Dear Dr Laura,
Last year I made some good muscle gains at the gym but this year I want to get a lot bigger. I got talking to one really ripped guy at the gym and he told me he has used steroids in the past. I’ve always thought of steroids as having a terrible reputation because they supposedly shrink balls and upset a body’s natural hormone balance, but this guy thinks they’re great and swears by them. Plus the ones he uses are legal. I’m almost persuaded to buy a course of pills, but wanted to get your opinion on them first before I spend my cash.
Thanks for your letter.
Steroids work by mimicking natural chemicals in the body – anabolic steroids are similar to the male hormone testosterone and the main types used to ramp up the effects of gym workouts. Anabolic steroids differ from the steroids commonly prescribed for medical conditions (for example, creams, inhalers or tablets), which are also called corticosteroids.
Testosterone can improve exercise endurance and performance, reduce body fat and stimulate muscle growth, so you can do more exercise and get bigger doing it. As well as boosting muscle steroids can improve exercise recovery time. HOWEVER there are several risks to cover first.
1. Mood: feeling paranoid, irritable, aggressive or even violent, dramatic mood swings; so-called ‘roid rage’.
2. If you are young (early 20s or less) steroids can mess around with your development by interfering with natural hormones leading to bone thinning or reduced growth.
3. Unwanted body changes: these include hair loss, breast development, shrinking of your balls and acne.
4. Impaired sexual performance: some steroid users have difficulty getting or keeping an erection.
5. General health: high blood pressure (which is not good for you in the longer term, increasing risk of conditions like stroke), liver damage (there have been reports of deaths from liver damage caused by online steroids), heart damage, increased risk of prostate cancer.
6. Risks of injecting: steroids are often injected – in one study more than 1 in 20 people who inject steroids had hepatitis C, so it’s important to not share any injecting equipment (which includes syringes and the steroid itself, not just needles – hep C can linger for days and even weeks on surfaces and in water). HIV and hepatitis B can also be passed on. Injecting can also lead to bacterial infections of the skin causing abscesses or skin ulcers – or even septicaemia (blood infection).
Coming off steroids can also cause a lot of symptoms including tiredness, feeling low and muscle/joint aches. Long-terms user should come off them gradually.
In terms of the law, anabolic steroids are class C, which means pharmacists can only supply them with a prescription. It’s legal to buy small amounts for personal use but it is illegal to supply them to anyone else, including friends.
However, like other things that are not necessarily recommended, many people use steroids without coming to harm and there are things you can do to minimise your risks. Although you get more rapid effects with tablets (and none of the risks of injecting) it is said that injecting is better in terms of side effects (particularly the liver). Other tips include:
1. Do not use for long periods of time – most people recommend ‘cycling’ where you have periods on and off steroids. Try to not use for more than 8 weeks at a time – this gives less time to interfere with your natural hormone production.
2. Take long breaks in between steroid courses (at least 3 months).
3. Avoid other things that can stress the liver such as chems and excess alcohol.
4. Steroids aren’t a magic wand – you get the best effects by combining them with a healthy diet and you still need to work our A LOT! Make sure you have maximised your diet and exercise schedule and consider steroids as an added extra, not the main route to a bigger body.
If you decide to use injected steroids then the following may help:
1. Check if the steroid you have should be injected under the skin or into muscle – steroids should NEVER be injected into a vein.
2. Always use your own injecting gear (including the steroids themselves).
3. Always use sterile needles and syringes ONLY ONCE.
4. Sterilise your skin with an alcohol-based wipe before you inject.
5. Dispose of any injecting gear safely: NHS Choices gives good advice on how to do this at nhs.uk/chq/pages/2421.aspx or you can google local needle exchange venues.
The following website has sensible advice on how to inject: steroid.com/Steroid-Injection-Information.php#.
Dr Laura Waters is an HIV and sexual health consultant at the Mortimer Market clinic and the Boyz Doc. Dr Laura answers your questions every two weeks in Boyz. If you have a question for Dr Laura please email her at firstname.lastname@example.org.