The Effects of Anabolic Steroid Use on Sexual Health

Anabolic steroids, also known as anabolic-androgenic steroids (AAS), are synthetic substances that are similar to the male hormone testosterone. They are used medically to treat hormonal issues but can be misused by athletes and bodybuilders to enhance muscle growth and performance. Steroids can improve a person’s physical performance and appearance, but they come with significant health risks, particularly concerning sexual health.

Understanding Anabolic Steroids

Anabolic steroids promote muscle building and the development of male sexual characteristics, which is why they may be medically prescribed to treat delayed puberty, hormonal problems, or muscle loss from certain diseases. While they are beneficial in these controlled medical treatments, their misuse can lead to severe health problems. Users often take doses much higher than medically recommended, leading to various side effects.

Sexual Health Effects in Men

1. Decreased Testosterone Production: When men use anabolic steroids, their bodies reduce or stop the natural production of testosterone to maintain hormonal balance. This can lead to a condition called hypogonadism, where the body doesn’t produce enough testosterone, resulting in reduced sexual desire and performance.
2. Testicular Atrophy: Anabolic steroid use can cause the testicles to shrink in response to elevated levels of synthetic testosterone. This shrinkage occurs because the testicles receive a signal that there is sufficient testosterone in the body, leading them to reduce their function.
3. Decreased Sperm Production: Testicular atrophy is closely linked to decreased sperm production. As the testicles shrink and their function diminishes, the production of sperm decreases, which can eventually lead to infertility.
4. Erectile Dysfunction: Long-term steroid use can lead to difficulties in achieving or maintaining an erection. This is because the natural balance of hormones is disrupted, affecting one’s erectile function.
5. Breast Development: Men who use anabolic steroids may experience gynecomastia, the development of breast tissue. This happens because some anabolic steroids are converted into estrogen, a hormone that contributes to breast growth.

Sexual Health Effects in Women

1. Menstrual Irregularities: Women using anabolic steroids may experience changes in their menstrual cycle, including irregular periods or amenorrhea (the absence of menstruation). This is due to the hormonal imbalance caused by the steroids.
2. Clitoral Enlargement: Anabolic steroid use can lead to an increase in the size of the clitoris, a condition known as clitoromegaly. This occurs because there is erectile tissue in the female genitals similar to that of the penis, and the androgenic effects of the steroids can cause it to grow.
3. Deepening of the Voice: Women might also experience a deepening of their voice, which is another result of increased androgens. This change can be irreversible even after stopping steroid use.

Psychological Effects

Both men and women may experience negative psychological effects due to anabolic steroid use, which can indirectly affect sexual health. These include increased aggression, mood swings, and depression. Some mental health issues such as depression can reduce sexual desire, and aggression and mood swings can negatively impact relationships.

Long-Term Consequences

Long-term use of anabolic steroids can lead to permanent changes in sexual health. For men, this might mean persistent hypogonadism and infertility even after discontinuing steroid use. For women, the deepening of the voice or clitoral enlargement may not reverse after stopping the steroids.

Conclusion

The misuse of anabolic steroids poses significant risks to sexual health, manifesting differently in men and women. These effects, ranging from decreased testosterone production and testicular atrophy in men to menstrual irregularities and clitoral enlargement in women, highlight the serious consequences that extend beyond physical appearance and performance enhancement. The psychological impact of anabolic steroid misuse further complicates the overall health and wellbeing of users. It is crucial for individuals to be informed about these potential long-term and often irreversible effects when considering anabolic steroid use, underscoring the importance of weighing these substantial health risks against the short-term gains.

For more information on this topic, please read these publications from the ISSM Journals: The Journal of Sexual Medicine, Sexual Medicine Reviews, and Sexual Medicine Open Access:

Exposure to an Anabolic Steroid Changes Female Mice’s Sexual Responses According to Sex Partner

Selective Androgen Receptor Modulators: Current Knowledge and Clinical Applications

References:

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.

Hartgens, F., & Kuipers, H. (2004). Effects of androgenic-anabolic steroids in athletes. Sports medicine (Auckland, N.Z.), 34(8), 513–554. https://doi.org/10.2165/00007256-200434080-00003

Kanayama, G., Hudson, J. I., & Pope, H. G., Jr (2008). Long-term psychiatric and medical consequences of anabolic-androgenic steroid abuse: a looming public health concern?. Drug and alcohol dependence, 98(1-2), 1–12. https://doi.org/10.1016/j.drugalcdep.2008.05.004

Maravelias, C., Dona, A., Stefanidou, M., & Spiliopoulou, C. (2005). Adverse effects of anabolic steroids in athletes. A constant threat. Toxicology letters, 158(3), 167–175. https://doi.org/10.1016/j.toxlet.2005.06.005

Nieschlag, E., & Vorona, E. (2015). MECHANISMS IN ENDOCRINOLOGY: Medical consequences of doping with anabolic androgenic steroids: effects on reproductive functions. European journal of endocrinology, 173(2), R47–R58. https://doi.org/10.1530/EJE-15-0080

Pope, H. G., Jr, & Katz, D. L. (1994). Psychiatric and medical effects of anabolic-androgenic steroid use. A controlled study of 160 athletes. Archives of general psychiatry, 51(5), 375–382. https://doi.org/10.1001/archpsyc.1994.03950050035004

Pope, H. G., Jr, Wood, R. I., Rogol, A., Nyberg, F., Bowers, L., & Bhasin, S. (2014). Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocrine reviews, 35(3), 341–375. https://doi.org/10.1210/er.2013-1058