This is the scenario: a guy, say age 21, becomes serious about gaining muscle. He’s 5′ 10″, 7″ wrists, 9″ ankles, average genetics for muscle size-and-proportioned. He’s played sports, but never done more than an occasional resistance workout. Now, he begins a good training-eating-and-resting program. With his genetics, he has the potential for naturally gaining 45 pounds of lean mass if he stays consistent with progressive training/proper eating for a continuous 3 to 4 years.
But, about three months after beginning his training, he starts taking steroids. He does three steroid cycles in the following 18 months, and includes proper post-cycle therapy. That entire time, he’s continuing to consistently train and eat properly. Before the end of two years, he’s gained 45 pounds of lean mass (which with steroids, by the way, is not necessarily typical but neither improbable). At that point, he permanently quits using steroids, but he does continue properly training and eating for another two years. At the end of four years, he carries the same 45 pounds of lean mass.
All bets are off the table when high-dose testosterone and its many metabolites are used illegally, such as with anabolic steroid abuse. Strokes, embolisms, and cardiovascular disease are all more likely, as is sudden death, and liver and kidney disease. 44 In women, acne, irreversible deepening of the voice, baldness, increased facial hair, enlarged sex organs, breast reduction, depression, and infertility have all been reported. In adult men that abuse anabolic steroids, acne, baldness, permanent infertility, gynecomastia, loss of libido, erectile dysfunction, testicle shrinkage, and profuse sweating are all reported side effects. Increased testicular cancer hasn't been reported, though. 45,46
One last point: Because steroids have all these side effects, a lot of abusers will then take other drugs to offset the effect—steroid abuse causes you to grow man-boobs, so people take another drug to mitigate those side effects. Guys who take steroids often also take augmenting drugs to decrease estrogen production or to improve athletic performance even further, like human growth hormone, insulin-like growth factor 1, insulin, erythropoietin, stimulants, diuretics, levothyroxine, and/or gamma-hydroxybutyrate, according to the study in FP Essentials . That means on top of all these side effects of steroids, most abusers are also looking at a whole separate list of effects from their peripheral drug habits.