The 16 Worst Steroid Side Effects in Bodybuilding

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Written By Jonathan Deventer

What Is Being Done to Prevent Steroid Shot Side Effects?

It’s no wonder that steroid side effects are a common occurrence with bodybuilders experimenting with anabolic substances.

Anabolic steroids are powerful compounds that have far-reaching effects on the body.

While some adverse reactions can be fairly minor, such as acne and oily skin, others can be quite dangerous. Interference with cholesterol levels and liver failure could prove deadly.

Still, considering anabolic steroids?

A lot of people think that the positive effects of steroids are worth the risks, but when you have natural steroid alternatives that can also benefit your bodybuilding, their allure seems to fade.

We’re going to cover the side effects of anabolic steroids below and explain the benefits of boosting your gym performance without the potential for adverse effects.

Steroid Side Effects

The medical establishment has determined that anabolic steroids can be used as therapeutic compounds with very little risk in the right context.

However, their use does present the risk of side effects.

Risks of side effects increase with performance-level dosages, which often exceed what is medically recommended.

When it comes to the world of anabolics, side effects are almost a given.

Some bodybuilders see the side effects of anabolic steroids as a rite of passage. Some performance users wear their side effects like a badge that shows commitment to getting results.

Common adverse effects can include:

  • Acne, oily skin, and hair
  • Hair loss and male pattern baldness
  • Heart disease
  • Kidney disease
  • Altered mood, depression, suicidal tendencies
  • Shrinking testicles
  • Infertility
  • Stunted growth
  • Excess facial or body hair

The side effects of anabolic steroids in bodybuilding listed above are common, though kidney disease results from oral steroid use more often than it does from injectable steroids.

One study observed that the frequency of side effects in a group of 772 anabolic steroid users was 96.4%.

The risk of using anabolic steroids is indeed high, but the 96.4% figure represents the rate of experiencing any steroidal side effects across the board.

That is just to say that not all of the participants experienced severe, life-threatening adverse reactions. This statistic only reinforces that it is not common for performance users of steroids to escape side effects entirely.

The side effects that result from using anabolic steroids can be divided into three distinct categories:

  1. Basic side effects
  2. Side effects in men
  3. Side effects in women

This article will only cover the most common Steroid side effects attributed to anabolic steroid use.

Several anabolic steroids cause certain side effects that are unique to them only side effects that the majority of other anabolic steroids do not share and those will not be discussed here.

What are steroids used for?

While they are used in medical contexts, the dominant use of steroids remains improving physique and athletic performance.

First and foremost, anabolic steroids are hormones that influence and control several functions in the human body with very diverse effects.

Bodybuilders and athletes use steroids to enhance their looks, get an edge over their competition, and gain substantial muscle size and strength.

But are they worth the gains with all the dangers they bring?

Increasingly bodybuilders are deciding that they are not and are turning to legal and safe supplements to bolster their results at the gym.

bulking ans cutting steroids

Liver Damage

Liver damage is something you’ve probably heard of in the media. It is perhaps the most talked about side effect of oral steroids.

And it’s no joke—oral anabolics are particularly harmful to the liver because they must pass through untouched.

The threat of toxicity to the liver from anabolic steroids generally arises when they are taken orally. The hormone must be modified chemically to allow bioavailability when taken orally.

Without this change to its chemical structure, oral anabolic steroids will be largely metabolized by the liver and converted into inactive metabolites that are excreted. Very little of the anabolic steroid reaches the bloodstream as a result of this process, so there is very little effect.

For an anabolic steroid to be effective when taken orally, it must be chemically altered at the 17th carbon.

This is what is called C17-Alpha Alkylation (also known as methylation or, in some cases, methylation). A methyl group (or ethyl group) is bonded to the anabolic steroid, and this alkylation makes the anabolic steroid particularly resistant to hepatic metabolism.

The stronger this resistance to being broken down in the liver, the more toxic it is on the liver and the more strain it puts on the organ. In chemically altering the anabolic steroid in this manner, a good percentage of the hormone can survive being metabolized in the liver to enter the bloodstream.

Oral steroids like Dianabol, Anadrol, and Winstrol can cause permanent damage to the liver. This is especially true when doses are higher and the user is cycling for long periods.

