What is steroid abuse?

Steroid abuse is when someone takes steroids without any medical need, to increase physical performance (e.g. increased strength or endurance), alter their appearance (e.g. increased muscle mass) or for their work (e.g. military, police, security). These steroids are versions of testosterone, which is the main sex hormone in males.

Steroid abuse usually involves massive doses of illegally sourced drugs, often used in combination with other performance- and image-enhancing drugs (this is called “stacking”) as well as substances to counter the side effects of steroids. People also “cycle” their use with breaks for “recovery”, and “pyramid” use by gradually increasing intake to a peak and reducing again. However, there is no evidence that any of these methods actually reduce the side effects and harm from taking steroids.

Steroid abuse carries significant health risks such as heart attack, liver and brain damage and infertility. In adolescents, steroids can cause premature ageing and stunted growth. 

Learn more about steroid misuse and abuse on our health topic page.

Signs of steroid abuse

Physical signs:

• Rapid weight gain (approx. 10 kg in two to three months)
• Muscular physique (disproportionate muscle growth around chest, neck and shoulders)
• Severe acne (mainly on the back, shoulders and chest)
• Stretch marks (usually between biceps and pectoral muscles, possibly back and thighs)
• Excess body hair and/or accelerated baldness
• Injection site swelling, tenderness and/or redness
• Tendon and muscle tears
• Gynaecomastia
• Erectile dysfunction
• Male infertility
• Testicular atrophy (shrinkage of the testes)

Psychological signs:

• Aggression
• Impulsivity
• Higher or lower sex drive 
• Anxiety
• Depression
• Reduced empathy
• Jealousy
• Muscle dysmorphia
• Mood instability
• Panic attack
• Psychosis    
• Sleep problems
• Suicidal ideation
• Suicide attempt
• Violence
• Worry

What your partner could be feeling

There are a range of reasons why your partner might feel the need to use steroids. While steroids used to be associated with competitive athletes and bodybuilders, they’re now used by recreational athletes and gym users to build muscle and improve performance. They’re also used by people who need muscle strength to do their jobs like bodyguards, security personnel, construction workers, police and members of the armed services.

Men and boys with muscle dysmorphia (a type of body dysmorphic disorder) see themselves as not muscular enough and might abuse steroids in a bid to fix this perceived flaw. If your partner has muscle dysmorphia, it’s likely that they don’t recognise their beliefs about their appearance are inaccurate and don’t realise they have a serious but treatable condition. Access our Partner's Guide for Body Dysmorphic Disorder here.

Most steroid users experience side effects and know the risks, but would stop if they experienced a serious health problem. However, many people who abuse steroids are untrusting of doctors so it’s unlikely their health is being adequately monitored to ensure the damaging effects of steroid abuse are caught before it’s too late. Some people believe steroid abuse to be part of a healthy lifestyle. Your partner might feel dependent on steroids, especially if they rely on them for confidence and self-esteem. 

Withdrawing from steroids can be tough because it takes the body weeks to months to get back to making its own testosterone. During this process, your partner may experience headache, tiredness, nausea, muscle pain, restlessness, poor sleep, low mood, low sex drive, body dysmorphia and suicidal thoughts. If your partner has come off steroids suddenly and has experienced depression, they should be monitored by a health professional.

What you could be feeling

Steroid abuse can come with rough side effects and serious long-term physical health, mental health, social and financial problems that can take a long time to go away. If your partner experiences these, they can undoubtedly impact you and your relationship. Side effects such as irritability, reduced empathy, mood swings and aggression can lead to conflict and reduced emotional support. More troublingly, men who abuse steroids are more likely than others to be perpetrators of intimate partner violence. If you are currently experiencing domestic violence or feel unsafe in an intimate or family relationship, call the 24-hour National Sexual Assault, Domestic, and Family Violence Counselling Service on 1800 RESPECT (1800 737 732). 

You might also be worried about how steroid abuse might impact your partner’s health in the long run, or how it could impact yours. Injecting steroids increases the risk of contracting blood-borne viruses such as HIV and Hepatitis B, which can be passed on to a sexual partner. 

Steroid abuse causes male infertility, which can be distressing if you’re trying to start or grow your family. Many men who abuse steroids decide to stop when they want to recover their fertility. It usually takes around six to 18 months for fertility to return.

