Anabolic Steroids in Bodybuilding: Benefits, Dangers & Real-World Use

What are Anabolic Steroids (AAS)? Performance speaking.

Content Table

Anabolic steroids are used by bodybuilders to increase muscle mass, strength, and recovery beyond natural limits. These synthetic versions of testosterone allow athletes to train harder, grow faster, and achieve physiques that would otherwise be impossible through diet and training alone.

What Are Anabolic Steroids?

Anabolic steroids are synthetic derivatives of the male hormone testosterone. They mimic its effects in the body, promoting muscle growth (anabolism) and masculine characteristics (androgenic effects).

The term “anabolic” refers to tissue-building processes, while “steroid” describes their chemical structure—a cyclical carbon-hydrogen framework similar to cholesterol.

According to Anabolics by William Llewellyn, one of the most comprehensive references on performance-enhancing drugs, anabolic-androgenic steroids (AAS) bind to androgen receptors in muscle cells, triggering increased protein synthesis and nitrogen retention—key drivers of muscle hypertrophy [Amazon – Anabolics] .

While some steroids are FDA-approved for conditions like delayed puberty, muscle wasting, or hormone replacement therapy, many are used off-label in sports and bodybuilding.

Common forms include:

  • Injectable esters: Testosterone enanthate, nandrolone decanoate (Deca), trenbolone acetate
  • Oral tablets: Methandrostenolone (Dianabol), oxandrolone (Anavar), Anadrol
  • Topical gels/patches: Less common, used primarily in clinical settings

Each compound has unique properties based on its half-life, bioavailability, and metabolic pathway.

Why Do Bodybuilders Use Anabolic Steroids?

Bodybuilders turn to anabolic steroids because they deliver results far beyond what’s achievable naturally.

Accelerated Muscle Growth

Steroids dramatically increase muscle protein synthesis, allowing users to gain size at a much faster rate than with training and nutrition alone.

A 2015 clinical trial published in The Journal of Clinical Endocrinology & Metabolism found that men using supraphysiological doses of testosterone experienced significant gains in lean body mass—even without resistance training [PubMed – Bhasin et al., 1996] .

When combined with weightlifting, these effects are amplified.

Enhanced Strength and Performance

Users report rapid increases in strength, enabling heavier lifts and more intense workouts. This creates a positive feedback loop: greater mechanical tension → more muscle damage → enhanced growth signals.

Studies show that steroid use can boost strength by 5–20% within weeks, depending on dosage and training status [Scholar – Hartgens & Kuipers, 2004] .

Faster Recovery Between Workouts

Intense training causes micro-tears in muscle fibers. Steroids accelerate repair by increasing satellite cell activity and reducing inflammation.

This allows bodybuilders to train more frequently and with higher volume—critical during contest preparation phases.

Fat Loss and Improved Definition

Certain steroids, such as trenbolone and stanozolol, have strong fat-burning properties due to their ability to increase metabolic rate and preserve lean mass during calorie deficits.

Primobolan (methenolone) is favored in cutting cycles for its mild nature and low estrogenic activity, helping maintain hard, dry muscle appearance pre-competition.

Psychological Effects

Many users describe heightened motivation, aggression (“pump mentality”), and confidence while on cycles. However, these can also manifest as irritability, anxiety, or mood swings—especially with potent compounds like trenbolone.

Dr. Michael C. Scally, MD, notes in his research that AAS can alter brain chemistry, affecting dopamine and serotonin pathways linked to reward and impulse control [ResearchGate – Scally, M.C.] .

How Do Anabolic Steroids Work Biologically?

Understanding how steroids work requires knowledge of endocrinology and cellular physiology.

Binding to Androgen Receptors

Once injected or absorbed, steroids enter the bloodstream and bind to androgen receptors (AR) in skeletal muscle, bone, skin, and other tissues.

Activation of AR triggers gene expression related to muscle growth, including upregulation of mTOR and IGF-1 signaling pathways—central regulators of protein synthesis [ScienceDirect – Basaria, 2010] .

Nitrogen Retention and Anti-Catabolic Effects

Muscle tissue is rich in nitrogen. Positive nitrogen balance indicates an anabolic state where muscle building exceeds breakdown.

Steroids enhance nitrogen retention, preventing catabolism even under caloric restriction. This helps preserve muscle during fat-loss phases.

Suppression of Cortisol

Cortisol is a catabolic hormone released during stress and prolonged exercise. High levels break down muscle.

Anabolic steroids counteract cortisol’s effects, protecting muscle tissue and improving recovery [ClinicalTrials.gov – NIH Study on Hormonal Responses] .

