What are anabolic steroids?

Anabolic-androgenic steroids (aka anabolic steroids) are a group of chemicals with a similar structure to testosterone. These include testosterone, testosterone esters, nandrolone decanoate, methandienone, and trenbolone.

What are the effects of anabolic steroids?

Not all anabolic steroids have the same effects, although all tend to increase muscle mass. Let’s start with testosterone, which is produced in the testes. Effects of testosterone and its esters depend on the person, but generally include:

Increased muscle mass
Increased sex drive
Mood changes
Acne
More body hair

Hypogonadism is a common effect in cis men taking testosterone, as the excess testosterone can be converted into estrogen in the body. Your body then stops making testosterone itself, instead relying on getting it from injections or other sources. Symptoms of hypogonadism can include gynecomastia (enlarged breast tissue), erectile dysfunction and infertility. Some of these symptoms may only show up after you’ve stopped taking testosterone.

When cis women and transmasculine people take testosterone, effects include a deeper voice, fat redistribution, clit growth and irregular/ cessation of periods. You might get male-pattern baldness, depending on your age and family history. Some of the effects of testosterone are permanent, like voice changes, whereas some, like fat redistribution, go away once you stop taking it. You can still get pregnant while on testosterone. However, getting pregnant on testosterone can cause harm to the fetus, so it’s best to stop taking testosterone and other steroids if you’re considering having children, and use contraception while on anabolic steroids.

Testosterone and other steroids can strain your cardiovascular system. They can increase your risk of high blood pressure, high cholesterol (dyslipidemia), and liver damage. Steroids also may have an impact on kidney function, although this is still being researched.

The effects of other anabolic steroids are often less well known. A study of nandrolone decanoate in rats found that the rats exhibited anxiety and depression-like behaviours, however, there haven’t been many studies done on humans. While some studies have shown that nandrolone can convert to estradiol (E2) in rats and fish, we don’t generally see some of the estrogen-based effects like gynecomastia in cis men. Methandienone has similar effects to testosterone. Trenbolone increases muscle mass, but it comes with a high risk of neurotoxicity, often decreasing the size of the brain. Folk who’ve taken trenbolone have reported that it influenced their sleep patterns, impulse control and levels of aggression.

Although anabolic steroids aren’t addictive in the classical sense, there are withdrawal symptoms, especially when they’re used for performance and image enhancing reasons. A 2022 literature review by Sharma et al. reported that symptoms of steroid withdrawal include low mood, decreased sex drive and hypogonadism. Some people also noticed body dysmorphia when going off steroids.

There are many other anabolic steroids not covered here which have different risks and effects, and may be less researched.

How to reduce risks taking steroids

There are a number of ways you can reduce your risks when you take steroids.

Routes of administration

Typically, steroids like testosterone are generally taken via intramuscular injection, although some can be sold in pills, gels, subcutaneous injection, or patches.

To inject steroids, you’ll need:

3mL syringe
Clean needles and wheel filters to draw up the steroid
Clean needles for injection
Plasters
Receptacle for used needles (a glass jam jar with a screwtop lid will be fine for at-home storage until you can get to a sharps bin. Most city councils will have a downloadable map of where the public needle disposals are)
Alcohol wipes

You can get all of these from your local NZ Needle Exchange or chemist.

The easiest place to self-inject steroids is at the meaty part of your thigh (intramuscular). Find your hip bone and knee, and measure halfway between on the outside of your thigh. Gender Minorities Aotearoa has more on where to inject testosterone.

If you’re taking steroids consistently, it’s important to rotate injection sites, for instance switching from one leg to another. This helps to minimise damage to one area of the body. If there’s any irritation at the injection site, this could be because your steroids were of substandard quality. It’s best to see a trusted medical professional if you have any pain or unusual effects after taking anabolic steroids.

To make steroids such as testosterone for oral administration, manufacturers tweak one corner of the steroid skeleton in a process called 17ɑ alkylation. This is because when testosterone is taken orally, only a small amount of it will get through to your muscles. Unfortunately, the 17ɑ alkylation of a steroid makes it more toxic to the liver (hepatotoxic), which is why injection is often the preferred route of administration.

Cycling and cruising

There are generally two ways that anabolic steroids are taken non-medically. Cycling, where people take steroids for a few weeks before having a rest period, and blast-and-cruise, where a high dose of steroids is taken followed by a lower maintenance dose. Cycling is the least harmful way of taking steroids. Researchers from the Department of Internal Medicine in the Netherlands recommend 8-10 week cycles to minimise withdrawal symptoms. Breaks between cycles ideally should be around three months, to give your heart and body time to recover. If you still want to take T via the blast-and-cruise method, the Dutch researchers recommend a maintenance dose of less than 100mg/ week.

We also recommend getting blood tests once a year or so when you’re taking steroids. That way any adverse effects on your heart and liver can be picked up, and to ensure you’re taking an effective dose.

Mixing drugs/medications and anabolic steroids

Multiple steroids are sometimes taken together. This can increase stress on your cardiovascular system. As steroids aren’t necessarily more effective when you take more, it’s safer to reduce your dose of individual steroids when mixing.

Sometimes people take medications to counter the side effects of steroids, or during the rest period of a cycle. This is called post-cycle therapy (PCT), and its effectiveness is debated by researchers and the bodybuilding community. A study by Grant et al. reported that PCT treatments were more difficult to access than the steroids themselves. Selective estrogen receptor modulators (SERMs) are commonly used in PCT. SERMs can, in theory, prevent estrogen binding to receptors, reducing effects like gynecomastia. Other PCT treatments include aromatase inhibitors and human chorionic gonadotropin.

As some steroids can affect your emotions, be more cautious about things like set and setting when you’re taking recreational drugs. If you’re not feeling quite right before a trip or a night out, maybe give it a rest until another day. There isn’t a lot of reliable data on the interactions between party drugs and steroids so we recommend proceeding with caution.

Drug checking and steroids

A study by Schrebier et al. into samples of methandienone (a steroid) sold over the internet found that all of the samples were misadvertised. They either had inaccurate dosage, contained a cutting agent, or something other than the steroid advertised. Another literature review of clandestine markets in Europe and Brazil found that only ⅓ of anabolic steroids were the dose and chemical they were sold as. Post cycle therapy medications are also commonly falsified, according to a study by Blazewicz et al.

The best way to check anabolic steroids is using HPLC-MS or another chromatography method (see Know Your Science part 3 for how HPLC-MS works). Most drug checking clinics in Aotearoa use Fourier Transform Infrared Spectrometers (FTIR) which are often not able to detect steroids, depending on the preparation. Fortunately, drug checkers are able to send samples away for testing at laboratories with the correct equipment. This means you can bring a sample for checking and typically get a result online within two weeks.

It is possible that a drug checking clinic will be able to detect anabolic steroids in-house. How the steroids are prepared will make a big difference. Pressed pills such as stanozolol can be tested via FTIR but there’s a good likelihood it will only detect the filler, as the active ingredient (the steroid) is present in very small amounts. This is similar for steroids suspended in oil, as the signal from the oil may overpower the one from the steroid.

If you’re planning on taking your anabolic steroids into a drug checking clinic, it’s helpful if you bring the sample in its most concentrated form, if possible. This will increase the likelihood that your local drug checker can detect it.