Steroid abuse is illegal, so users may feel ashamed and keep their behaviour secret, which has the potential to cause stress and strain on your relationship.

What you can do

If your partner is abusing steroids and you’re concerned about it, communication is important. There are a few ways to make the conversation more comfortable and constructive.

• Pick a time and place where you have privacy, and you’re both relaxed and receptive. Avoid moments when you’re stressed, tired or vulnerable
• Use ‘I’ statements to express your worries or feelings, such as “I’m a bit worried because…” or “I’ve noticed that lately…” to avoid coming across as judgemental or accusatory
• Encourage your partner to share how they feel and their reasons for using steroids

Consider talking to your partner about the more immediate side effects and consequences of steroid use, for them, you and your relationship. Your partner might not agree that their steroid use is a problem and could become defensive, so it may help to revisit the topic after a bit of time or get some help from a counsellor who specialises in addiction or substance abuse.

If your partner wants to stop abusing steroids, encourage them to see a doctor and be honest to get the right support. A doctor-assisted detox can help with managing withdrawal symptoms. This can involve seeing a psychologist (for cognitive behavioural therapy) to address the underlying reason for steroid abuse and help avoid relapse. 

Learn more about steroid misuse and abuse on our health topic page.

Watch this 1-hour on-demand webinar discussion, with Prof Robert McLachlan and Prof David Handelsman, on the physiological harms of anabolic steroid use on Australian males and the physiological management of patients on the journey to cessation.

More than one in six Australian men is a smoker. Smoking has become less common in Australian men and women over the last 20 years, but it remains the biggest preventable cause of disease and death. It’s believed that, in general, people smoke to control their feelings. Either to increase good feelings or decrease bad feelings. They may also smoke because it’s a habit or because they are addicted to nicotine. The more someone smokes, the more likely they are to be smoking because it’s a habit or because of addiction, and this makes it difficult to quit.

Learn more about smoking on our health topic page.

The health effects of smoking

Everybody knows that smoking is unhealthy. It harms almost every part of your body and increases your risk of developing a range of cancers, heart disease, diabetes, chronic respiratory conditions, fertility issues, vision loss, dental problems and more.

Some of the health effects of smoking are noticed every time someone smokes, while other health effects take years to appear. For example, heart rate and blood pressure increase almost straight away when someone smokes, but it takes around 25 years for lung cancer to appear. This might lead people to believe it won’t happen to them, but up to two-thirds of long-term smokers will die of a smoking-related disease and have their lives cut short by about 10 years on average, compared to non-smokers.

Smokers who quit have some improvements in their health almost straight away, and their risk of some diseases can eventually be the same as non-smokers. 

What you might feel about someone else’s smoking

There are lots of reasons why you might want your partner to quit smoking. You might be concerned about their health, your own health or the health of others. You might want to start a family and have concerns about secondhand smoke on the baby, or if you’re a female, your chances of getting pregnant. You might just not like the smell. The financial cost might be too much of a burden.

Secondhand smoke is associated with lots of bad health outcomes, including low birth weight, sudden infant death syndrome, respiratory infections and asthma in children, and breast cancer, heart disease and lung cancer in adults. There’s concern that secondhand smoke might also cause mental health problems.

What you can do about someone else’s smoking

You can’t make someone quit smoking if they don’t want to. They have to want to do it for themselves, but the right support can help. 

• Always take a positive, non-judgmental approach — nagging, lecturing and criticising won’t help
• Ask them what support they would like — whether they want help with distracting activities, avoiding triggers or tracking their goals

Share some information on quitting smoking, but reassure them it might take a couple of goes. There’s a lot of information available to help people quit smoking. The most effective way to quit seems to be a combination of behavioural support (counselling) and nicotine replacement therapy in both slow-acting (e.g. nicotine patches) and fast-acting (e.g. chewing gum) forms.

If your partner is quitting cold turkey, they may go through nicotine withdrawal and experience symptoms like mood swings, irritability, insomnia, anxiety, restlessness, difficulty concentrating and increased appetite. It’s usually worst in the first 24 to 48 hours of quitting, and you might need to give them some space during this period. 

You can find more information on supporting someone to quit smoking here:

• Quit
• Quit HQ
• The Australian Government Department of Health and Aged Care

Not many people who smoke manage to quit the first time they try, but there are more ex-smokers in Australia than people who smoke, so most people end up succeeding eventually.

Learn more about smoking on our health topic page.