Increased Red Blood Cell Production

Compounds like erythropoietin (EPO) are sometimes stacked with steroids, but even standalone AAS like testosterone stimulate red blood cell production.

More oxygen-carrying capacity improves endurance and delays fatigue—beneficial during long training sessions.

When Are Steroids Typically Used? (Phases of Use)

Bodybuilders typically time steroid use around specific goals and competition schedules.

Bulking Phase

During bulking, the focus is on gaining size and strength. Calorie surplus supports muscle growth.

Common compounds:

Cycle length: 12–16 weeks
Goal: Maximize lean mass accumulation

Cutting Phase

Cutting involves reducing body fat while preserving muscle. Diet shifts to a calorie deficit.

Preferred steroids:

  • Primobolan: mild anabolic, low water retention
  • Winstrol: enhances vascularity and hardness
  • Trenbolone: powerful fat burner, appetite suppressant

Cycle length: 8–12 weeks
Goal: Achieve stage-ready leanness and definition

Recomposition (Recomp) Phase

Some intermediate users aim for simultaneous fat loss and muscle gain using moderate doses.

Low-to-moderate testosterone with ancillaries may support recomp in trained individuals, though results vary.

Pre-Contest Preparation

In the final 4–8 weeks before a show, bodybuilders often introduce:

  • Diuretics (to reduce subcutaneous water)
  • Insulin (off-label, high risk)
  • Thyroid hormones (T3/T4) to boost metabolism

These substances carry serious health risks and are strictly regulated.

Common Types of Anabolic Steroids

There are dozens of available compounds, each with distinct profiles.

Testosterone Derivatives

  • Testosterone Enanthate/Cypionate: Long-acting injectables, dosed weekly
  • Testosterone Propionate: Shorter ester, requires frequent injections
  • Testosterone Suspension: Fast-acting, painful, rarely used outside competition

As noted in The Steroid Bible by Steve Gallaway, testosterone remains the cornerstone of nearly all cycles due to its well-understood pharmacokinetics and broad physiological impact [Amazon – The Steroid Bible] .

Nandrolones

  • Nandrolone Decanoate (Deca): Promotes collagen synthesis, beneficial for joints
  • Nandrolone Phenylpropionate (NPP): Faster release, better for shorter cycles

Deca is known for causing prolactin elevation, requiring dopamine agonists like cabergoline in some cases.

DHT-Derived Compounds

Derived from dihydrotestosterone, these do not aromatize into estrogen.

Examples:

  • Masteron (drostanolone): Popular in cuts for hardening effect
  • Winstrol (stanozolol): Oral or injectable, enhances strength and density
  • Primobolan (methenolone): Considered one of the mildest injectables

Primobolan is especially valued for its low hepatotoxicity and minimal suppression compared to other oral agents.

Oral Steroids

Orals pass through the liver and are associated with hepatotoxicity.

Types:

According to RUN SWIM THROW CHEAT by Chris Cooper, Anadrol was originally developed for anemia treatment but quickly adopted by athletes for its dramatic strength gains [Amazon – Run Swim Throw Cheat] .

Strong Androgens

  • Trenbolone: Up to five times more anabolic than testosterone
    • Variants: Trenbolone acetate (short), hexahydrobenzylcarbonate (Parabolan), enanthate (long)
    • Known for side effects: night sweats, insomnia, anxiety

Tren is often described as a “game-changer” in forums like r/steroids and UGBodybuilding.com, where users report extreme gains—but also warn of psychological strain.

Administration Methods and Frequency

Most anabolic steroids are administered via injection.

Intramuscular Injections

  • Deep IM into glutes, quads, or deltoids
  • Typical frequency: Every 3–7 days depending on ester half-life
  • Example: Testosterone enanthate every 5–7 days

Subcutaneous injections are less common but gaining traction for certain peptides and shorter esters.

Oral Administration

Taken daily due to short half-lives.

  • Dianabol: 20–50 mg/day for 4–6 weeks
  • Anavar: 20–80 mg/day, often split into two doses

Liver enzymes must be monitored regularly when using orals.

Topical Applications

Transdermal creams or patches are occasionally used, mainly in TRT contexts. Not common in performance circles due to inconsistent absorption.

Supportive Compounds and Ancillaries

Using steroids often requires additional medications to manage side effects and restore hormonal balance.

Post Cycle Therapy (PCT)

After a cycle ends, the hypothalamic-pituitary-testicular axis (HPTA) is suppressed. PCT helps restart natural testosterone production.

Common PCT drugs:

Protocols usually last 4–6 weeks post-cycle.

Aromatase Inhibitors (AI)

Used mid-cycle to prevent estrogen buildup.

