How to Avoid Erectile Dysfunction on Steroids

According to, well, locker room talk, using steroids can make testicles shrink and hair fall out; and for bodybuilders, it can also make their gains extreme. But do steroids cause erectile dysfunction (ED) as well?

Put simply, yes — steroid use and abuse may cause erectile dysfunction due to how they impact your hormone levels and your testicles. But if you’ve been prescribed steroids for a legitimate medical condition (and no, having less muscle than your gym bros isn’t a medical condition), you may be wondering how to avoid erectile dysfunction on steroids.

Below, we’ll explain how steroids impact your sex life and how to avoid erectile dysfunction by practicing responsible steroid use.

Yes, steroid use has been linked to erectile dysfunction. Even more, the relationship between steroids and sex drive isn’t great either.

A 2022 review, which looked at several meta-analyses of anabolic steroid use, found that almost 20 percent of anabolic-androgenic steroid-using males had erectile dysfunction issues. Further, over 30 percent reported a reduced sex drive due to steroid use (though the review pointed out that the data was limited).

Some clarification to start: Steroids are a broad class of compounds. The above review examined anabolic steroids, which are structurally similar to testosterone (the main male sex hormone) and have similar physiologic effects. They are also referred to as anabolic-androgenic steroids (AAS) because of their effect on muscle-building (anabolic) and virilizing (androgenic) processes in the body.

Still, we can infer that the steroid may cause sexual dysfunction as it is more prevalent in men abusing anabolic steroids.

Other Causes of ED

There are a wide variety of typical causes of ED. For instance, performance anxiety and other mental health issues can lead to decreased libido and difficulty achieving an erection. Medications like selective serotonin reuptake inhibitors (SSRIs) can induce ED in some, as can cardiovascular diseases, obesity, diabetes, and hypertension.

Additionally, low testosterone and disorders that affect your hormone production can cause ED, which is where steroids come in because they disrupt normal testosterone by suppressing testicular function. Using anabolic steroids like testosterone supplements can result in other serious side effects, including decreased sperm count and shrunken testes, in addition to erectile dysfunction.

There are two kinds of steroids that can negatively impact your sexual health: corticosteroids and anabolic steroids.

Corticosteroids

Corticosteroids like prednisone are a type of steroid commonly used to treat inflammation and allergies. But in doing so, they can temporarily lower testosterone levels, potentially causing prednisone erectile dysfunction. There’s also a negative relationship between prednisone and sex drive. Remember, lower testosterone also means a lower libido.

Anabolic Steroids

As we mentioned above, anabolic steroids are synthetic derivatives of the hormone testosterone. They can be used legally in the treatment of medical conditions like hypogonadism, testicular failure, and others. However, they’re also used illicitly or illegally as performance-enhancement medications for athletes hoping to gain muscle mass.

Side effects of anabolic steroid use are difficult to predict, according to the current research available. But basically, anabolic steroids can mess with a sex hormone, which can impact how the blood flows to the penis, sexual function, and desire. Further, taking anabolic steroids can increase the risk of heart attacks and other serious cardiovascular issues, as well as cause testicular shrinkage and infertility.

Muscle growth and athletic performance enhancement may sound like great benefits to reap, but it can be difficult to reverse certain types of damage that are caused by anabolic steroid use.

Alternatives like pre-workout supplements may have lower risks, though you’ll still want to understand how pre-workout and erections interact.

Treating steroid-induced erectile dysfunction generally involves stopping the usage of anabolic steroids and then waiting for normal testosterone production to return.

Because it’s necessary to account for factors like dosage and other variables, it’s difficult to say for sure how long it will take for your normal levels of testosterone to return after you stop taking steroids. This uncertainty also applies to when symptoms of ED from steroid usage may disappear.

Some research showst it’s likely that normal testosterone levels will return within 13 to 24 weeks from the start of withdrawal. However, it can take longer after anabolic steroid misuse. Even then, some of the adverse effects may be irreversible — mood swings may fade, but hair loss from steroids may stick around.

Can You Take ED Medication on Steroids?

One way to avoid erectile dysfunction on steroids is to take a PDE5 inhibitor like Viagra® (sildenafil) or Cialis® (tadalafil), drugs that increase blood flow to the penis. These prescription drugs help you obtain and maintain an erection long enough for satisfying sexual intercourse.

But while we’re all for recommending erectile dysfunction medications for the treatment of vascular erectile dysfunction, you’ll have to ask your provider first about taking these medications to treat ED related to steroid use. They may recommend you stop taking steroids first and wait it out. There can be risks associated with taking Viagra on steroids (this goes for other PDE5 inhibitors as well).

But if your testosterone levels return to normal after stopping steroids and you’re still experiencing erectile dysfunction or other sexual function issues, talk to a healthcare provider. They may suggest any number of erectile dysfunction treatment options.

We just explained  how steroids might kill your erections, but are there ever exceptions? Do steroids make you last longer in bed in some instances, or increase your sex drive?

Some studies show that taking high doses of anabolic steroids can protect erectile function during use, but once these drugs are discontinued, problems ensue. Men who were taking high doses may experience decreased libido and erectile dysfunction when they stop taking the steroids. They may also have other undesirable symptoms like decreased energy, less muscle mass, and depression, some of the things you were probably trying to reduce with steroid use.

So, do steroids make you horny or help you last longer? For some men taking high doses of these drugs, they just might do one or both. But not for long.

The use of anabolic-androgenic steroids, especially when they are not medically prescribed or are taken recreationally, can be a serious problem. As such, you should never take steroids without medical advice. Remember:

• There’s a big difference between being a steroid user and being someone engaging in steroid abuse. Even if you think you’re using them carefully and know what you’re doing, the long-term effects of steroid use can be serious and permanent.

• Even if you’re using steroids as prescribed, those effects can be serious and can mess with your erectile health and well-being. Men taking anabolic steroids and corticosteroids have reported sexual problems like erectile dysfunction and low sex drive, especially if they’ve been abusing these drugs.

• If you’re wondering how to prevent ED or at least deal with it when it becomes an issue, talk to your healthcare provider. If you’re using steroids illicitly, they’ll tell you to abandon the use of anabolic steroids. If you’re using steroids as directed, they may offer slightly different instructions for the management of ED based on your unique circumstances.

If you’re not sure where to turn first, schedule an online consultation with a healthcare professional today to find solutions. They may suggest drugs like Viagra or Cialis or other similar medications like Stendra® (avanafil), Staxyn® (vardenafil), or chewable ED meds.

They may also suggest improving your ED holistically: getting better sleep, following a healthy diet, managing your stress levels, and more. If you’re not ready for medication, check out over-the-counter solutions like penis rings that support penile blood flow.