Although there are some supplements that bodybuilders take to ease the strain on the liver, the bottom line is natural steroid supplements are a much more healthy option.

When someone uses anabolic steroids in the doses needed for bodybuilding, they can and do adversely affect the cardiovascular system.

This is true for all anabolic steroids, but the degree to which these adverse changes occur in the cardiovascular system can depend on the particular anabolic steroid taken.

Some steroids, like Winstrol, are known to produce more severe adverse effects than others.

Physique builders will often suggest that many of the adverse effects on the cardiovascular system can be mitigated with appropriate changes in nutrition and diet.

Anabolic steroids taken in therapeutic doses, which are a lot less than the doses taken for bodybuilding, have been known to cause adverse effects on the cardiovascular system under certain conditions. These instances are far less frequent, however.

Some performance users believe that most of the cardiovascular effects that result from using anabolic steroids are short-lived and entirely reversible. Instances of people suffering from heart attacks and strokes from solitary cycles of anabolic steroids are held to be rare.

However, abusing these drugs excessively by taking high doses, engaging in long periods of use, and/or running extremely long cycles can help produce a long-term cumulative effect that can increase long-term risk to the heart.

The cardiovascular side effects of steroid use include adverse changes in cholesterol levels, an increase in blood pressure, and ventricular hypertrophy.

Cardiovascular Side Effects

When someone uses anabolic steroids in the doses needed for bodybuilding, they can and do adversely affect the cardiovascular system.

This is true for all anabolic steroids, but the degree to which these adverse changes occur in the cardiovascular system can depend on the particular anabolic steroid taken.

Some steroids, like Winstrol, are known to produce more severe adverse effects than others.

Physique builders will often suggest that many of the adverse effects on the cardiovascular system can be mitigated with appropriate changes in nutrition and diet.

Anabolic steroids taken in therapeutic doses, which are a lot less than the doses taken for bodybuilding, have been known to cause adverse effects on the cardiovascular system under certain conditions. These instances are far less frequent, however.

Some performance users believe that most of the cardiovascular effects that result from using anabolic steroids are short-lived and entirely reversible. Instances of people suffering from heart attacks and strokes from solitary cycles of anabolic steroids are held to be rare.

However, abusing these drugs excessively by taking high doses, engaging in long periods of use, and/or running extremely long cycles can help produce a long-term cumulative effect that can increase long-term risk to the heart.

The cardiovascular side effects of steroid use include adverse changes in cholesterol levels, an increase in blood pressure, and ventricular hypertrophy.

Cholesterol Interference

The use of all anabolic steroids will cause adverse changes in the cholesterol profiles of the user.

Taking steroids leads to lower levels of high-density lipoprotein (HDL), which is considered to be good cholesterol.

Conversely, low-density lipoprotein (LDL) offers no protection to the arteries. LDL is known as bad cholesterol, and it can be increased with steroid use at the same time that HDL levels decline.

These changes result in an increased risk of developing arteriosclerosis. Higher doses produce stronger negative changes and more risk.

Other factors contributing to the negative changes in cholesterol levels are administration route as well as duration of use.

Anabolic steroids taken orally have a bad reputation for causing more severe adverse effects on cholesterol levels when compared to anabolic steroids administered through injections.

The liver acts as the processing center for cholesterol in the body, and the rise in hepatotoxicity that comes with the use of C17 Alpha Alkylated oral steroids use can cause the negative changes in cholesterol levels to be even worse as it puts added stress on the liver.

A study in 1996 had test subjects take 300mg of Testosterone Cypionate a week. HDL levels in the participants were shown to decrease by 25%.

However, when the dose was raised to 600mg a week in these same subjects, there were no further reductions in HDL cholesterol. This seemed to indicate a ceiling for this effect, at least with this particular anabolic.

Experience PED users suggest a clean diet that includes a variety of healthy foods to promote the right levels of cholesterol. 2 – 4 grams a day of fish oils and foods containing omega-3 fatty acids are recommended while engaging in an anabolic steroid cycle.

Bodybuilders claim that with the right diet, changes in cholesterol profiles resulting from anabolic steroid use can be assuaged to some extent.

