From a Nobel Prize-winning discovery in the 1930s to modern medicine, sport and regulation — how these compounds were developed, what they were built to treat, and what we have learned about their benefits and risks.
The story of anabolic steroids begins not in a gym, but in a laboratory. For centuries, physicians had suspected that something produced by the testes influenced strength, body composition and vitality. In 1849 the German physiologist Arnold Berthold demonstrated this directly: he removed the testes from roosters, observed that they lost their combs and aggression, and then transplanted the tissue back — restoring their male characteristics. He had shown that a chemical messenger, not a nerve signal, was responsible.
It took almost another century to isolate that messenger. In 1935, three separate research groups working in Germany, Switzerland and the Netherlands independently isolated and then synthesised testosterone. The names most associated with this work are Ernst Laqueur, who first isolated the hormone from bull testes, and Adolf Butenandt and Leopold Ruzicka, who worked out how to synthesise it from cholesterol. Butenandt and Ruzicka were awarded the 1939 Nobel Prize in Chemistry for this achievement.
Almost immediately, researchers noticed something important. Testosterone did two things at once: it produced androgenic effects (male characteristics such as body hair, deepening voice and reproductive tissue development) and anabolic effects (increased protein synthesis, muscle mass and bone density). For medicine, the anabolic side was the prize. The next fifty years of chemistry were largely an attempt to separate the two — to keep the tissue-building effects while reducing the masculinising ones.
That separation has never been fully achieved. Every anabolic steroid in existence today still carries androgenic activity to some degree. This is why the correct scientific term is anabolic-androgenic steroid (AAS) — the two properties travel together.
The development of anabolic steroids spans nearly two hundred years, moving from basic endocrinology through pharmaceutical innovation, into sport, and finally into regulation.
Arnold Berthold demonstrates that the testes secrete a substance that travels through the blood and controls male characteristics — the foundation of endocrinology.
The 72-year-old physiologist Charles-Edouard Brown-Sequard injects himself with an extract of animal testicles and reports renewed vigour. The effect was almost certainly placebo, but it triggered widespread scientific interest in hormone therapy.
Laqueur isolates testosterone; Butenandt and Ruzicka independently synthesise it from cholesterol. The hormone can now be produced in quantity for the first time.
Butenandt and Ruzicka share the Nobel Prize for their work on sex hormones, formally recognising the field.
Testosterone is prescribed for hypogonadism, delayed puberty and impotence. After the Second World War, reports circulate of steroids being used to help severely malnourished concentration camp survivors regain body weight — one of the first uses of the anabolic effect for recovery.
Pharmaceutical companies begin modifying the testosterone molecule to reduce androgenic side effects. Nandrolone (1950s) and later oxymetholone and oxandrolone emerge from this effort, developed specifically for anemia, osteoporosis and muscle wasting.
Dr John Ziegler, a physician working with the US weightlifting team, collaborates with Ciba Pharmaceuticals to develop methandrostenolone (Dianabol). It was designed to be a more anabolic, less androgenic oral alternative to testosterone. It became the single most influential compound in the history of the sport.
Oxymetholone (Anadrol) is approved for the treatment of anemia, particularly aplastic anemia, where it stimulates red blood cell production. It remains a legitimate medicine in several countries to this day.
Oxandrolone (Anavar) is introduced by Searle. It is approved for weight regain after surgery, trauma, chronic infection and severe burns — and remains one of the very few AAS with an FDA-approved indication in the United States today.
Eastern Bloc nations, most notoriously East Germany under State Plan 14.25, systematically administer anabolic steroids to thousands of athletes, many of them minors and often without their knowledge. The long-term health consequences for these athletes became one of the darkest chapters in sporting history.
Reliable testing methods finally exist. The International Olympic Committee formally adds anabolic steroids to its banned list, with testing beginning at the 1976 Montreal Games.
Canadian sprinter Ben Johnson wins the Olympic 100m in world-record time, then tests positive for stanozolol. He is stripped of his gold medal. The event transforms anabolic steroids from a niche sporting issue into a global news story.
The United States classifies anabolic steroids as Schedule III controlled substances, placing them under criminal law rather than purely medical regulation. Many other countries follow with their own restrictions.
The World Anti-Doping Agency is established, creating a unified international framework for testing and sanctions across all sports.
The BALCO scandal reveals purpose-built "designer" steroids such as tetrahydrogestrinone (THG), engineered specifically to evade existing drug tests. Regulators respond by broadening the definitions in law.
