Performance-Enhancing Steroids: Benefits, Side Effects, and Dangers

Steroids seem like miracle drugs. These are synthetic compounds that mimic the natural hormones produced by our adrenal glands. They reduce inflammation and ramp up our nervous system and suppress the immune system in people who are suffering from AIDS and cancer.

But mostly, people associate steroid use with athletes and bodybuilders. The majority of steroid users take steroids to either enhance their athletic performance or improve their personal appearance. Those are a category of steroids that strengthen your muscles and enhance protein synthesis.

Most steroid users take these drugs in a stronger dose that is normally not recommended by the doctor and slowly falls in the trap of addiction. As a shortcut to becoming leaner, more muscular, and generally look better, they misuse it.

In this article, we will generally reexamine the different types of steroids, their importance, benefits, uses, performance-enhancing steroids, side effects, dangers, and addiction.

What are Steroids?


Steroids are the man-made version of hormones that are naturally produced by the body. The body makes these hormones normally in order to support functions like promoting growth and development and fighting stress.

Steroids are designed to mimic these hormones, in order to reduce inflammation.

Steroids are found in plants, animals, and fungi. Biosynthesis of steroid is an anabolic pathway ( that uses energy to synthesize large molecules), and produce steroids from simple precursors.

The Different Types of Steroids

The steroids either maintain the integrity of the cell’s membranes or regulate its function (1). There are several types of steroids found in nature. They are :

  • Sex steroids such as testosterone, estrogen, and progesterone
  • Corticosteroids, including  glucocorticoids, such as cortisol and mineralocorticoids, such as aldosterone
  • Secosteroids
  • Neurosteroids
  • Sterols, popularly known as steroid alcohol

How Do Steroids Work?

Steroids work by decreasing inflammation and repressing the activity of the immune system (2).

Inflammation is a process in which the body’s white blood corpuscles and chemicals protect the body against foreign organisms like bacteria and viruses. They also protect against infection. In some diseases, this system of protection becomes overactive and functions improperly. They start working against the body’s own tissue and result in tissue damage. This may cause inflammation.

Steroids reduce this production of a chemical that causes inflammation, thereby reducing tissue damage. It also reduces the activity of the immune system by minimizing the work of the immune system.

The other group of steroid AAS works by promoting muscle cell growth and stimulates protein synthesis.

9 Benefits of Steroids 

Effective in the Treatment of Several Medical Conditions

Steroids are used to treat several medical conditions in which the body’s defense system malfunctions. It may cause tissue damage as well. 

They are used mainly in the treatment of certain inflammatory conditions.

Glucocorticoids are the most effective anti-inflammatory drug that is available for the treatment of several chronic and inflammatory diseases, asthma, systemic vasculitis (inflammation of blood vessels) and myositis (inflammation of the muscle).

They may also be selectively used to treat inflammatory conditions such as rheumatoid arthritis, lupus or gout (3).

They also treat many immune diseases. Several conditions that lead to muscle loss include Chronic Obstructive Pulmonary Disease (COPD), AIDS, cancer, kidney and liver disease. Anabolic-androgenic steroids are effective on some of them to help preserve muscle mass.

As loss of muscle mass has been directly linked to mortality, preventing it can enhance therapeutic outcomes and thereby extend lifespan.

Summary: Steroids like glucocorticoids, which are inflammatory drugs, are used in treating severe chronic and inflammatory diseases. AAS which are androgenic is used to treat muscle losses in autoimmune diseases.

Improves Speed and Power in Athletes

As relentless competition clouds the area of sports, athletes are constantly looking for ways that will get them an edge over the other competitors (4).

Proper nutrition and advanced strength exercise go a long way in this regard, some of them a step further by using performance-enhancing drugs (PEDs).

AAS is one of the major PEDs that is used by them. 

They have been shown to increase muscle mass which directly affects speed and power.

Those using AAS experience gain in strength from 5 to 20 percent and a weight gain ranging from 4.5 pounds to 11 pounds.

Even though most sporting federations ban the use of AAS, some athletes do take the risk.

Summary: Anabolic-androgenic steroids (AAS) are one of the major performance-enhancing drugs (PEDs) that increases muscle mass. This is taken by the athletes to improve speed and power.

Increases Muscle Tissue Due to Enhanced Protein Synthesis

Anabolic steroids, also known as anabolic-androgenic steroids (AAS), are the synthetic derivatives of testosterone. They promote the growth of muscle which is the anabolic effect of this steroid and the typical male characteristics of puberty which is the androgenic effect (5).

When prescribed by doctors, they are an option for patients who produce abnormally low levels of testosterone or who suffer from body-wasting diseases such as cancer or AIDS. 

When used by athletes, the only goal is to speed up the body’s natural muscle-building process. 