Individuals often carry out anabolic steroid cycles in periods ranging from 8 to 12 weeks at a time with 4-month breaks between cycles.

This type of protocol is used to help eliminate the risk of long-term cumulative changes occurring in the user’s arteries.

When someone uses steroids continuously without taking breaks, there is a greater chance that severe buildup of cholesterol in the arteries will result over time. This is what causes arteriosclerosis and oral anabolic steroids taken without breaks over an extended time increase the risk of this condition.


Increased Blood Pressure

Elevated blood pressure is a potential side effect of steroid use, but this seems to happen only in certain situations under specific conditions.

Reportedly, an increase in blood pressure usually results from an increase in water retention.

This can be caused by higher Estrogen levels resulting from androgens being aromatized (converted) into Estrogen.

When someone is bloated from water retention, their blood pressure rises from the increased fluid, both intracellularly and extracellularly. This in turn increases the pressure on both arterial walls.

Bodybuilders attempt to eliminate this side effect by using a type of anabolic steroid that won’t turn into Estrogen in the body, or by using an aromatase inhibitor, such as Letrozole, Arimidex, or Aromasin.

These are used to stop the aromatase enzyme that is responsible for converting androgens into Estrogen.

When a large number of these enzymes are disabled, the process of Estrogen conversion stops and the levels of Estrogen circulating in the blood will drop.

This causes a drop in the bloating and water retention that was due to high levels of Estrogen, which in turn can lower the blood pressure.

Elevations in blood pressure among anabolic steroid users can be moderate. Several other factors besides estrogen-related water retention can cause an increase in blood pressure in anabolic steroid users.

But the main cause of increased blood pressure is still held to be either excessive amounts of Estrogen conversion or an unhealthy diet that contains too many simple carbohydrates and too much sodium.

Advanced performance users argue that blood pressure can be kept in the normal range in someone using anabolic steroids if they avoid large increases in Estrogen and maintain a healthy nutritious diet that contains a moderate amount of sodium, with no carbohydrates or simple sugars.

Heart Enlargement

Using anabolic steroids raises the probability that both the left and right ventricular walls will thicken and enlarge.

However, the left ventricle is the one that’s especially been seen to grow in muscular size among anabolic steroid users. The heart muscle in athletes who do use anabolic steroids has been observed to grow in size to a greater extent than the hearts of non-steroid-using athletes.

Athletes who use anabolic steroids and have a left ventricle that has grown beyond a specific point can exhibit impairment in heart efficiency and function.

The degree to which the muscles in the heart exhibit significant changes in growth is said to be directly related to the dosages taken of the anabolic steroids. Higher doses are often reported to result in a greater amount of heart tissue growth.

Heart size in users can also get smaller or grow larger depending on the user’s habits. For example, the heart gets smaller when the use of anabolics is discontinued.

Whether heart growth benefits the athlete or is a hindrance continues to be a topic of debate among experts in sports medicine.


Probably one of the most common side effects of anabolic steroid use is acne.

Effects will vary depending on the steroids you’re using, dosages, and your genetics.

Let’s break this down:

The subcutaneous glands of the skin have a high affinity to the chemical Dihydrotestosterone (DHT).

This is an androgen that is naturally produced by the body when testosterone and other anabolic steroids based on testosterone are converted through an enzyme called 5-alpha Reductase.

DHT is highly androgenic. Androgens like DHT have varying levels of affinity to androgen receptors that lie just beneath the skin.

When DHT binds to these receptors, it can stimulate excess secretion of sebum causing oily skin. Sebum is an oil secreted by the sebaceous glands, and the size of these glands can also increase from anabolic steroid use.

With more activity in these subcutaneous glands, oily skin develops, which can combine with dead skin and bacteria. Without taking the proper precautions, pores can become clogged leading to acne.

This side effect is certainly not life-threatening, and it does affect individuals differently. Some may not develop any acne, while others may get a minor case of acne. Some will develop severe acne with very noticeable breakouts.

Here are the most common solutions that bodybuilders use:

  • Natural steroid alternatives
  • Regular skin cleansing with an oil-free, non-comedogenic cleanser
  • Topical anti-androgen

Take a look at any steroid side effects pictures and you’ll see just how out of control they can get.


