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Steroids and Performance and Image Enhancing Drugs

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

Performance And Image Enhancing Drugs (PIED's), including steroids are a large group of compounds produced by the body of all animals, including humans. Steroids occur naturally or can be produced synthetically. Different groups of steroids include corticosteroids, anabolic steroids, androgenic steroids, oestrogenic steroids and anti-inflammatory steroids.

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.

Anabolic androgenic steroids have two types of effects. The Anabolic effects include increased muscle growth and the androgenic effect increases the body’s male characteristics.

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 are PIEDs used? 

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. 

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).

Short and Long Term Effects

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:



Males and Females

Shrinking testicles

Growth of facial hair



Changes in the menstural cycle (it may stop)


Testicular cysts

Enlargement of the clitoris

High blood pressure

Reduced sperm count

Deepened voice

Liver damage and cancer


Decreased breast size

Increased risk of injury

Pain when urinating

Hair growth on the back and bottom

Increased cholesterol levels

Development of breasts


Decreased immune function

Decreased testosterone production


Increased muscle size and strength

Stunted growth and physical development


Damage to kidneys and heard

Increased testosterone levels



    Urinary tract infections

Cardiac arrest


Psychological effects, depression, paranoia and mood changes


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.

Method of 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.


This means that a person needs more of the drug to achieve the same effects they did previously with smaller amounts. Steroids work differently than other drugs. The amount taken does not need to be increased over time to achieve the same effect. Increasing doses of steroids is related to cycles, stacking and pyramiding to achieve greater effects and results. Many steroids are made illegally and can contain harmful, unknown substances that may increase the side effects. 


People who use steroids may become dependent on the drug and continue to use it despite the side effects and health risks. Many PIED’s users report psychological dependence and body dysmorphia.


When a person stops using steroids they may experience withdrawal symptoms. Anecdotal reports indicate many people experience symptoms including headaches, insomnia, cravings, decreased sexual libido, depression, suicidal thoughts, fatigue, restlessness, muscle pain, anorexia, muscle loss and dissatisfaction with body image.

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

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 they are using anabolic androgenic steroids and during pregnancy, anabolic androgenic steroids 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.

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.

Using alcohol and other drugs with PIED’s may lead to increased harms and effects.

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

It is illegal to possess, use, manufacture, supply, import or trade steroids without a prescription or licence. Penalties range from a $2,000 fine and/or a two-year prison term to a $100,000 fine and/or imprisonment for 25 years. Any person convicted of a drug offence will receive a criminal record and this can lead to difficulties in getting a job, health insurance, credit or visas for overseas travel.

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.

PIEDs treatment pathways 

There are a variety of treatment pathways available for people with steroid-related problems. The drug(s) used and the availability of services as well as the user’s health, desired outcome, support network and unique circumstances need to be taken into consideration. Deciding on the most appropriate treatment pathway is best done in consultation with an alcohol and other drug counsellor.

See Staying Safe for information on safer use.



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