Weight lifters lift weights heavier than what we humans are used to, it results in tiny micro-tears in muscle fibers. The body’s natural repair process repairs this tear and then overcompensates it by adding bigger cells to build a stronger fiber which is called muscular hypertrophy. Over time, this repeated process of teardown and rebuild will result in muscle growth.

Natural testosterone is the body’s main substance for this process, but anabolic steroids can serve as a supplement.

Once taken, an AAS travels through the bloodstream to the muscle tissue. It is taken by the muscle cells at a place called an androgen receptor. Once delivered to the muscle cell, the steroid can interact with the cell’s DNA and stimulate the protein synthesis process that promotes cell growth.

Different variants and amounts of AAS can cause different reactions producing either massive body-building physiques or more toned athletic muscles. 

Summary: One of the main AAS is testosterone that promotes muscle growth. It interacts with cells’ DNA and stimulates protein synthesis, which makes it a very important drug in muscle tissue repair.

Increases Muscle Strength and Power

Steroids for Muscle

Anabolic steroid intake and exercises for strength training cause an increase in the size of the muscles by inducing hypertrophy. It also leads to the formation of new muscle fibers. 

It is purported that the activation of satellite cells is a key process and is enhanced by steroid use.

Satellite cells are small cells that are found in the mature muscles. These cells have been found to play a very important role in muscle hypertrophic growth. That means the growth of muscles with more power and strength. 

These satellite cells, when incorporated into pre-existing fibers, helps maintain a constant nuclear to cytoplasmic ratio. This is one of the main mechanisms for muscle fiber growth.

Summary: AAS use strengthens your muscle fiber by hypertrophic growth.

Enhance Recovery from Injury

A New Northwestern medicine study reported that weekly doses of glucocorticoid steroids like prednisone helped speed the recovery of muscles in case of injury.

The steroids repair muscles that are damaged by muscular dystrophy (6).

The major problem of using these steroids is that they cause muscle wasting and weakness if taken for a prolonged period. It is a massive problem because people often take steroids for several chronic conditions and can’t stop treatment midway.

This study showed that instead of daily doses, the weekly dose can promote muscle repair and not have any negative side effects.

The study showed prednisone directs the production of annexins, a protein that stimulates muscle healing. Weekly doses of prednisone also stimulate KLF15, a molecule that improves muscle performance.

Summary: Weekly dose of glucocorticoid steroids help speedy recovery from muscle injury. Proper guidance is required when taking them though to avert harmful side effects.  

Increased Red Blood Cell (RBC) Production

Red Blood Cells (RBC)  are the cell type in our blood that plays a vital role in transporting oxygen around the body as well as carbon dioxide to the lungs. Injuries that cause significant blood loss forces the body to secrete signals like stress steroids and erythropoietin. This stimulates red blood cell production in the blood marrow (7).

This signal forces the immature red blood cells to become mature. In a certain type of anemia, called Diamond- Blackfan -Anemia (DBA) which is a rare genetic disorder, usually diagnosed in infants and toddlers, the bone marrow doesn’t produce enough Burst Forming Unit Erythrocyte (BFU-Es). They are early red blood cell progenitors that respond to glucocorticoids.

Lack of BFU-Es in DBA patients means that the glucocorticoid signal has a limited target and the process which should result in plenty of red blood cells is contracted to produce insufficient amounts.

One of the normal treatments for DBA is to boost red blood cell production with high doses of synthetic glucocorticoids, such as prednisone or prednisolone.

The mechanism behind them is still not understood perfectly. More studies need to be done in this regard so as to combat the harsh side effect that the long term use of synthetic glucocorticoid does.

Summary: Certain types of anemia in which the RBC production is not sufficient enough due to lack of proper stimulus, glucocorticoids can boost the production. 

Improves Muscle Endurance

The muscles that are attached to the bones are known as skeletal muscles. They are made of two major types of fiber- the “fast-twitch” that burns sugar for energy and the “slow-twitch”, the ones that prefer to burn fat (8).

The bodies of sprinters and bodybuilders have plentiful bulkier fast-twitch varieties and can contract more quickly and powerfully. This provides a short burst of strength and speed to them.

The slow-twitch muscles are more resistant to fatigue and it can carry on working for hours. Mountain climbers and marathon runners have them.

Endurance training triggers the button and starts the genetic changes that convert the fast-twitch fibers into the slow-twitch one. This improves the muscles staying power. Steroids replicate the effects of exercise by the same genetic pathways and reprogram the muscles thereby increasing endurance.

Summary: Skeletal muscles are fast twitch and slow twitch, and are used in accordance with the sports you are in. Steroids replicate the endurance training and trigger muscle staying power thereby improving muscle strength.

