a body image disorder.

Impact on Your Life

Steroid use can impact on your life in many ways. It can lead to relationship, financial and legal problems.

Steroids and relationship issues 

Drug use can lead to social and emotional issues and can affect relationships with family and friends. People who use steroids often report they experience:

  • Mood changes
  • Increased aggression and behaviour – often known as ‘roid rage’.
  • Frustration
  • Depression
  • Over competitiveness
  • Anger
  • Irritability
  • Irrational behaviour
  • Addiction or dependence
  • Negative financial impacts.

Steroids and financial problems

The street price of steroids depends on availability, supply and the type of steroid being purchased. The cost of purchasing steroids can lead to financial problems for both occasional and regular users.

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:

  • Possession offences: up to $2,000 in fines and/or two years in prison.
  • 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.

Steroids and sport

Athletes who compete in sports which are governed by a World Anti-Doping Code compliant anti-doping policy need to be aware that they cannot just take any drug or medication, or even use certain methods.

The World Anti-Doping Agency has a Prohibited List that sets out which substances and methods are banned in sport. This is updated each year based on scientific and medical, research, trends and intelligence gathered from law enforcement and pharmaceutical companies.

Frequent testing of athletes both in and out of competition increases the chance of athletes getting caught and being banned from competition, sometimes for life.

Quitting Options

People decide to quit using PIEDs for a lot of reasons including it is harming 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.

Thinking about quitting your PIEDs use? Worried you may struggle? You are not alone. Help is only a phone call away.

You can call a 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).

See the Staying Safe section for harm reduction tips.

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