Steroids Side Effects: Cause and Prevention

Read this comprehensive guide on steroids side effects and how to prevent such incidents and best treat symptoms when they arise.

In your journey of using anabolic steroids, you will almost certainly fall victim to steroids side effects at some point. It is almost impossible to not fall victim of at least one or two steroids side effects. The spectrum of side effects associated with steroid use is so broad, that avoiding all of the side effects isn’t going to happen in your trial and error of steroid use. The good news is the steroids side effects we are about to list, can be limited or controlled using a variety of medications. Some will limit the occurrences; some will prevent them altogether, other cannot be avoided even if low doses of steroids are taken and need to be expected. The side effects will range from temporary, to possibly permanent but we will do our best here to state what needs to be taken to prevent the steroids side effects and why the sides may become apparent. The good news is that many of these steroids side effects will be avoided if you’re a healthy adult with a good diet rich in nutrient foods.

Male Steroids Side Effects

  • Gynecomastia:

Cause – This is caused by anabolic steroids that aromatase to estrogen. This process then raises estrogen levels in the body and causes breast tissue growth by increasing cell proliferation and differentiation. Estrogen is not the sole cause of gynecomastia, prolactin is also a culprit, so anabolic steroids that increase prolactin, such as, Deca-Durabolin and Trenbolone can pose a risk or a greater risk if combined with aromatasing steroids.

Prevention – The best way to combat gynecomastia isto use an Aromatase Inhibitor, such as, Arimidex, Letrozole or Exmestane (Aromasin). These drugs will keep estrogen in normal ranges and not let it get wildly out of control when using cycle in aromotasable steroids. Another alternative is a Selective-Estrogen-Receptor-Modulator (SERM), an example of this is Tamoxifen Citrate (Nolvadex). This works by preventing the estrogen receptor from activating and renders it useless.


  • Acne:

Cause – This is often, again, caused by estrogen and also dihydrotestosterone (DHT). Acne occurs when we have large amounts of estrogen, DHT or androgenic steroids present in the body, such as, Testosterone. Acne is determined by the sebaceous glands enlarging, inflaming and becoming blocked. It is a genetically pre-disposed condition and those who get acne in puberty often also suffer when using anabolic steroids.

Prevention – Avoiding DHT derived steroids, controlling estrogen, using mild androgens and limiting doses to low/moderate will all aid in preventing acne occurring. Washing regularly will prevent oil building up and using salicylic acid, benzoyl peroxide and vitamin A (retin) creams and gels will also aid. In extreme cases oral anti-biotic can be taken, as well as Isotretinion (Accutane) but a doctor’s guidance is needed using Accutane and regular blood work due to its direct toxicity.

  • Cholesterol:

Cause – This is a difficult problem to treat as anabolic steroids can impair lipid profile two ways. One of which is to lower good HDL cholesterol and increase bad LDL cholesterol, so as you can see, both may need adjusting. Certain steroid will affect lipids than others, some more so than others. Anavar and Winstrol have been known to be extremely tough on lipid profiles. Generally DHT derived steroids are and also compounds that increase estrogen are also culprits. The dose of the said steroid is going to impact the steroids side effects on cholesterol the most.

Prevention – The most important factor to treat cholesterol problems is diet, supplementation and lifestyle choices. A smoker or binge drinker will generally have worse cholesterol than someone who abstains from both. Regular exercise and a diet or supplement regime containing some of these foods and products will help greatly:


Omega 3 caps

Red Yeast Rice



Coconut Oil



Fish (wild caught salmon)



Coconut milk

In a recent study 500mg injection of Testosterone Enanthate impaired lipid profile by 15% [1]. So as we can clearly see, prolonged doses may mean more problems and so may increasing the dose.

[1. Subst Abuse Treat Prev Policy. 2012 Mar 20;7:12.

Single dose testosterone increases total cholesterol levels and induces the expression of HMG CoA reductase.

Gårevik N, Skogastierna C, Rane A, Ekström L.]

  • Hair Loss:

Cause – This is when DHT attacks the hair follicles in the scalp and causes them to deteriote and hair loss to occur. This steroid side effect usually comes from using DHT derived steroids directly, but can also appear from using compounds, such as, Testosterone, where DHT builds up gradually from conversion. This steroids side effect will not appear in all steroid users, but only the ones who are genetically pre-disposed to male-pattern-baldness (MPB). If it’s not in your genetics to lose your hair when you age, then this side effect is not applicable. Anabolic steroids will only speed the process of MPB and accelerate it, not cause it per se.

Prevention – The easiest and safest way to avoid MPB is to avoid using DHT derived steroids and to not use large amounts of anabolic steroids where DHT levels may rise. If all else fails then using a 5-alpha-reductase inhibitor, such as, Finasteride, Dutastride or Propecia will reduce DHT levels and prevent them from destroying the hair follicles. These are anti-androgens and can also affect the gains of your steroid cycle negatively so should be used sparingly.

  • High Blood Pressure (Hypertension)

Cause – Steroids can increase blood pressure directly, but many times this is due to increasing water retention. The dose of the said androgen will impact blood pressure and so will choice of the steroid. Trenbolone is notoriously bad on blood pressure, even in small doses. Again, genetic pre-disposition will impact blood pressure greatly. Some suffer from hypertension even when not on steroids.

Prevention – Controlling water retention by use of an AI will help control elevations in blood pressure. This can be done simply by taking the AI Aromasin at 10mg every day or Arimidex at 0.5mg every two days. Water weight will be limited and kept off. Lifestyle choices and nutrition will place crucial roles in this, just like they do in leading a healthy life. Omega 3 has been shown to reduce blood pressure and so can taking a daily baby Aspirin.