The Anabolic Steroid Control Act is amended to cover prohormones and precursor compounds that had been sold openly as supplements.
Selective androgen receptor modulators, originally developed by pharmaceutical companies for muscle wasting and osteoporosis, move from clinical trials into the grey market. Regulators begin issuing warnings about products sold as research chemicals.
GLP-1 agonists such as semaglutide and tirzepatide transform obesity treatment. Growth hormone secretagogues and repair peptides become widely discussed. The line between performance enhancement and legitimate metabolic medicine grows increasingly complex.
It is easy to forget that almost every anabolic steroid in circulation today was originally created to solve a medical problem. These were not developed for bodybuilding — they were developed for patients who were wasting away, and in many cases they are still prescribed for exactly that reason.
Oxymetholone (Anadrol) was approved in 1960 to stimulate red blood cell production in patients with aplastic anemia and other bone marrow failures. Nandrolone was similarly used for the anemia of chronic kidney disease. Before synthetic erythropoietin existed, these drugs saved lives.
Oxandrolone (Anavar) remains one of the most studied compounds in severe burn recovery. Clinical trials show it improves lean body mass retention, speeds wound healing and shortens hospital stays in patients with major burns, including children.
Anabolic steroids increase bone mineral density by stimulating osteoblast activity. Nandrolone decanoate was used for post-menopausal osteoporosis for decades before bisphosphonates and modern alternatives became standard.
During the HIV/AIDS crisis, anabolic steroids and growth hormone were among the few effective treatments for the catastrophic muscle loss associated with the disease. Oxandrolone and nandrolone are still used for cachexia in cancer and chronic illness.
Testosterone replacement therapy remains the primary and entirely legitimate use of testosterone worldwide, treating men whose bodies do not produce adequate levels due to age, injury, or medical condition.
Stanozolol (Winstrol) and danazol are approved treatments for hereditary angioedema, a rare genetic disorder causing dangerous swelling. They work by increasing production of a specific blood protein that patients lack.
This medical heritage matters because it explains the compounds themselves. When you read that Anavar is "mild" or that Anadrol is "aggressive", you are reading the residue of decisions made by pharmacologists trying to help specific groups of patients. Anavar had to be gentle enough for children with burns. Anadrol had to be powerful enough to restart a failing bone marrow.
Anabolic steroids exert their effects through several mechanisms, working together.
The primary route. The steroid molecule enters the cell, binds to the androgen receptor, and the resulting complex travels to the cell nucleus where it binds to DNA and switches on genes that increase protein synthesis. More protein synthesis means more muscle tissue built from the same amino acids.
Anabolic steroids also block the glucocorticoid receptor, interfering with cortisol — the body's main muscle-breakdown hormone. This means less tissue is lost between training sessions, which over time contributes as much to the visible result as the building effect itself.
Muscle tissue is roughly 16% nitrogen. Anabolic steroids improve the body's ability to hold onto nitrogen, keeping it in a positive balance where building exceeds breakdown. Many also stimulate erythropoiesis — red blood cell production — which improves oxygen delivery and endurance. This is exactly why they were used for anemia.
Perhaps the most significant long-term effect. Anabolic steroids increase the number of myonuclei in muscle fibres by activating satellite cells. Research suggests these additional myonuclei may persist for years after use stops — a phenomenon sometimes described as "muscle memory" — which is part of why the effects of a past cycle are not entirely reversible.
Nearly every anabolic steroid derives from one of three parent structures. Understanding which family a compound belongs to tells you a great deal about how it will behave.
| Family | Examples | Characteristics |
|---|---|---|
| Testosterone derivatives | Testosterone (all esters), Methandienone, Boldenone | Aromatise to estrogen; cause water retention; strong mass gain; generally well tolerated as a base compound. |
| Dihydrotestosterone (DHT) derivatives | Stanozolol, Drostanolone, Oxandrolone, Oxymetholone, Mesterolone | Do not aromatise; produce a dry, hard look; higher risk of hair loss and prostate effects; many are liver-toxic in oral form. |
| 19-Nortestosterone derivatives | Nandrolone, Trenbolone | Strongly suppressive; can raise prolactin; nandrolone is joint-friendly, trenbolone is exceptionally potent with a difficult side effect profile. |
Oral steroids are chemically modified — usually by 17-alpha-alkylation — so they survive the first pass through the liver. This is what makes them orally active, and it is also precisely what makes them hepatotoxic. Injectable steroids bypass this process entirely, which is why they are generally considered easier on the liver, despite the injection itself carrying its own risks.
