Anabolic Steroids: Why Prescription Is Mandatory and Risks of Non-Medical Use

Anabolic-androgenic steroids (AAS) are controlled substances requiring a prescription. Non-medical use carries serious health and legal risks.

Risks of Non-Prescription Use

• Cardiovascular: Hypertension, dyslipidemia, cardiomyopathy, stroke, sudden cardiac death.
• Endocrine: Testicular atrophy, infertility, gynecomastia, HPTA suppression (hypogonadism).
• Hepatic: Cholestasis, peliosis hepatis, hepatocellular adenoma/carcinoma (oral 17α-alkylated).
• Psychiatric: Aggression ("roid rage"), mania, depression, dependence.
• Infection: Non-sterile injections → abscess, HIV, hepatitis B/C.
• Legal: Felony possession/distribution without prescription (Schedule III in US).

Legitimate Medical Uses

• Hypogonadism (testosterone replacement therapy)
• Constitutional delay of puberty
• Muscle-wasting diseases (HIV, cancer, COPD)
• Certain anemias
• Gender-affirming hormone therapy

Only a physician can assess risk/benefit, order appropriate monitoring, and ensure safety.