Steroids: Male and Female Reproductive Systems and Fertility

Read more to learn more about anabolic steroids and their potential impact on the reproductive system.

Steroids, specifically anabolic-androgenic steroids or “AAS”, are relatively popular in the US—it’s estimated that over 1 million adults in the United States have used steroids. Individuals often take these steroids for aesthetic purposes or to enhance athletic performance, as steroids can increase muscle mass and have anabolic effects.

Most people who use steroids are male non-athlete weightlifters in their 20s or 30s, though they are used by both men and women. This use may start in high school, since 5% of high school students report having used steroids without a prescription.

Steroids have an impact on both men and women. Some of the desired impacts include increased muscle mass. However, there are a host of negative effects associated with steroid use.  Some of the negative effects occur in the reproductive system and may have an impact on fertility.

Potential negative effects on the male reproductive system

In men, the negative effects of anabolic steroids include low sex hormones, breast enlargement (gynecomastia), impotence (erectile dysfunction), low sperm count (oligospermia), no sperm in the ejaculate (azoospermia), prostate enlargement (prostatic hypertrophy), and shrinkage of the testicles (testicular atrophy).

Potential negative effects on the female reproductive system

For women, the negative effects of steroids include breast tissue shrinkage (breast atrophy), clitoral enlargement (clitoral hypertrophy), menstrual irregularities, and uterine tissue shrinkage (uterine atrophy).

It’s important to note that prolonged and high doses of steroids like testosterone and its derivatives don’t only affect the reproductive system—they may lead to serious consequences in all body tissues and organs.

Can steroids Impact Fertility?

Yes, anabolic steroids can have a negative impact on fertility.

Do anabolic steroids impact male fertility?

One review of 33 studies found that anabolic steroids significantly decreased reproductive hormone levels and had “prolonged effects on the reproductive system of athletes and recreational users and potentially on fertility.”

The Cleveland Clinic explains how anabolic steroids like testosterone impact male fertility. They report, “when you take testosterone, the hormonal signals that tell your testicles to make testosterone and to make sperm are blocked. Your natural testosterone production then stops. This causes the level of testosterone in the testicles to drop sharply -- too low to support strong sperm production. The most likely outcomes are a very low sperm concentration or a complete absence of sperm from the semen.”

The good news is that this may be reversed in some cases, though it’s not clear how long it takes for sperm production to return back to normal.