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What Are the Risks Between Steroids and Erectile Dysfunction?

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As we rush to become better physical versions of ourselves, we often look towards items that will give us quick results like diet programs, supplements, and steroids. For men, anabolic steroids are appealing because they offer a way to bulk up and grow muscle quickly while still being able to recover from workouts rapidly (1).

When misused or for long periods, men may run into some severe side effects; among these linked to steroids are erectile dysfunction, heart problems, kidney failure, and extreme aggression (2).

What Are Anabolic Steroids & Who Uses Them?

Anabolic steroids are synthetic (human-made) variants or derivatives of the male sex hormone, testosterone, which plays a wide range of roles in the male body.

Naturally occurring testosterone helps the penis and testes develop, deepens the voice, increases muscle size and strength, boosts bone growth, is responsible for your sex drive, and sperm production (3).

Anabolic steroids will imitate the properties of natural testosterone, and because it has a similar chemical composition, it will activate or bind to the testosterone receptors in your brain.

Contrary to popular belief, the vast majority of male adults who misuse anabolic steroids are not high-performance athletes or competitive bodybuilders but are instead non-athletic weightlifters between the ages of 20-30 (4).

The use of steroids in the female population is far less common, as women tend not to favor extreme muscularity (5).  Common similarities in men who use anabolic steroids include those with

  • Poor self-esteem,
  • Depression,
  • Inadequate knowledge about health,
  • Those participating in sports that emphasize weight or size,
  • Eating disorders,
  • Muscle dysmorphia,
  • Higher rates of eating disorders,
  • Experiences with sexual abuse (6).

Unfortunately, those who suffer from the above may be too focused on their physical appearance or mental health and how to quickly fix it, to understand that side effects with steroids, like erectile dysfunction, may occur.

How Are Steroids Commonly Misused?

Individuals who misuse steroids often do so mistakenly. Misuse may happen if the individual chooses to cycle, stack, pyramid, or plateau them (2).

  • When an individual takes multiple doses for an extended period, chooses to stop, and then restarts again, this is called cycling.
  • If an individual combines the steroids, they are taking or mixes them with other steroid options or types; this is called stacking. For instance, if a male chooses to take an oral steroid of one kind and an injectable of another kind, at the same time.
  • If the individual gradually increases the dose or the frequency of use, up to the peak amount, and then gradually tapers off to nothing, this is called pyramiding.
  • If an individual alternates, overlaps, or substitutes steroids with one another to prevent a tolerance buildup, this is called plateauing.

This misuse may occur if the individual falsely believes that tapering off, stopping and restarting, or gradual increases are beneficial to their health or prevent the harmful side effects.

Unfortunately for the individual, the detrimental effects of steroid use, like erectile dysfunction, is not impacted by cycling, tapering, or stacking and can still easily occur.

What Is the Link Between Steroids & Erectile Dysfunction?

The link between steroids and erectile dysfunction appears when there is an over-dependence on the anabolic steroids. While these types of steroids do not cause a “high,” they can lead to substance abuse and addiction.  There are a few reasons that over-dependence can occur.

  1. Those who try to withdraw may experience adverse symptoms such as sleep problems, steroid cravings, decreased sex drive, loss of appetite, restlessness, and fatigue.
  2. Those who are using steroids due to body image issues may psychologically be unable to successfully drop the steroids entirely as they may fear that their body will become weak, waste away, or be “less than” its current state.
  3. Coming off steroids may induce depression in some individuals, leading to unwanted suicide attempts.

If any of the above reasons (or avoidance of the reasons) are being used to stay on steroids for lengthy periods, an individual may experience steroid-induced erectile dysfunction as a result. This is because androgen steroid use interferes with the body’s ability to produce endogenous testosterone, leading to impotence, testicle shrinkage, and low libido (8).

We also see low libido occur with long-term steroid use in individuals who use it for long durations (9).  Those who consume anabolic steroids for seven weeks may notice changes in their testicular volume and sperm concentration (reduction in both).

Does Erectile Dysfunction Disappear When Steroids Are Stopped?

With medical help, most men can recover their natural levels of testosterone, sperm production, and their baseline luteinizing hormones, but the time it takes varies from individual to individual.

Unfortunately, there are hypogonadal side effects due to the inhibition of the luteinizing hormone, which can persist for many months after the cessation of anabolic steroids (10).

This means that men may experience diminished production of natural testosterone. The sperm production may return to normal within a few months, or it may take up to a year or longer.

Permitting that there is no pre-existing diagnosis of penile impairment before anabolic steroid use, it is reasonable to expect the erectile dysfunction to cease. If it does not, erectile dysfunction caused by steroids can be treated with medical options or external devices.