The dreaded “man-boobs,” also known as gynecomastia, is the prototypical male-only side effect of steroids.

It is a condition in which men develop breast tissue that can resemble female breasts.

The reason?

Men who use anabolic steroids are at significant risk of gynecomastia if the type they’re using causes substantial Estrogenic activity.

This could be via aromatization, a process whereby the aromatase enzyme converts androgens into estrogen. From here, estrogen finds its way to breast tissue receptors.

Estrogenic activity can come directly from the steroid itself independent of aromatization. Anadrol is a steroid that carries the risk of estrogenic side effects despite being impervious to aromatization.

Gynecomastia can also be caused by the use of anabolic steroids that demonstrate high Progestogenic activity since both Estrogen and Progesterone are essential hormones in the development of breast tissue.

The development of breast tissue can cross a point of no return with anabolic steroid use. The result is an unsightly appearance that can only be fixed with cosmetic surgery.

If you’re someone who values your appearance (which we’re assuming you are), this is not something that you want to experience.

Testosterone Suppression

One of the most common side effects of anabolic steroid use is testosterone suppression. This is another side effect that is only relevant to male users.

When a bodybuilder floods his system with exogenous testosterone, his body compensates by decreasing natural production.

This leads to a decline in testosterone in the body. Sometimes the endocrine system simply slows down the release of natural testosterone. Sometimes it shuts down its production entirely.

When physique builders are building a cycle of powerful anabolic steroids, they will almost always include testosterone.


Because the other steroids will cause levels of naturally produced testosterone to drop.

Testosterone plays an important role in the body’s physiology, especially when it comes to building muscles.

Keeping up adequate levels of testosterone is necessary to stay healthy and gain results from a steroid cycle.

Most bodybuilders also engage in post cycle therapy (PCT) that helps restore the function of the endocrine system so it can begin naturally producing testosterone at peak levels again.



Virilization describes a collection of side effects that primarily pertain to women.

The long and short of this condition is the onset of male secondary sexual characteristics.

This is largely held to be an issue for female bodybuilders since it is not as visible in men who have already developed male sexual characteristics. Still, men can experience a deepening of their voice or excessive body hair growth as a result of increased androgenic activity introduced by steroids.

Possible virilization side effects include:

  • Irregular menstrual cycles
  • Dysphonia, or the development of a deeper voice
  • Reduced Breast Size
  • Clitoromegaly, is a condition in which the clitoris becomes enlarged
  • Hirsutism, or excessive hair growth on the face and body

Natural Steroid Alternatives

Natural bodybuilding supplements can be taken instead of steroids. They often come with claims from the brand of no side effects (including acne and oily skin), such as CrazyBulk which has a variety of products that claim to be very safe.

Take a look at their product list:

CrazyBulk suggests that people can see results within 30 days when combined with a proper exercise and diet plan, but absolutely no side effects, and free shipping anywhere in the world.

You’re never going to find this commitment from anabolic steroid suppliers.

Even better?

No prescriptions, no injections, and completely natural ingredients.

Steroid side effects are no joke. At the end of the day, you could end up damaging your body to the extent that your bodybuilding suffers.

But remember:

Use natural alternatives such as legal dietary supplements and you’ll never have to worry about damaging your body the way you would with steroids —you can simply focus your energy on improving it.

Steroid side effects are something you have to watch out for.

Anabolic androgenic steroids include the endogenous male sex hormone testosterone and drugs like Dianabol.

What are the effects of steroids on the body?

Anabolic steroids can promote the development of bone and muscle, and they can increase nitrogen retention, protein synthesis, and red blood cell count.

With these upshots are a series of potential negative effects which we will explore in detail.

Steroid Side Effects

Is taking steroids bad for you?

Whether used in an intended context such as health care or illegally to help an athlete reach new levels in their performance and physique, steroids carry the risk of harm to those who use them.

Common side effects of anabolic steroids used under medically approved conditions include but are not limited to;

  • postponed puberty in pre-adult young men
  • hypogonadism and weakness in men
  • breast cancer
  • pallor
  • osteoporosis
  • weight reduction in HIV/AIDS patients
  • endometriosis

Can you do steroids safely?
When taken under the supervision of a medical professional, steroids can be taken in a way that minimizes their adverse health risks.