  • Water Retention:

Cause – This is caused by letting estrogen levels climb too high, but it’s also caused by steroids and particularly Human Growth Hormone (HGH) can change the bodies electrolyte balances via sodium retention.

Prevention – Using an AI will control estrogen from climbing too high and causing water retention in steroid users. Diet, cardiovascular exercise and lifestyle choices that limit estrogen aromatisation will also contribute to water weight being help from steroids. Aromasin 10mg every day or Arimidex at 0.5mg every 2 days will aid in this prevention, as well as regular cardio and limiting sodium (salt) intake in your diet. Also drink plenty of water.

  • Prostate Enlargement:

Causes – This is caused by both DHT and lately research has pointed to this occurring from estrogen also. If you suffer from DHT related side effects, such as an enlarged prostate, its best to avoid both DHT related steroids and estrogen increasing steroids that aromatase. Do not use steroids if you suffer from prostate enlargement.

Prevention – Controlling DHT and estrogen can both be done by using a 5-AR inhibitor, such as, Finastride or Aromasin respectively. This can also be done by choice of anabolic steroids and using low to moderate doses. DHT and estrogen receptors are both causative factors in the enlargement of the prostate and cause cell proliferation and differentiation. Omega 3, CQ-10 and Saw Palmetto all help keep the prostate healthy.

  • Testosterone Inhibition:
Low Testosterone

Cause – Unfortunately all steroids will cause the body’s own testosterone to be inhibited because of the way they act on the brain, specifically hypothalamus. The body will sense that steroids are being injected and will lower or stop its own production of testosterone. It does this because it’s an efficient organism – this cannot be avoided. Suppression of endogenous testosterone production will vary from steroid to steroids, but the worst offenders are compounds, such as, Trenbolone and Deca-Durabolin. Hypogonadism (low testosterone) will appear rapidly when these steroids are used.

Prevention – When we use steroids, such as, Deca-Durabolin, Trenbolone and Equipoise, they will impair are own natural testosterone production, so we need to simply replace the body’s own lost production with Testosterone derived steroids – Testosterone Enanthate, Testosterone Cypionate or the shorter acting Testosterone Propionate are all excellent alternatives.

  • Liver Toxicity (Hepatoxicity)

Cause – This is caused by the oral steroid group that are the C17-alpha alkylated (17aa) anabolic steroids. These steroids have been altered at the 17th carbon position to enable them to stay orally active and enter the blood stream through oral ingestion. It enables them to survive the “first pass” in liver metabolism; where as other anabolic steroids would become inactive and require far higher doses. The only steroids that remain active to a degree and do not become useless are Proviron and Primobolan. The exception to this rule is also Winstrol (Stanozolol) where it is an orally active 17aa steroid but also comes in an injectable depot version.

Prevention – Avoiding alcohol is one of the best ways to limit the negative effects on the liver when taking hepatoxic oral steroids. Drinking plenty of water, lemon and water is also an excellent weapon against liver stress and will aid in liver regeneration and detoxification. Oral steroids should not be used for more than 5-7 weeks without having a break due to hepatoxicity. Doses should also be limited or tailored correctly.

  • Testicular Atrophy (shrinkage)

Cause – This is caused when the body’s own natural testosterone levels have become suppressed or “shutdown”. The testes rely on a supply of certain natural hormones to maintain spermatogenesis, size and function, but this can be turned off by steroid use.

Prevention – We can address the testes directly using Human Chorionic Gonadotropin (HCG). This peptide hormone will mimic the effects of luteinizing hormone (LH) on the testes and prevent them from becoming dormant when not stimulated from the body’s own hormone output. After we have prevented the testes from dysfunctioning we need to start up the body’s own testosterone output. HCG at 500ius injected twice per week will keep the testes online and functioning fine. This is done by conducting a post cycle therapy (PCT) protocol. Tamoxifen can be taken for 5-6 weeks after the steroid cycle is finished at 20mg every day. Clomid can also be combined with it at 50mg every day, or the newer SERM, Toremifene Citrate at 60mg every day.

Adolescent Side Effects 

Adolescents or those under the age of 23-25 years of age can experience these above side effects to a greater degree due to their HPTA not being fully developed yet. The male HPTA is not fully matured until this age, so supressing it using steroids can cause long term and permanent damage. It’s advised to avoid using anabolic steroids during your younger years due to this and due to the fact that some steroids, mainly those which aromatase and increase estrogen, can cause growth plate closure and stunt growth. This can then not be reversed. Hormonal changes during the younger years can also increase the chances of getting gynecomastia and acne. One of the most common reason not to start a steroid cycle or stack, is due to the fact that teens of those in early twenties have very high levels of natural testosterone and they should take advantage of this. Many teens and young adults have levels of testosterone that a light Testosterone Enanthate cycle would yield, so there is simply no point in starting as steroidal cycle during this time and it’s better to build a solid muscular base and wait till the time is right.

Female Steroids Side Effects

The majority of the side effects listed above are still applicable to females, but a few obvious ones are not. These are prostate enlargement, gynecomastia and testicular side effects. The other steroids side effects are evident, hypertension, water retention, acne, hair loss, lipid problems and hepatoxicity all appear in females. Another to note, which are not apparent in males and solely linked to females is – virilisation. This is when the female’s body undergoes masculine changes, such as, facial hair growth, hair loss, deepening of vocal chords and enlargement of sexual organs (clitoris). These side effects can be avoided if the correct low doses of anabolic steroids are used and also time spent using them is kept short. Abuse will often lead to permanent side effects in women. Once virilisation steroids side effects begin to arise stop the steroid(s) immediately or lower the said dose considerably. Certain androgenic steroids are far worse for women than others. An example would be Primobolan and Anavar are both safe in low doses for short periods, which Trenbolone and Dianabol aren’t really safe at any dose for any time frame.