A. External Changes

a) Changes in the skin
The skin is the largest organ on the human body and is the most sensitive area for side effects, especially for women. The most apparent side effects are the pores in the skin becoming larger making the skin rough. This is more prominent in woman when they use androgenic steroids because they usually have smoother skin to begin with. This process is called virilization and once this has occurred, the result is irreversible. Another large problem is acne. Acne that already is apparent may become worse and if there is no acne already, it can be evoked. This side effect will differ from person to person as all side effects do, depending on the person’s composition and the type and amount of steroid used. Again, females are more prone to acne as well. There are a number of over the counter agents that have proven themselves to help get rid of acne. Stretch marks are also prominent, not directly from the use of steroids but from the rapid growth of the muscles. The only way to prevent stretch marks is to grow slowly, this however, isn’t what you are looking for I’m sure. I recommend using aloe or other healing and moisturizing gels or lotions to help the skin stretch while you are in the process of your biggest gains, this may not prevent it but it could help.

Above: Severe Steroid Back Acne

b) Baldness
Steroids do not cause baldness, however, they can speed the process up for those who are going to loose it anyway. Steroids convert largely into DHT, this is what causes hair loss to quicken. Steroids that are derivatives of DHT can also promote baldness. And yes this is irreversible as well, 99% of the time when you loose your hair it is gone for good. 



Above: Balding

B. Internal Changes

a) Psychic 
With the use of high dosages of anabolic and androgenic (especially androgenic) steroids, over a long-term cycle, both men and woman can develop extremely aggressive behavior or “roid rage”. Some athletes consider this an advantage because of their increased ability to train harder and more intensely, however it has been proven to do more harm than good. Most of the time this “rage” results in loss of friendships, destructiveness, and inability to control ones behavior. The best way to prevent this potentially destructive behavior is to limit the amount and duration of androgenic compounds in ones system. Also, be aware of this particular side effect and it will be easier to make the necessary changes to rid yourself of it. Another negative psychic side effect is the feeling of depression. Often times when athletes have been using steroids and have experienced huge gains, they expect to keep the gains after they come off of their cycle. When reality hits and their performance falls to that of their natural ability without steroids, he may become depressed. High estrogen levels can enhance this feeling in the athletes system as well.

b) Feminization 
Feminization occurs in males only. Excessive levels of testosterone can often be converted into the female sex hormone estrogen resulting in some female characteristics such as the formation of breasts (gynecomastia), increased tendency toward fatty deposits, and extremely soft muscles. This usually happens after a steroid cycle had just been discontinued when the males’ androgen level is low and is easily over shadowed by estrogen. Estradiol, an estrogen, also has an inhibiting effect on the male gonad cycle, resulting in lowered natural production of testosterone and thus effecting the male sperm count. Supplementing your steroid cycle with anti-estrogens (nolvadex, Proviron, Fludestrin, Teslac, etc…) is a good way to combat these feminization side effects. In general, these symptoms do go away with time, however, they are probably the most feared symptoms by all bodybuilders who expect to be in a competition. 


c) Masculinization 
Primarily in females, virilization will result in the assumption of masculine characteristics. Some of the irreversible side effects include increased facial and body hair (hirsutism), deepening of the voice, enlarged clitoris, menstrual irregularities, increased acne, increased libido, thinning of the hair, baldness, anxiety, depression, increased aggression, and changes in the texture of the skin. This process is usually brought on by the use of testosterone or steroids with high androgenic characteristics in high dosages over a long duration. Remember, everybody is different; these symptoms vary greatly from person to person.

d) Cardiovascular 
The risk of heart disease increases with the use of anabolic/androgenic steroids. The use of steroids raises the level of cholesterol in ones system, which causes thickening of arterial walls and could ultimately be life threatening. It is recommended that athletes always consult a physician before beginning a steroid cycle to be sure they are not already at a high risk of cholesterol levels. It is also recommended that regular visits be made in order to monitor ones cholesterol. With this one can assume that older male steroid users are at the highest risk, however this does not mean that younger users are not at risk. Some other undesirable factors that could promote heart disease are stress, high blood pressure, and rapid weight increase. The only thing good about this major side effect is that is not irreversible. Usually after a steroid cycle is discontinued, the athlete’s cholesterol levels return to normal.

e) Gynecomastia 
As explained earlier, gynecomastia (bitch tits) is the abnormal enlargement of one or both breasts in a man. This is usually brought on by a hormonal imbalance, which can be achieved by the use of steroids. This condition can occur naturally, without the use of steroids as well. This is definitely one of the least favorable of side effects because can look terrible, especially if you are planning to be in a competition. If caught early, gynecomastia, along with other feminization side effects can be prevented by the use of anti-estrogens such as Nolvadex and Proviron.