But as we elaborated above, even under medically approved situations life-threatening side effects are a possibility.

Now consider a situation where these drugs are taken without medical oversight and with dosages exceeding what the medical community would consider safe.

This situation virtually encompasses all steroid use by bodybuilders.

It is difficult to imagine a scenario where this would be considered “doing steroids safely.”

Anabolic steroids can be taken by mouth or given by injection.

Steroid injection side effects differ very little overall from other anabolic steroid side effects pictures considering that there are varying formulations meant for different methods of consumption.

In the U.S., they are ordered as Schedule III Controlled Substances due to the likelihood of antagonistic impacts and a potential for misuse.

Anabolic Steroid Prohibitions in Sports

Some competitive athletes may abuse anabolic steroids to build muscle, and enhance endurance and performance.

Anabolic steroid users are rejected frequently from rivalry in university and pro leagues, and they are listed on both the World Anti-Doping Agency (WADA) and U.S. Against Doping Agency (USADA) Prohibition Lists.

Anabolic steroid use is also disallowed by the International Olympic Committee (IOC) and additionally the National Collegiate Athletic Association (NCAA).

Anabolic steroids include every engineered subsidiary of testosterone, both oral and injectable. Examples of anabolic steroids incorporate testosterone, danazol, methyltestosterone, and oxandrolone.


What is the Extent of Illicit Anabolic Steroid Use in the U.S?

Illicit use and sales of anabolic steroids can be dangerous.

Illegal steroids are sometimes sold at rec centers, and by mail order, and purchasers may be at risk of buying tainted or debased products, which even further increases the risk of steroid side effects.

Frequently, illegal steroids are carried into the U.S. from nations that don’t cooperate with the authorities of other countries.

Steroids might likewise be wrongfully sourced from domestic drug stores or circulation may be orchestrated in clandestine research centers. Common street names that are utilized to refer to anabolic steroids include:

  • Juice
  • Rec center sweet
  • Pumpers
  • Andro
  • Stackers

According to the National Institute on Drug Abuse (NIDA), experimental data demonstrates that anabolic steroid misuse among competitors may range somewhere between one and six percent.

The NIDA-financed study from 2011 demonstrated that 0.5% of eighth graders, 0.9% of tenth graders, and 1.3% of twelfth-grade boys had mishandled anabolic steroids at any rate of no less than once a year.

There are even reports about anabolic steroids being used in dogs and information online about the steroid side effects in dogs.

Laboratory drug testing can, more often than not, distinguish the vicinity of anabolic steroids, and competitors in competitive games, much of the time when checked for misuse of an expansive number of substances, including steroids.

Are Steroids Addictive?

Those who abuse anabolic steroids can get to be both physically and mentally dependent on them, proceeding with utilization even with antagonistic impacts, and physical withdrawal indications.

For example, emotional episodes, weakness, fretfulness, loss of appetite, sleep problems, decreased sex drive, and cravings for the drug.

Extreme withdrawal can prompt melancholy and thoughts of suicide. Depressive manifestations can endure for up to one year after the client quits taking the steroid.

Intensive clinical treatment may be required for the recovery of the most serious cases of anabolic dependence.

Medicines that have been used for treating anabolic steroid withdrawal permit the normal hormonal framework to return to normal. Different medicines target particular withdrawal manifestations.

For instance, antidepressants may be endorsed to treat depressive scenes, and analgesics, such as acetaminophen or ibuprofen, may be of use for migraines and muscle and joint pain.

A few patients might likewise benefit from behavioral therapies.

What is Being Done to Prevent Anabolic Steroid Abuse?

Endeavors are attempting to help forestall anabolic steroid misuse in schools and groups are constantly being devised and implemented.

Adolescents Training & Learning to Avoid Steroids (ATLAS) and the Athletes Target Healthy Exercise and Nutrition Alternatives (ATHENA) projects, subsidized by the NIDA, and upheld by the Oregon Health & Science University projects is educating competitors why they needn’t bother with steroids to promote large, defined muscles and enhance their athletic abilities.

Those healthy supplements are superior for long-term use– and for longevity, especially in terms of avoiding steroid side effects.