Steroids Can Decrease Body Fat Percentage

The obesity epidemic directly results in adverse health conditions. Even though a modest weight loss provides important health benefits, successful weight loss is very difficult to achieve.

Most studies for obesity focus on body weight. In men, obesity is one of the biggest factors which is associated with low testosterone, more than the effects of age. 

An obese man has 30 percent lower testosterone compared to non-obese men and 40 percent lower than the lowest limit of a healthy man. This reduction in the level of testosterone hormone is because of the obesity-associated lowering of sex hormone-binding globulin (SHBG).

Studies in this area have concluded that treatment with testosterone decreased total fat mass and visceral adipose tissue and also protected from loss of total and appendicular lean mass (9).

Myogenesis is the formation of muscle tissue. Testosterone inhibits the stem cell differentiation into adipocytes and favors this myogenesis. 

Summary: AAS like testosterone when administered in the body decreases the total fat mass and visceral adipose tissue and favors myogenesis. 

Steroids can Help Those with Muscle-Wasting Disease

Several clinical conditions tend to get more complicated by the loss of weight and skeletal muscle which contributes to morbidity and mortality (10). 

These are AIDs, cancer, kidney diseases, chronic obstructive pulmonary disease (COPD) and some diseases related to the liver.

Anabolic-androgenic steroids (AAS) can be used to help them preserve muscle mass. AAS has been shown to help in increasing fat-free mass, muscle mass and provide strength in men and women who are healthy without any major side effects and therefore could be highly beneficial in these conditions.

Muscle mass loss is linked closely to mortality and to be able to prevent it can improve therapeutic outcomes. This can extend the lifespan.

There are other methods as well as to preserve muscle mass and may be of more benefit to these populations but AAS has its own positive effect. Still, the potential adverse effect of taking steroids must be kept in mind before using them.

Summary: In muscle wasting diseases like AIDs and cancer, AAS administration increases fat-free mass, muscle mass and provides strength in men and women; thereby preserving muscle mass.

The Possible Side Effects of Steroids

The side effects related to steroid use can be categorized into two sections. One with short time use and one after a prolonged period of usage (11).

Short time side effects:

  • Acne
  • Stomach irritation
  • Increased risk of infection
  • Blurred vision
  • Insomnia
  • Easy bruising
  • Premature balding or hair loss
  • Weight gain
  • Mood swings
  • Aggression

Long term side effects:

  • Kidney problems or kidney failure
  • Liver damage
  • Tumour
  • High blood pressure
  • Enlarged heart
  • Increased risk of stroke
  • Heart attack
  • Stunted growth

Several other side effects are gender and age-specific. They are:

In men:

  • Development of breasts
  • Shrinking testicles
  • Decreased sperm count
  • Increased risk of prostate cancer
  • Baldness

In women:

  • Decreased breast size
  • Male pattern baldness
  • Deepened voice
  • Growth of facial hair and excess facial hair
  • Enlarged clitoris

In teenagers:

  • Stunted growth
  • Stunted height

Steroids can have serious psychological side effects. Some users have shown aggressive traits, have become delusional or show symptoms of paranoia.

People who are in the habit of using steroids appear to be at a higher risk of using banned drugs like cocaine in order to counteract the negative effects of steroids.

Frequently Asked Questions (FAQs) About Steroids

What Are Anabolic Steroids?

Anabolic-Androgenic Steroids (AAS) are synthetically produced variants of the male sex hormone, androgens. There are more than 100 different anabolic steroids amongst which the most powerful androgen is testosterone.

These steroids are mainly used to promote the growth of skeletal muscles (anabolic effect) and the development of male sexual characteristics (androgenic effect) (12).

What Are Performance Enhancing Steroids?

Performance-enhancing steroids or Performance enhancing drugs (PEDs) are pharmacologic agents that athletes and nonathlete weightlifters use to improve their performance (13).

It boosts their physical and mental ability and helps in achieving the coveted results in competitive sports. Earlier only athletes and performers used this but now it has become prevalent even in average gym-goers. 

PEDs are anabolic steroids, which are a derivative of male sex hormone, testosterone. This increases the muscle mass, vigor, and athletic prowess in men manifolds. Testosterone boosting supplements are legal and easily available over the counter. 

Amongst the several categories of PEDs that have been extremely popular among non-weight lifters and athletes, lean mass builders, have been particularly used. They are mainly pro-myogenic (anabolic) drugs that increase muscle mass or reduce fat mass (14).

By far, AAS has been the most prevalent illicit drug in this category. Among non-athlete weightlifters, the use of AASs represents a higher proportion of overall PED use than that of all other categories of PEDs combined (15).

What are Anabolic Steroid Calculators?

