# Anabolic steroids, testosterone misuse and ED > They can. Misused anabolic steroids, including testosterone taken without a prescription, can switch off the body's own testosterone production. NIDA and the FDA list sexual problems and shrinking testicles among the risks, and studies of former users found ED and low desire more often after stopping, sometimes for years. A clinician can help. _Last updated: 2026-10-17_ --- Status: FDA-approved for another condition, not for ED (prescription testosterone, for men with low testosterone and an associated medical condition). Source: FDA Testosterone Information and AndroGel 1.62% prescribing information, DailyMed, checked 2026-10-17. **The short version:** anabolic steroids are man-made versions of testosterone and related hormones. Used without a prescription, usually at levels well above what a doctor would prescribe, they signal the body to stop making its own testosterone. Reviews tie that shutdown, called anabolic steroid-induced hypogonadism, to erection problems. Research on men who stopped shows ED and low desire turning up more often than in men who never used them, sometimes years later, though most of these studies are small and cannot prove cause on their own. This page covers what the labels, the FDA, NIDA and the research actually say. ## How can anabolic steroids affect erections? Reviews point to hormones. The body keeps testosterone in balance with a feedback loop: when levels are high, the brain stops sending the signals that tell the testicles to make more. A review in the European Journal of Endocrinology explains that because of this negative feedback, steroid misuse in men causes "reversible suppression of spermatogenesis, testicular atrophy, infertility, and erectile dysfunction," together called anabolic steroid-induced hypogonadism ([Nieschlag and Vorona, 2015](https://pubmed.ncbi.nlm.nih.gov/25805894/)). Prescription testosterone labels describe the same feedback, noting that large doses can suppress sperm production through "feedback inhibition of the hypothalamic-pituitary-testicular axis" ([AndroGel 1.62% prescribing information, DailyMed](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f4e8d29b-8707-4d47-e053-2a95a90aecee)). NIDA lists the hormonal effects in men as decreased sperm production, enlarged breasts, shrinking of the testicles, male-pattern baldness and testicular cancer, and lists sexual dysfunction among the problems people with a steroid use disorder can face ([NIDA, Anabolic Steroids and Other APEDs](https://nida.nih.gov/research-topics/anabolic-steroids)). The FDA's consumer warning on bodybuilding products lists "sexual dysfunction" and "testicular shrinkage" among the reactions linked to anabolic steroids and steroid-like substances ([FDA, Caution: Bodybuilding Products Can Be Risky](https://www.fda.gov/consumers/consumer-updates/caution-bodybuilding-products-can-be-risky)). Timing matters. In an online survey of 231 steroid users analysed by a Mayo Clinic urology team, high testosterone doses appeared to protect erections during use, while new ED and lower desire were reported more often after men stopped, especially among those who had used for longer and more often ([Armstrong et al., Translational Andrology and Urology, 2018](https://pubmed.ncbi.nlm.nih.gov/30050806/)). The authors wrote that the long-term effect on sexual function "remains poorly defined." ## What happens to erections after stopping? For some men, the body's own testosterone is slow to come back, and erection and desire problems can last well beyond the last use. Two studies of former users found this pattern: | Study | Who was studied | What it found | | -------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | | Rasmussen et al., PLoS One, 2016 | 37 current users, 33 former users (about 2.5 years after stopping on average) and 30 non-users, all men aged 18 to 50 in recreational strength training | 27.3% of former users reported ED and 40.1% reported decreased libido, higher than in the other two groups. 27.2% of former users had total testosterone below the lower reference limit, compared with none of the non-users. | | Kanayama et al., Addiction, 2015 | 24 former long-term users and 36 weightlifters who never used | Untreated former users had smaller testicles, lower testosterone and lower sexual desire scores; 5 had testosterone below 200 ng/dL despite 3 to 26 months without steroids. 29% had a major depressive episode during withdrawal. 