Steroid Side Effects in Bodybuilding: FAQs Answered

1. What are the long-term health risks of using steroids for bodybuilding?

Steroid use can lead to a range of serious health problems, including:

  • Liver damage: Steroids can cause liver inflammation, scarring, and even liver failure.
  • Heart problems: Steroids can increase the risk of heart attack, stroke, and high blood pressure.
  • Kidney problems: Steroids can damage the kidneys, leading to kidney failure.
  • Reproductive issues: In men, steroids can shrink testicles, decrease sperm production, and cause erectile dysfunction. In women, steroids can cause irregular periods, masculinization, and infertility.
  • Mood swings and aggression: Steroids can cause mood swings, irritability, and aggression, often referred to as “roid rage.”
  • Stunted growth: For adolescents, steroid use can stunt growth by prematurely closing growth plates in bones.
  • Increased risk of infection: Steroid use, especially through injection, can increase the risk of infections due to unhygienic practices.

2. Can steroid use lead to addiction or dependence?

Yes, steroid use can lead to both physical and psychological dependence. Physically, the body can become reliant on the artificial hormone levels created by steroids, making it difficult to function normally without them. Psychologically, users may become dependent on the feeling of increased strength and muscle mass, leading to compulsive use despite potential negative consequences.

3. How do steroids affect the cardiovascular system in bodybuilders?

Steroids can have a detrimental effect on the cardiovascular system by:

  • Increasing bad cholesterol (LDL) and decreasing good cholesterol (HDL): This imbalance raises the risk of plaque buildup in arteries, increasing the risk of heart attack and stroke.
  • Enlarging the heart: This can lead to heart failure, a condition where the heart struggles to pump blood effectively.
  • Increasing blood pressure: High blood pressure further strains the heart and increases the risk of cardiovascular problems.

4. Are there any legal consequences to using steroids for bodybuilding?

In most countries, including the United States, possessing and distributing anabolic steroids without a prescription is illegal. There can be significant legal consequences for individuals caught using or selling steroids, including fines and imprisonment.

5. What are the psychological and behavioral effects of steroid use in athletes?

Steroid use can have a significant impact on mental health and behavior, including:

  • Increased aggression and mood swings: This can lead to violent outbursts, anger issues, and difficulty controlling emotions.
  • Depression and anxiety: Steroids can disrupt the body’s natural hormone balance, leading to symptoms of depression and anxiety.
  • Mania and paranoia: In some cases, steroid use can trigger episodes of mania, characterized by excessive energy and impulsive behavior, or paranoia, a heightened sense of suspicion and distrust.

6. Can women experience different side effects from steroids compared to men?

Yes, women can experience different side effects from steroids compared to men due to their distinct hormonal makeup. In addition to the general health risks, women specifically may experience:

  • Masculinization: This includes physical changes like developing facial and body hair, a deeper voice, and clitoral enlargement.
  • Irregular periods or amenorrhea (absence of periods): Steroids can disrupt a woman’s menstrual cycle and potentially lead to infertility.
  • Breast shrinkage: Steroids can cause a decrease in breast size in women.

7. How can someone identify if someone they know is using steroids?

Identifying steroid use can be challenging and not always definitive. However, some potential signs include:

  • Rapid muscle growth: This can occur within a short period, often accompanied by an unusual change in body shape and definition.
  • Mood swings and aggression: Increased irritability, anger outbursts, and difficulty controlling emotions might be a red flag.
  • Changes in physical appearance: Acne, oily skin, and male pattern baldness can be potential indicators, although not always conclusive.
  • Injection marks: Users who inject steroids may have visible scarring or marks at injection sites.

It is important to remember that these signs can also be caused by other factors, and it’s not advisable to make accusations solely based on these observations. Addressing concerns about steroid use is best done with open communication and encouragement to seek professional help from a healthcare professional.

8. What are the ethical considerations surrounding steroid use in sports?

Steroid use in sports raises many ethical concerns, including:

  • Unfair advantage: Athletes using steroids gain an unfair competitive edge over those who don’t, undermining the spirit of fair play.
  • Health risks: Pressuring athletes to use steroids for better performance disregards the potential health risks they face.
  • Setting unrealistic expectations: Promoting the use of steroids in sports can create unrealistic expectations


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