f) Growth Deficits
When athletes who have not reached their predicted height use steroids, it is likely that they will not grow to their full potential. With the exception of Oxandrone, all steroid compounds promote the closure of the epiphyseal plates, which in turn discontinues bone growth. This is why it is not recommended that teenagers use any type of steroid.

g) Headaches 
Steroidal compounds and other supplements used by bodybuilders can trigger a hormonal imbalance, which will alter the persons endocrine system. This could explain why many athletes have had this problem. Headaches are also a symptom of possible high blood pressure, which is another side effect associated with steroid supplementation. The only way to combat this side effect is by taking an over the counter medicine such as Tylenol, Advil, or Aspirin; or sometimes a visit to your chiropractor can help alleviate some head pain.

h) Kidney Problems 
Some steroid compounds have appeared to have an adverse effect on kidney function. This, like most of the side effects described, has a higher tendency to exist when longer durations or high dosages are being consumed. The kidneys main purpose is to filter toxic byproducts, and excrete them. Whenever a person is on any type of drug, their kidneys are under more stress than ordinary. An electrolyte imbalance and high blood pressure can both lead to improper kidney function. Kidney disorders are often reflected in edema, lower back pain, renal colic, fever, kidney enlargement, and swelling in the costovertebral region.

i) Liver Problems 
With the use of oral steroidal compounds in particular, liver damage can occur. A condition called Peliosis Hepatis is rare but is certainly life threatening, because it not usually found until the liver is completely shut down or until an intra-abdominal hemorrhage develops. The development of this problem usually repairs itself as steroid use is terminated. However, to further protect yourself, it is suggested that the use of large quantities of standardized Silymarin extract (Milk Thistle Seed), to the amount of 500mg per day, can promote improvement in liver function.

j) Immune System 
Some steroid supplements such as testosterone can provide an improved immune system state, making it easier to recover and ward off viral illnesses. The body then becomes somewhat dependent on the steroid supplementation and must be rejuvenated after the supplementation has been discontinued. A person in this position should do his best not to become over tired and rundown. This will allow the immune system to become self-reliant again and therefore effective. Often times when a person discontinues their steroid cycle, they allow themselves to become tired and rundown leading to a tendency to become infected with a viral illness, colds, and sometimes pneumonia.

k) Impotence 
When first administering steroids, a man will have an increase in sexual function. This unfortunately is only temporary as your body becomes used to the steroid in its system. With prolonged use of a steroid, eventually, the man will feel less sexual desire, and will be less capable of maintaining an erection. Luckily, this is only temporary as well and can even be totally prevented with the use of substance such as Gonakor and HCG. Also when the steroid use is discontinued, the body’s natural level of testosterone (like the immune system) will certainly be suppressed. Tribestan, is a great product to use to help revitalize a persons natural testosterone levels. 

l) High Blood Pressure 
The only way to monitor your blood pressure is to have it checked by a physician, unless you have other means of doing it yourself. There is no real “symptoms” that will let you know that you have high blood pressure until it is already too high. Then the symptoms are headaches, vision problems, insomnia, and difficulty breathing. High blood pressure is usually induced by high water or sodium retention accompanied with a rapid weight increase. Stress, overworking, over eating, and holding your breath during very heavy lifts can also promote high blood pressure.

m) Stomachaches 
Oral steroids can sometime bring about stomachaches in some users, the most common being Anapolon, Stenox, Primabolan, Winstrol, and Dianabol. The symptoms can be anything from a slight discomfort to nausea, diarrhea, and vomiting. Sometimes this can be avoided by taking the steroids at mealtime.

n) Water/Salt Retention 
Most steroids will cause a water and electrolyte storage in the muscles resulting in a swelling of the tissue. For the most part this is not such a bad side effect due to the increase in muscle size and strength. The problem is the increase water retention in the skin and blood. This usually causes a persons skin to look puffy and swollen and puts a larger strain on ones heart. The use of a diuretic can help to relieve ones body from the excess water and salt retention.

What Leads To Negative Side Effects
The biggest factor leading to negative side effects is misuse. Everybody is different and the affect that a certain steroid will have can vary widely from person to person. Most of the time, negative side effects are more prevalent in a person who has used large quantities of strong androgenic substances for extended periods of time. It is important to be aware of all the effects that a substance might produce, and be able to recognize that they are happening. Regular doctor visits are always recommended for blood checks and advice. Another factor leading to negative side effects is the use of fakes. As described above, most fakes do not even contain anabolic or androgenic substances and on top of that, may not even be sterile. This could lead to potential life threatening diseases such as AIDS. It is important that if you are using needles, you should never share with another person and always use sterile equipment. Steroids are illegal substances and can be very detrimental to the human body. They can also be very helpful if used the correct way and under a physician’s supervision.