Options:

  • Arimidex (anastrozole): Potent, requires careful dosing
  • Letrozole: Even stronger; risk of crashing estrogen
  • Aromasin (exemestane): Irreversible inhibitor, slightly safer profile

Blood work is essential to avoid over-suppression, which can lead to joint pain and low libido.

Blood Work Monitoring

Regular lab testing is critical for safety.

Key markers to track:

  • Total and free testosterone
  • Estradiol (E2)
  • Liver enzymes (ALT, AST)
  • Lipid panel (HDL, LDL)
  • PSA (prostate-specific antigen)
  • CBC (complete blood count)

Clinics like Mayo Clinic emphasize that long-term steroid use can negatively affect cardiovascular and metabolic health, making monitoring non-negotiable [Mayo Clinic – Anabolic Steroid Use] .

Risks, Side Effects, and Health Implications

No discussion of anabolic steroids is complete without addressing the risks.

Short-Term Side Effects

  • Acne and oily skin
  • Hair loss (in genetically predisposed individuals)
  • Gynecomastia (breast tissue development in males)
  • Mood swings, irritability (“roid rage”)
  • Elevated blood pressure

Gyno is caused by excess estrogen stimulation and can become permanent without intervention.

Long-Term Health Risks

Chronic use is associated with:

  • Cardiovascular disease (increased LDL, decreased HDL)
  • Liver damage (especially with oral 17-alpha-alkylated steroids)
  • Kidney dysfunction
  • Testicular atrophy and infertility
  • Increased risk of prostate issues

A longitudinal study in The Lancet Diabetes & Endocrinology concluded that long-term AAS users face significantly higher rates of heart attack and stroke—even after adjusting for lifestyle factors [The Lancet – Wood et al., 2023] .

Hormonal Suppression

All exogenous testosterone shuts down natural production. Without proper PCT, hypogonadism can persist for months—or permanently.

Dr. Jordan Grant, featured on The Anabolic Doc Podcast, stresses that HPTA recovery varies widely between individuals and depends on cycle length, age, and genetics [Anabolic Doc Podcast] .

Ethics, Culture, and Realities of Use

Anabolic steroid use exists in a gray area—illegal without prescription in most countries, yet widespread in professional bodybuilding.

Professional Bodybuilding

Open secrets abound in organizations like the IFBB Pro League. While drug testing exists in some federations (e.g., Natural Bodybuilding), top-tier pro shows operate under untested conditions.

Evan Centopani, a former IFBB pro, has spoken candidly about the realities of prep, stating that achieving extreme conditioning requires tools beyond natural means [RX Muscle Interviews] .

Social Media Influence

Platforms like YouTube and Instagram host influencers who walk the line between education and promotion.

Figures like Greg Doucette, Derrick from Geared Brain, and Your Friendly Pharmacist discuss PEDs openly, often emphasizing harm reduction over abstinence.

Podcasts such as Mind Pump Media and Ben Greenfield Fitness explore both sides—highlighting benefits while cautioning against reckless use.

Legal Status and Stigma

In the U.S., anabolic steroids are Schedule III controlled substances under the Controlled Substances Act. Possession without a prescription carries legal penalties.

Despite stigma, underground labs and online vendors make access relatively easy—though product authenticity is a major concern.

Counterfeit vials, mislabeled concentrations, and bacterial contamination are real dangers reported across forums like ThinkSteroids.com and AnabolicMinds.

Harm Reduction and Responsible Use (Educational Focus)

If someone chooses to use anabolic steroids, minimizing harm should be the priority.

Never Share Needles

Use sterile equipment for every injection. Sharing needles increases risk of HIV, hepatitis B/C, and bacterial infections.

Source Verification Challenges

Buy from reputable third-party tested suppliers when possible. Some companies offer COA (Certificate of Analysis) verification.

However, true pharmaceutical-grade sourcing is difficult outside regulated markets.

Keep a Journal

Track:

  • Injection dates and sites
  • Dosages and compounds
  • Mood changes, side effects
  • Lab results

This data helps identify patterns and optimize future decisions.

Mental Health Considerations

Steroid use can exacerbate underlying mental health conditions. Depression, anxiety, and suicidal ideation have been reported post-cycle.

The Steroid Mafia Podcast frequently discusses the psychological toll of long-term use, urging listeners to seek professional help when needed [Steroid Mafia Podcast] .

Emerging Trends and Alternatives

The landscape of performance enhancement is evolving.

SARMs (Selective Androgen Receptor Modulators)

Compounds like ostarine (MK-2866) and ligandrol (LGD-4033) target muscle and bone with less impact on other organs.