2 men (8%) had not regained normal desire or erections despite testosterone treatment. | Sources: [Rasmussen et al., 2016](https://pubmed.ncbi.nlm.nih.gov/27532478/); [Kanayama et al., 2015](https://pubmed.ncbi.nlm.nih.gov/25598171/). The Kanayama authors concluded that withdrawal hypogonadism "appears to be common, frequently prolonged and associated with substantial morbidity." The prescription testosterone label describes withdrawal too. It says people taking higher than therapeutic doses "may experience withdrawal symptoms lasting for weeks or months," including depressed mood, major depression, fatigue, craving, restlessness, irritability, poor appetite, insomnia, decreased libido and low testosterone from the brain's signals staying switched off ([AndroGel 1.62% label](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f4e8d29b-8707-4d47-e053-2a95a90aecee), section 9.3). NIDA lists a similar set of withdrawal symptoms and warns that depression is the most dangerous of them, "because it sometimes leads to suicide attempts" ([NIDA](https://nida.nih.gov/research-topics/anabolic-steroids)). ## Does prescribed testosterone carry the same risk? The serious problems on this page are described mainly in misuse, not in treatment at prescribed levels. The FDA says testosterone products are approved for men who lack or have low testosterone together with an associated medical condition, such as testicles that do not make testosterone because of genetic problems or chemotherapy ([FDA, Testosterone Information](https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/testosterone-information)). The AndroGel label states that drug dependence "in individuals using approved doses of testosterone for approved indications has not been documented," and describes abuse as typically "at doses higher than recommended for the approved indication and in combination with other anabolic androgenic steroids." Prescribed testosterone is not free of effects on the same hormone system. The label notes that reduced fertility "is observed in some men taking testosterone replacement therapy" and that with either prescribed use or abuse, "the impact on fertility may be irreversible." If you take prescribed testosterone and notice changes, raise it with your prescriber rather than stopping on your own. NIDDK, part of the NIH, advises, "Do not stop taking any medicines on your own. Talk with your health care professional first" ([NIDDK, Treatment for ED](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment)). Our guide to [ED and low testosterone](/ed-and-low-testosterone) covers how low testosterone is diagnosed and what treatment can and cannot do for erections. ## What does the FDA warn about? The FDA has issued several warnings that touch on steroid misuse, from prescription labels to products sold as supplements. | FDA action | What it says | | --------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | | Class-wide testosterone label change (October 2016) | All prescription testosterone labels gained a warning on abuse and dependence. Abuse is linked to serious risks to the heart, brain, liver, mental health and hormone system, including heart attack, stroke, depression, aggression, liver toxicity and male infertility, plus withdrawal symptoms such as decreased libido. | | Testosterone prescribing information (section 5.6) | If abuse is suspected, prescribers should check testosterone levels, but levels "may be in the normal or subnormal range in men abusing synthetic testosterone derivatives." Testosterone is a Schedule III controlled substance. | | Consumer update on bodybuilding products | Some products labeled as dietary supplements illegally contain steroids or steroid-like substances. Listed reactions include sexual dysfunction, testicular shrinkage, depression, liver injury, heart attack, stroke and blood clots. | | Warning on SARMs in bodybuilding products | SARMs mimic testosterone and steroids, are not FDA-approved and are unapproved drugs, not supplements. Listed risks include sexual dysfunction, infertility, testicular shrinkage, liver injury and a higher risk of heart attack or stroke. | Sources: FDA statement on the 2016 label change as summarized by [Hong Kong's Drug Office](https://www.drugoffice.gov.hk/eps/news/showNews/The+United+States%3A+Testosterone+and+other+anabolic+androgenic+steroids+%28AAS%29%3A+FDA+statement+-+Risks+associated+with+abuse+and+dependence/consumer/2016-10-26/en/26942.html); [AndroGel 1.62% label](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f4e8d29b-8707-4d47-e053-2a95a90aecee), sections 5.6 and 9; [FDA, Caution: Bodybuilding Products Can Be Risky](https://www.fda.gov/consumers/consumer-updates/caution-bodybuilding-products-can-be-risky); [FDA, Certain bodybuilding products put consumers at