RUMOR: Past steroid users can have difficulty getting it up during sex.
TRUE. A guy’s sexual prowess is probably unchanged on steroids (assuming his partner isn’t turned off by his small testicles.) But when he turns off the firehose of artificial testosterone in his system, it can result in the classic symptoms of “low T”—and that includes erectile dysfunction.
“Most patients don’t have a problem with erectile dysfunction while they’re on steroids,” Weinerman says. “But when they stop, or when they try to stop, then all of a sudden they have very low testosterone, and they can have a major problem with erectile dysfunction.”
RUMOR: Steroids can make guys grow breasts.
TRUE. Every guy’s body naturally converts some percentage of testosterone into estrogen. But when a guy takes huge quantities of testosterone, his body converts some percentage of that into estrogen to get back to what it thinks is a “normal” ratio of testosterone to estrogen. That spike in estrogen can have some results that are anything but manly.
“Some guys experience a growth in breasts,” Sebanegh says.
Weinerman elaborates: “With all these uncontrolled doses, you don’t know what you’re getting, and it’s pretty common to get either enlargement of the breasts—gynocomastia—or tenderness of the tissue—mastodynia. Most of the androgenic drugs that people use result in this.”
RUMOR: Steroids can hurt a guy’s fertility
TRUE. Just as steroids can shrink a guy’s testicles and drop his natural testosterone production, they can also damage his sperm count.
“Men naturally have super-high levels of androgens in their testicles, and that’s what turns on sperm production and keeps us at a normal level,” Sebanegh says. “If a guy is using drugs, however, his body will turn down those levels, and his sperm production will drop.”
That’s why “guys who are trying to improve fertility should be proactive regarding their health and ask a lot of questions when they’re going on drugs” like testosterone supplements, Sebanegh says. “For instance, the World Health Organization has been looking at testosterone-based therapies as a male contraceptive. If they’re looking at that as the ‘men’s pill,’ so to speak, then you definitely want to be careful about taking it with regards to your fertility.”
RUMOR: A guy can prevent production of excess estrogen.
NOT NECESSARILY TRUE. Faced with an unnatural rise in estrogen, some steroid users will then take a class of drugs called aromatase inhibitors, which are designed to block the production of estrogen in women with breast cancer, Weinerman says. That’s right: It’s a breast cancer drug. And aside from the obvious danger in further messing with hormones, guys who turn to aromatase inhibitors can have side effects like joint and muscle pain, the loss of sex drive, and the loss of bone density, which can then result in osteoporosis, according to a Susan G. Komen Foundation report.