However, they remain unapproved for human use and carry unknown long-term risks.

Peptides

Ipamorelin, CJC-1295, and TB-500 are used to boost growth hormone release or aid recovery.

While not steroids, they fall under anti-doping regulations and require careful handling.

Gene Doping (Future Concern)

Theoretical methods involving genetic modification to enhance EPO or myostatin inhibition are being studied—but remain largely speculative and ethically fraught.

WADA actively monitors developments in this space [WADA Gene Doping Research] .

Natural Optimization

For most people, sustainable progress comes from:

  • Progressive overload in training
  • Adequate sleep (7–9 hours/night)
  • Balanced nutrition (protein intake ~1.6–2.2g/kg/day)
  • Stress management
  • Blood work and hormone optimization (if clinically indicated)

Dr. Mike Israetel, PhD in Sport Physiology, advocates for maximizing the natural phase before considering any enhancements [RP Strength Podcast] .

Steroids in the Golden Era vs. Today

The use of anabolic steroids in bodybuilding has evolved dramatically since the so-called “Golden Era” of the 1970s and 1980s, when icons like Arnold Schwarzenegger and Sergio Oliva dominated the stage.

Back then, steroid use was shrouded in secrecy and myth. Doses were often lower by today’s standards, with testosterone, Deca-Durabolin, and Dianabol forming the core of most cycles. Many legendary physiques were built on what would now be considered moderate protocols—combined with high-volume training, whole-food diets, and years of dedication.

As Dr. Thomas O’Connor (“The Anabolic Doc”) explains on his podcast, much of the Golden Era pharmacology was based on trial and error, with limited access to blood work or advanced ancillaries like aromatase inhibitors [The Anabolic Doc Podcast] . Post-cycle therapy (PCT) was rudimentary, and understanding of estrogen control was minimal.

In contrast, modern bodybuilders leverage highly sophisticated stacking strategies. Triple and quadruple hormone therapies—combining testosterone, trenbolone, growth hormone, insulin, and SARMs—are common in competitive circles. Compounds like Primobolan, once rare and expensive, are now integrated into cutting phases for their hardening effects with reduced water retention.

Final Thoughts: Knowledge Over Guesswork

Anabolic steroids are powerful tools with profound physiological effects. Whether viewed as necessary evils or unethical shortcuts, they remain deeply embedded in modern bodybuilding culture.

By understanding the why, how, when, and what, you empower yourself to make informed decisions—whether that means avoiding them entirely or approaching use with caution, respect, and preparation.

Always remember:

  • This content is not medical advice
  • Consult a licensed healthcare provider before making changes to your health regimen
  • Prioritize long-term well-being over short-term gains

For those seeking deeper knowledge, books like Anabolics by Llewellyn and The Steroid Bible by Gallaway remain foundational resources—supported by decades of clinical research and user experience.

Stay curious. Stay safe. Stay informed.

Picture of Dr. Marko Trajanovski
Dr. Marko Trajanovski
Dr. Marko Trajanovski Specialist in Testosterone Replacement Therapy and Men's Hormonal Health Dr. Marko Trajanovski is a board-certified endocrinologist specializing in testosterone replacement therapy and male hormonal health. With over 15 years of clinical experience, Dr. Trajanovski helps men restore healthy testosterone levels and improve their overall well-being. His patient-centered approach focuses on safety, science, and long-term health outcomes. Education and Training Fellowship in Endocrinology – University of Skopje, North Macedonia Residency in Internal Medicine – Clinical Center Skopje, Faculty of Medicine Doctor of Medicine (M.D.) – University of Skopje, North Macedonia Professional Background Dr. Trajanovski completed his medical degree and endocrinology training at the University of Skopje. Throughout his career, he has worked in both hospital and private practice settings, helping men with hormone imbalances, fatigue, low libido, and muscle loss caused by low testosterone levels. He uses evidence-based protocols to diagnose testosterone deficiency and tailors each treatment plan to the patient’s needs, using testosterone replacement therapy to restore hormonal balance and vitality. He also monitors patient progress closely to ensure optimal results and safety. Research and Advocacy Dr. Trajanovski actively contributes to clinical research on testosterone therapy and men’s health. He regularly participates in international conferences, sharing insights on hormone optimization and patient outcomes. He is dedicated to educating both patients and professionals about responsible hormone therapy use. Personal Life Outside of work, Dr. Trajanovski enjoys cycling and hiking in the mountains of North Macedonia. He lives in Skopje with his wife and daughter and is passionate about promoting healthy aging and lifestyle balance. Contact 📍 Skopje, North Macedonia 📧 [email protected]

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