Medically reviewed by
Dr Beng Eu, General Practitioner, Prahran Market Clinic
What are steroids?
Steroids are a specific group of hormones that are needed for normal body function. There are different types of steroids that act in different parts of our bodies.
The steroids that people use for changing their appearance or enhancing physical performance are versions of testosterone (the main sex hormone in males) and are called ‘androgenic steroids’. They are sometimes also referred to as ‘anabolic steroids’ or ‘anabolic-androgenic steroids’.
Sometimes people refer to ‘steroids’ when using corticosteroids. This is a different type of steroid and has a different function, and can be used in treating asthma, eczema, autoimmune disease and more.
The use of testosterone for changing appearance or enhancing physical performance is different to when used as a medical treatment for testosterone deficiency.
Use of steroids for reasons other than testosterone deficiency can be categorised as 'off-label use' or 'non-prescribed use'.
It is against the law to buy, sell, supply, possess or use steroids without a prescription, so non-prescribed use of steroids is illegal.
What are 'off-label' and 'non-prescribed' steroid use?
Off-label use usually involves pharmaceutical products and use of normal clinical dosing, whereas non-prescribed use often involves illicitly sourced products of questionable quality taken at excessively high doses and in combination with other substances.
The myth that men’s testosterone levels naturally fall with age has led to the off-label use of steroids in the hope of an unproven rejuvenating effect in middle-aged and older men.
There is no evidence that off-label use of steroids is safe and evidence of limited benefits is only available for men aged over 65 years with health problems.
How common are off-label and non-prescribed steroid use?
Around 6-7 of people are believed to use non-prescribed steroids in their lifetime, with the rate about 50 times higher for males than females.
Non-prescribed steroid use begins most commonly in males aged in their early 20s, whereas off-label use is most predominant in middle-aged males. A large proportion of people who use off-label or non-prescribed steroids appear to develop steroid dependence.
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What are the signs of non-prescribed steroid use?
Health effects of non-prescribed steroid use
Steroid dependence
Off-label and non-prescribed use of steroids reduces the body’s own production of testosterone due to its negative feedback system. When you stop taking steroids, it takes your body weeks to months to get back to making its own testosterone.
People who use non-prescribed steroids show signs of addiction, like withdrawal, cravings and loss of control.
Psychological dependence on steroids and the effects of withdrawal (headache, tiredness, nausea, muscle pain, restlessness, poor sleep, low mood, low sex drive, body dysmorphia and suicidal thoughts) make it difficult to stop using steroids. The same scenario occurs with off-label use.
Stopping off-label or non-prescribed steroid use
Steroid dependence makes it difficult to stop using steroids, but stopping is necessary if you want to have children or if you develop health problems caused by off-label or non-prescribed use.
Methods described online for ‘post-cycle therapy’ or to ‘restart’ testosterone production are not proven to be safe or to work, and are not based on scientific evidence.
What to do about off-label or non-prescribed steroid use
You should visit a doctor to discuss the best way for you to stop using steroids.