risk](https://www.fda.gov/drugs/fraudulent-products/certain-bodybuilding-products-put-consumers-risk-heart-attack-stroke-serious-liver-damage-and-more). The supplement point matters because a product does not have to say "steroid" on the front to contain one. The FDA notes that SARM products are sometimes sold "for research purposes" or "not for human consumption" while being sold to consumers for human use, and that its own lab found an undeclared anabolic steroid in one product it tested. If you have used a bodybuilding product and are unsure what was in it, count it when you talk to a clinician. ## Is it the steroids, or something else? Often it is hard to say for one person, and the research has real limits. Nobody can ethically run a trial giving men the large amounts and combinations that misuse involves, so controlled trials of these side effects are lacking and researchers rely on observational studies ([Nieschlag and Vorona, 2015](https://pubmed.ncbi.nlm.nih.gov/25805894/); [Pope et al., Endocrine Reviews, 2014](https://pubmed.ncbi.nlm.nih.gov/24423981/)). A 2026 review of six systematic reviews found a consistent link between prolonged steroid use, lower hormone levels and ED in young men involved in weightlifting, powerlifting or bodybuilding, but rated the confidence in four of those reviews as critically low ([García Vidal et al., Actas Urológicas Españolas, 2026](https://pubmed.ncbi.nlm.nih.gov/41690470/)). Other things travel with steroid use. NIDA reports that steroid users say they use an average of about 11 appearance and performance enhancing products a year, are more likely than non-users to take other hormones and ED medicines, and links steroid use to a form of body image disorder called muscle dysmorphia ([NIDA](https://nida.nih.gov/research-topics/anabolic-steroids)). Depression during or after withdrawal also turned up in the studies above, and our guide to [ED and depression](/ed-and-depression) covers how mood and erections connect. A clinician can sort through these overlapping causes in a way no article can. ## Can erections recover after stopping? For many men the hormone changes ease with time, but not for everyone, and no one can promise a timeline. NIDA says most side effects of steroid misuse are reversible if use stops, and lists low testosterone from reduced testicle function and testicular shrinkage among the changes that can be reversed, while others, such as breast development, may be permanent ([NIDA](https://nida.nih.gov/research-topics/anabolic-steroids)). A systematic review published in 2023 found that sperm quality recovers in most cases within 4 months of stopping, but that effects on sperm production "can take up to 3 years to disappear" ([Esposito et al., Panminerva Medica, 2023](https://pubmed.ncbi.nlm.nih.gov/35146992/)). The former-user studies are the caution. In the Danish study, lower testosterone and more ED were still seen an average of 2.5 years after stopping ([Rasmussen et al., 2016](https://pubmed.ncbi.nlm.nih.gov/27532478/)), and in the US study a small number of men had not regained normal function even with treatment ([Kanayama et al., 2015](https://pubmed.ncbi.nlm.nih.gov/25598171/)). Lower desire showed up alongside these hormone shifts in both studies, which our guides to [low libido in men](/low-libido-in-men) and [hormones and ED](/hormones-and-ed) explain. ## What should you tell a clinician? Tell them plainly what you used, for how long and when you stopped. The FDA recommends that anyone taking bodybuilding products that claim to contain steroids or steroid-like substances consult a health care professional right away, both because of the health risks and "because of dangerous withdrawal problems that can arise from quickly ceasing the use of such products" ([FDA consumer update](https://www.fda.gov/consumers/consumer-updates/caution-bodybuilding-products-can-be-risky)). Being specific helps, because the label notes that a testosterone blood test may not reveal misuse: levels "may be in the normal or subnormal range in men abusing synthetic testosterone derivatives." Useful things to bring up: - **What and when.** Every product you took, including anything sold as a supplement or SARM, and when you last used it. - **Erections and desire.** When changes started, and whether they began during use or after stopping. - **Mood.** Low mood, irritability or loss of interest since stopping. These are listed withdrawal symptoms and deserve attention on their own. - **Fertility.** Whether you hope to have children, since steroids and testosterone can both affect sperm. - **Other medicines.