The ester attached to an injectable determines how quickly it releases. Propionate releases over days and requires frequent injections. Enanthate and cypionate release over a week or more. Decanoate can persist for weeks. The ester changes nothing about what the hormone does — only the timing of its arrival.
The transition from medicine to athletics happened quickly, and it happened through weightlifting.
At the 1954 World Weightlifting Championships in Vienna, the American team physician Dr John Ziegler reportedly learned from a Soviet colleague that their athletes were being given testosterone. Returning to the United States, Ziegler worked with Ciba Pharmaceuticals to develop a compound with a better ratio of anabolic to androgenic effects. The result, released in 1958, was Dianabol.
Ziegler's intent was modest — low doses, medical supervision, a level playing field. What actually happened was that athletes discovered more produced more, and dosages escalated far beyond anything he had envisioned. Ziegler later publicly regretted his role, saying he wished he had never been involved.
By the 1960s, use had spread through weightlifting, throwing events, American football and the emerging sport of bodybuilding. The Golden Age of bodybuilding in the 1970s — the era of Arnold Schwarzenegger and Muscle Beach — occurred during a period when steroids were legal, openly discussed and available by prescription. Schwarzenegger himself has acknowledged their use in that era, when they were not prohibited.
The state-sponsored programmes were another matter entirely. East Germany's State Plan 14.25, running from 1974, administered the steroid Oral-Turinabol to an estimated 10,000 athletes, many of them teenage girls who were told they were taking vitamins. The consequences — infertility, liver tumours, heart disease, irreversible virilisation, and profound psychological harm — emerged only after the fall of the Berlin Wall, when the documents came to light. It remains the most comprehensive and disturbing dataset we have on what long-term, high-dose, unsupervised use does to a human body.
An honest account requires both sides. These compounds work — that is precisely why they are used, and precisely why they are dangerous when misused.
Selective androgen receptor modulators represent the most recent attempt at the old goal — anabolic effects without androgenic ones. They are non-steroidal molecules designed to bind selectively to androgen receptors in muscle and bone while largely ignoring receptors in the prostate, skin and scalp.
They were developed by legitimate pharmaceutical companies for real conditions: Ostarine (enobosarm) was trialled for cancer cachexia; Ligandrol (LGD-4033) for age-related muscle loss; Andarine for benign prostatic hyperplasia and osteoporosis. Several reached advanced clinical trials.
None have been approved for human use. Trials were discontinued for various reasons, including efficacy that did not meet endpoints and, in some cases, safety signals. Despite this, they are widely sold as "research chemicals". The evidence that they are meaningfully safer than traditional steroids is thin: they still suppress natural testosterone, still affect cholesterol, and reports of liver injury exist. Independent analyses have also repeatedly found that products sold as SARMs frequently contain something other than what the label claims.
Peptides are short chains of amino acids that act as signalling molecules. Some have genuine, approved medical uses:
Recombinant human growth hormone is a genuine pharmaceutical, approved for GH deficiency, Turner syndrome and several other conditions. In performance contexts it is used for fat loss and recovery, though the research on its ability to increase strength in healthy adults is far less impressive than its reputation suggests. It carries real risks: insulin resistance, joint pain, carpal tunnel syndrome, and tissue overgrowth with prolonged high doses.
Legal status varies enormously, and this is one of the most misunderstood areas. What is a criminal offence in one country is available over a pharmacy counter in another.
| Region | Status | Notes |
|---|---|---|
| United States | Schedule III controlled substance | Possession without a prescription is a criminal offence. Distribution carries significant penalties. |
| United Kingdom | Class C controlled drug | Possession for personal use is legal; supply and production are offences. Importation for personal use is permitted in limited circumstances. |
| Canada | Schedule IV | Possession is not criminalised; trafficking is. |
| Australia | Schedule 4 prescription-only | Strictly enforced; importation without a permit carries serious penalties. |
| Most of the EU | Prescription medicine | Varies by member state; generally not criminalised for personal possession but supply is regulated. |
| Pakistan and much of South Asia | Prescription medicine | Regulated as pharmaceuticals under DRAP; enforcement in practice varies considerably. |
| Thailand, Mexico, parts of Eastern Europe | Widely available | Often obtainable directly from pharmacies, which is why these countries feature heavily in international supply chains. |
In competitive sport, the position is uniform: WADA prohibits anabolic agents at all times, in and out of competition, across every signatory sport. A therapeutic use exemption is possible but requires substantial medical documentation.
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