Anabolic Steroid Calculators are spreadsheets that use empirical formulae to eliminate mathematical guesswork. It enables us to see the pharmacokinetic ( which is concerned with the movement of drugs within the body) dose-response curve in a graphical format.

All the important parameters of your anabolic cycle are presented to you in a manner that you can design and plan your own cycle. It shows you the date, cycle-day, dosage summary, gross consumed totals of tablets or injected dose, cumulative total, and many more.

It can efficiently calculate the effect of one or more steroids, in accordance to your intake and the addictive effect it has. This gives a complete understanding of the overall picture of the cycle (16).

Why Do Doctors Prescribe Steroids?

Doctors make the decision of prescribing steroids on an individual basis. Depending on the severity of the disease, doctors give steroids and their dosage (17). 

Physical activity, age, sex, consumption of other medicine is considered by the health caregiver before prescribing one. They also ensure that you are aware of all the potential benefits and risks of steroid use before you start using it.

Doctors also prescribe them to solve certain problems like delayed puberty and some other medical problems related to the lower levels of testosterone secretion. Steroids make muscles bigger and bones stronger. They may cause puberty to start in some boys born with a genetic disorder (18).

Why Have Steroids Became Illegal?

Anabolic steroid users are mostly males who are non-athlete and trying to improve their overall appearance by building muscles. Male body image disorder is called muscle dysmorphia and is similar to the female body image disorder that is linked to the unrealistic portrayal of the female.

The Anabolic Steroid Act of 1990 was passed by Congress in response to the illicit trafficking of steroids. This Act identified the anabolic steroid as a separate drug class.

In 2004, congress enacted the Anabolic Steroid Control Act which banned over the counter steroid precursors as well (19). Later, other countries also followed suit.

How Are Steroids Administered?

Steroids can be used topically as cream and ointment. It can also be taken through the mouth. Steroids can be administered by injection (20).

Steroid injections are normally given into a vein or a muscle, directly into a joint or bursa, around tendons or near soft tissue area.

What is Steroid Stacking?

People ‘cycle’ their steroid dosage. They take manifold doses of steroids for some time, stop for a certain duration and start again (21). 

“Stacking” is taking two or more different anabolic steroids together. Other steroid users ‘pyramid’ their steroid use which means starting with a low dose and slowly increasing it.

Stacking enhances the effect more than the pyramid, as, in the pyramid, the body gets time to get used to the dose. There is another technique that is used to use steroids. It is called the “plateauing”. This is the method where the steroids are staggered, overlapped or substituted with another steroid. This is done in order to avoid developing tolerance.

Unfortunately, it is very easy to fall into the trap of using steroids and get addicted. The intentional use for a short period may become an addiction very soon.

How Can Steroid Side Effects Be Minimized?

There are certain guidelines that doctors follow to minimize the effect of steroids (22). These include:

  • Use steroids only when it is absolutely necessary 
  • Monitor closely to detect side effects
  • Monitor blood pressure closely
  • Check the bone density as frequently as possible
  • Use minimal dose to gain control
  • Recommend calcium supplements and vitamin D
  • Take steroids injection locally in place of oral administration.
  • Reduce the dose gradually as possible 

Does Everyone Develop Side Effects From Steroids?

The side effect of steroids and its frequency varies from person to person. If steroid use is for a brief period of time, like a few days or a few weeks, it is possible that none of the side effects occur (23). Steroid injections occasionally are given to people suffering from arthritis, tendinitis or bursitis. 

However, if the use of steroids involves very high doses and is used for a prolonged period of time, side effects can occur and increase in frequency.

Who Should Not Take Steroids?

Steroids are very potent and have strong effects as well as strong side effects. People with the following conditions should never use steroids in any form. They are:

  • Uncontrolled diabetes
  • Uncontrolled high blood pressure
  • Peptic ulcer patient
  • People suffering from osteoporosis
  • People who have glaucoma
  • People with infection or those who are prone to one

The Final Note

Steroids are the synthetic counterpart of the natural hormones that are produced by the body. Corticosteroids, a kind of steroid, that is used to treat medical conditions. 

Anabolic steroids are the kind of steroid that replicates human sex hormone-like testosterone and estrogen and are often used to build muscles and enhance protein synthesis in people suffering from muscle wasting diseases like cancer and AIDS.

Steroids are often misused these days in order to alter one’s physical appearance. The use of anabolic steroids is a very serious decision and should be done in accordance with the doctor’s guidance, in using the steroid for a specific purpose for a short duration can bring out its benefit. 

Anything other than that is constitutionally illegal and may have long term severely negative side effects which won’t be reversible.

Legal steroids, which are multi-ingredient workout supplements, can offer you many similar benefits without the adverse side effects. These can easily be ordered online, without any prescription.

Sharing is caring!