** Anything else you take, because many medicines can affect erections, as our guide to [medicines that affect erections](/medications-that-affect-erections) explains. Book a visit if erections or desire have changed during or after steroid, testosterone or SARM use, or if you plan to stop and want to do it safely. The FDA advises contacting a health care professional about chest pain, shortness of breath, yellowing of the skin or eyes, or brown urine after using these products. Seek help right away for severe low mood or any thoughts of self-harm. ## Sources Every clinical statement on this page traces to one of these sources: - National Institute on Drug Abuse (NIDA), Anabolic Steroids and Other Appearance and Performance Enhancing Drugs (APEDs). Hormonal effects in men, sexual dysfunction, reversible and permanent effects, withdrawal symptoms, dependence, average of about 11 APEDs a year: [nida.nih.gov, anabolic steroids](https://nida.nih.gov/research-topics/anabolic-steroids) - AndroGel (testosterone gel) 1.62% prescribing information, DailyMed, published November 2025. Sections 5.6 (abuse and monitoring), 5.8 (feedback suppression of sperm production), 8 (fertility), 9 (Schedule III, abuse-related reactions, withdrawal lasting weeks or months, no documented dependence at approved doses): [dailymed.nlm.nih.gov, AndroGel 1.62% label](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f4e8d29b-8707-4d47-e053-2a95a90aecee) - U.S. Food and Drug Administration, Testosterone Information. Approved uses: [fda.gov, testosterone information](https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/testosterone-information) - Department of Health, Hong Kong Drug Office, summary of the FDA statement on risks associated with abuse and dependence of testosterone and other anabolic androgenic steroids, October 26, 2016: [drugoffice.gov.hk, FDA statement summary](https://www.drugoffice.gov.hk/eps/news/showNews/The+United+States%3A+Testosterone+and+other+anabolic+androgenic+steroids+%28AAS%29%3A+FDA+statement+-+Risks+associated+with+abuse+and+dependence/consumer/2016-10-26/en/26942.html) - U.S. Food and Drug Administration, Caution: Bodybuilding Products Can Be Risky (consumer update): [fda.gov, bodybuilding products consumer update](https://www.fda.gov/consumers/consumer-updates/caution-bodybuilding-products-can-be-risky) - U.S. Food and Drug Administration, Certain bodybuilding products put consumers at risk for heart attack, stroke, serious liver damage and more (SARMs): [fda.gov, SARMs warning](https://www.fda.gov/drugs/fraudulent-products/certain-bodybuilding-products-put-consumers-risk-heart-attack-stroke-serious-liver-damage-and-more) - Rasmussen JJ, et al. Former abusers of anabolic androgenic steroids exhibit decreased testosterone levels and hypogonadal symptoms years after cessation: a case-control study. PLoS One, 2016: [pubmed.ncbi.nlm.nih.gov/27532478](https://pubmed.ncbi.nlm.nih.gov/27532478/) - Kanayama G, et al. Prolonged hypogonadism in males following withdrawal from anabolic-androgenic steroids: an under-recognized problem. Addiction, 2015: [pubmed.ncbi.nlm.nih.gov/25598171](https://pubmed.ncbi.nlm.nih.gov/25598171/) - Armstrong JM, et al. Impact of anabolic androgenic steroids on sexual function. Translational Andrology and Urology, 2018: [pubmed.ncbi.nlm.nih.gov/30050806](https://pubmed.ncbi.nlm.nih.gov/30050806/) - Nieschlag E, Vorona E. Medical consequences of doping with anabolic androgenic steroids: effects on reproductive functions. European Journal of Endocrinology, 2015: [pubmed.ncbi.nlm.nih.gov/25805894](https://pubmed.ncbi.nlm.nih.gov/25805894/) - Esposito M, et al. Impact of anabolic androgenic steroids on male sexual and reproductive function: a systematic review. Panminerva Medica, 2023: [pubmed.ncbi.nlm.nih.gov/35146992](https://pubmed.ncbi.nlm.nih.gov/35146992/) - García Vidal M, et al. Erectile dysfunction and related variables due to anabolic steroid use. A review of reviews. Actas Urológicas Españolas, 2026: [pubmed.ncbi.nlm.nih.gov/41690470](https://pubmed.ncbi.nlm.nih.gov/41690470/) - Pope HG Jr, et al. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocrine Reviews, 2014: [pubmed.ncbi.nlm.nih.gov/24423981](https://pubmed.ncbi.nlm.nih.gov/24423981/) - NIDDK (National Institute of Diabetes and Digestive and Kidney Diseases, NIH), Treatment for Erectile Dysfunction. "Do not stop taking any medicines on your own": [niddk.nih.gov, ED treatment](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment) --- _Affiliate disclosure: some links on the web version of this site go to Bodybuilding Peptides (trybbpeptides.com), an affiliate destination, and we may earn a commission if you buy there. Our coverage is independent of that relationship. Details: https://theedreport.com/affiliate-disclosure/_