Information for healthcare professionals

Anabolic abuse

Anabolic abuse of testosteroneAnabolic-androgenic steroid abuse can be associated with mental and health risks. Health problems can be severe and irreversible.

Long-term abuse is associated with irreversible cardiovascular toxicity, especially atherosclerotic effects and cardiomyopathy.1 Abuse can lead to damage of the liver, jaundice, fluid retention, elevated blood pressure, increased low-density-lipoprotein (LDL) and decreased high density lipoprotein (HDL). Reported are renal failure, severe acne and trembling.3 Men with testosterone abuse can develop shrinking of testicles, reduced sperm mount, infertiltiy, baldness, gynecomastia as well as elevated risk of prostate carcinoma, although study results differ.1,3

Furthermore anabolic abuse can lead to psychiatric dysfunction and psychoactive effects: Aggression, mood and behaviour disturbances, manic-like symptoms, paranoid jealousy, irritability, delusions, and impaired judgment are reported.3,4

Nonmedical use of testosterone has addictive potential. Dependence was found in weightlifters and bodybuilders, who chronically administered supraphysiologic doses of injected and oral anabolic-androgenic steroids.4,5

In contrast there is no evidence for abuse or dependence, that develops from therapeutic dosing and formulation because of testosterone deficiency.4


1 Kanayama G et al.: Long-term psychiatric and medical consequences of anabolic androgenic steroid abuse: A looming public health concern. Drug Alcohol Depend. 2008; 98:1-12.

2 Gooren LJ, Behre HM: Testosterone treatment of hypogonadal men participating in competetive sports. Andrologia 2008;40:195-199.

3 National Institute on Drug Abuse (NIDA), National Institutes of Health: Steroids (Anabolic-Androgentic); July 2009

4 Brower KJ: Anabolic steroid abuse and dependence. Curr Psychiatry Rep. 2002;4:377-387.

5 Brower KJ: Anabolic steroid abuse and dependence in clinical practice. Phys Sportsmed 2009;37:131.140.

Last updated: 2019