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Although medical experts disagree, on balance it seems that taking anabolic steroids combined with intensive training and a high protein diet builds body weight and increases the size of muscles. They also often make users feel more aggressive and competitive and better able to perform strenuous physical activity.

There are reports of regular users becoming physically violent and sexually abusive, in a fit of so called 'roid rage'. But whether those involved had violent tendencies in the first place is unclear.

Users often take steroids in multiple combinations and at much higher doses than would be prescribed medically. Some of the main risks include:

• Liver abnormalities and a rare form of hepatitis.
• Hypertension - steroids encourage the body to retain water and raise blood pressure.
• HIV and other infections if users inject and share injecting equipment.
• Stunted growth in young people.
• Changes in male reproductive system. Sperm output and quality is reduced and can take 6 months to return to normal. Sex drive may at first increase but then be lowered. Some men have also experienced over-development of their breast tissue.
• Changes in the female body. Women report increased sex drive, menstrual problems and enlarged clitoris. They also run the risk of developing 'male' features such as growth of facial and body hair, deepening of the voice and decreased breast size. Once these happen they are usually irreversible even when steroid use stops.
• Problems such as sleep disorders, confusion, depression and paranoia. These tend to lessen once steroid use is stopped.
  

In injectors, infections resulting from the use of shared needles or nonsterile equipment, including HIV/AIDS, hepatitis B and C, and infective endocarditis, a potentially fatal inflammation of the inner lining of the heart. Bacterial infections can develop at the injection site, causing pain and abscess.

Counterfeit steroids pose additional risks. Many are made without the controls of legitimate drugs, and so vary in purity and also safety. Like most illicit drugs, you can never be sure of what is in them. Because steroids users often inject their drugs, sometimes in large quantities over a long period of time, they bypass their body's natural defenses to impurities and infections and run considerable risks. Counterfeits also vary in strength, which again can affect the safety of short and long-term use.

Whilst not regarded as drugs of physical dependence regular steroid use can lead to psychological dependence when the user is convinced they cannot perform well without being on drugs. Some users say they feel lacking in energy and depressed after stopping steroids and continue to use them rather than face these symptoms.

Steroids are not physically addictive but a user can quickly become psychologically dependent. After stopping, withdrawal can include lethargy and depression