Diagnosis of Anabolic Steroid Misuse
Diagnosing anabolic steroid misuse involves recognising both physical and behavioural signs, often supported by blood tests and medical history. Because steroid use is often hidden, diagnosis of anabolic steroid misuse can be challenging without open conversation.
Clinical Signs and Symptoms
Doctors may suspect misuse if they notice:
- Rapid muscle growth beyond what is typical from exercise
- Severe acne, particularly on the back and shoulders
- Oily skin and hair
- Hair loss (especially in men prone to male pattern baldness)
- Breast development in men (gynecomastia)
- Shrunken testicles and reduced fertility
- Deepening of the voice, excessive body hair, and menstrual irregularities in women
Behavioural Clues
- Increased aggression or irritability (sometimes called “roid rage”)
- Risk-taking or impulsive behaviour
- Use of supplements, syringes, or unlabelled vials
- Frequent gym attendance with a sudden change in body size or shape
Blood and Hormonal Tests
- Testosterone levels may be abnormally high or suppressed.
- Liver function tests can show signs of liver strain or damage.
- Cholesterol levels (particularly HDL/LDL balance) may be disrupted.
- Blood tests may also show altered red blood cell counts.
Doctors may also ask about:
- Gym routines, supplement use, or sudden physical changes
- Mental health symptoms (mood swings, depression, paranoia)
Diagnosis of Anabolic Steroid Misuse
In South Africa, testing for anabolic steroid use is available through private clinics and anti-doping labs, especially in athletes. However, many users remain undiagnosed unless complications arise.
Let’s now explore the short- and long-term consequences of steroid misuse.
👉 [Next: Complications of Steroid Misuse]
Causes and Motivations for Anabolic Steroid Misuse


