The use of anabolic steroids can cause erectile dysfunction in some men by affecting the natural production of testosterone, the main male sex hormone.
Many men turn to anabolic steroids to gain muscle mass and improve sports performance.
However, the Resolution No. 2,333/2023 of the Federal Council of Medicine prohibits use for aesthetic purposes and allows it only in cases of proven hormonal deficiency.
The CFM established this rule to warn about the risks of anabolic steroids, such as hormonal changes and erectile dysfunction. Below, understand the impact of these substances on sexual function and when to seek medical advice.
Do anabolic steroids cause erectile dysfunction?
According to Dr. Paulo Egydio, PhD in urology, anabolic steroids can cause erectile dysfunction because they make the hypothalamus and pituitary gland reduce stimulation to the testes for testosterone production.
It is also highlighted that the use of anabolic steroids can reduce testicle size, impair fertility, increase the risk of cardiovascular and liver problems, and impact mental health.
Effects of anabolic steroids on erection?
Check the table below for the effects of anabolic steroids on erection and libido:
| Effect | What happens in the body | Impact on erection |
|---|---|---|
| Suppression of natural testosterone | The body reduces testosterone production by interpreting that levels are already high. | Lower production of nitric oxide, reducing blood flow to the penis. |
| Hormonal changes and libido | The drop in testosterone decreases activity in areas linked to pleasure and motivation. | Lack of sexual stimulation, making erection difficult or impossible. |
| Impact on the testicles | The testicles receive less stimulation and may atrophy over time. | The reduction in testosterone further compromises erectile function. |
What are the main side effects?
Anabolic steroids can cause various side effects. See the main ones:
- Erectile dysfunction: anabolic steroids reduce the natural production of testosterone, leaving the body with insufficient levels to maintain erectile function.
- Infertility: the use of these substances reduces the production of FSH, a hormone essential for sperm formation, which can decrease or even stop fertility.
- Low libido: the drop in testosterone reduces sexual desire.
- Cardiovascular problems: anabolic steroids increase blood viscosity, raise bad cholesterol (LDL), and reduce good cholesterol (HDL), favoring fat accumulation in the arteries and increasing the risk of heart attack and stroke.
Is erectile dysfunction caused by anabolic steroids curable?
Erectile dysfunction associated with anabolic steroids can be reversible in most cases. The first recommended clinical step is to stop using them.
The process of recovering hormonal function can be slow and depends on several factors:
- Duration and dosage: the longer the use and the higher the dosage, the harder it is to recover natural testosterone production.
- Age and prior hormonal function: younger men with good hormonal health tend to have better results.
- Testicular atrophy: reduced testicle size indicates greater impact on testosterone production and may hinder recovery.
How long does the impact on sexual function last?
Anabolic steroids can affect sexual function in the medium and long term, depending on the duration and dosage of use.
A study on anabolic steroid-induced hypogonadism analyzed 179 men and identified complete reversal in only 4 cases.
Difference between medical and aesthetic use
Understand the differences between medical and aesthetic use in the infographic below:
How to treat erectile dysfunction caused by anabolic steroids?
The urologist should prescribe and monitor the treatment to track progress and identify possible side effects. Here’s how it works:
1. Post-cycle therapy (PCT)
PCT combines strategies to restore natural testosterone production using medications that stimulate testicular function.
Studies indicate that therapy can improve the side effects of anabolic steroids, but it does not guarantee complete recovery of hormonal production.
2. Hormone replacement therapy
Hormone replacement therapy may be considered when clinical evaluation and laboratory tests show persistent changes and the person presents symptoms such as decreased libido, erectile dysfunction, fatigue, and loss of muscle mass or strength.
3. Treatments for erectile dysfunction
Treatment may include medications that stimulate the production of LH, a hormone that activates the testes.
The doctor may also prescribe drugs like tadalafil or sildenafil to improve erection.
Additionally, follow-up may include psychological support and lifestyle changes, such as a healthy diet.
When to see a urologist?
See a urologist if you experience a drastic drop in libido, frequent difficulty achieving or maintaining an erection, absence of morning erections accompanied by fatigue and mood changes.
Seeking medical evaluation as soon as possible prevents symptom worsening and allows starting appropriate treatment.
Fill out the pre-analysis form to schedule a consultation with Dr. Paulo Egydio, a urologist with 28 years of experience in treating erectile dysfunction.
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