Is Testosterone a Steroid? Here’s the Truth

Key Takeaways:

• Testosterone is a naturally occurring steroid hormone. Despite its status as a steroid, prescription testosterone replacement therapy (TRT) isn’t the same as taking anabolic steroids.

• TRT is an FDA-approved treatment designed to restore healthy testosterone levels in men with low T. The treatment course is intended to happen under medical supervision.

• Anabolic steroids are often taken illegally and in much higher doses to boost muscle mass and performance — a practice that comes with serious health risks.
  

Technically, yes, testosterone is a steroid hormone.  But it’s not the kind of steroid that gets high-performing athletes stripped of their titles. Rather, testosterone replacement therapy (TRT) is a treatment approved by the Food and Drug Administration (FDA) for low testosterone. It’s a therapy that should happen under medical supervision.

TRT differs from anabolic steroid use, which typically includes dangerously high doses of testosterone. 

Keep reading to understand the differences between testosterone therapy and anabolic steroid use, which one’s safer, and how to find out if you might be a good candidate for testosterone therapy.

Testosterone is the primary male sex hormone and a naturally occurring steroid. Natural steroid hormones like testosterone and estrogen are fat-soluble compounds that help the body regulate cellular, tissue, and organ functions. They’re made from cholesterol in the testes, adrenal gland, and ovaries in women and are released when required.

What Does Testosterone Do?

Testosterone drives various aspects of your growth and development throughout life. It plays a central role in shaping both your physical characteristics and reproductive functions, including:

• Penis and testicle development

• Muscle growth

• Body hair growth (including pubic and facial hair)

• Voice deepening

• Bone density

• Sex drive

• Sperm production

• Red blood cell count

When you have low testosterone levels (hypogonadism) and symptoms like low libido, erectile dysfunction (ED), or loss of muscle mass, your provider may prescribe testosterone replacement therapy (TRT). The treatment aims to bring your levels of the hormone back into the normal range. The aim is to  resolve the aforementioned symptoms by replacing your body’s testosterone with a synthetic version of the hormone.

TRT is an FDA-approved hormone therapy available in several forms, including injections, patches, gels, and pills. It’s prescribed only after blood tests and a medical evaluation confirm testosterone deficiency, and treatment should always be carefully monitored by a healthcare professional.

Anabolic-androgenic steroids, often referred to simply as “steroids,” are performance-enhancing drugs. Weightlifters, bodybuilders, and athletes may use anabolic steroids  to build muscle and boost their physical abilities.

Like TRT, anabolic steroids use a synthetic version of testosterone, but in much higher doses. These high levels can disrupt the body’s natural hormone balance and cause serious side effects. Unlike prescription TRT, anabolic steroids are often obtained illegally, smuggled from overseas, or sold without medical supervision.

TRT is not the same as anabolic steroids. You can think of it this way: While TRT aims to restore what’s missing, anabolic steroids push the body far past its natural limits. Here’s how they stack up in various categories:

Uses

The goal of TRT and other prescription treatments for low testosterone is to restore normal levels of the hormone and reduce symptoms associated with low T. The reference range for healthy testosterone levels varies by lab, but is generally considered to be between 300 and 1,000 nanograms per deciliter (ng/dL) for adult men.

The typical goal of anabolic steroids is to bring testosterone levels into the supraphysiologic range, meaning a higher level than what’s naturally found. This allows for a rapid and robust increase in muscle size and strength and supercharges athletic performance. Some research defines 2,000 ng/dL of testosterone as supraphysiologic. 

Doses

TRT dosing depends on the formulation, your baseline testosterone level, and treatment goals. For example, intramuscular injections of testosterone enanthate or cypionate typically start at 100–200 milligrams (mg) weekly, while a daily transdermal gel usually contains around 50 mg. Pellet implants, on the other hand, deliver about 75 mg per pellet and are inserted every 3 to 6 months, usually two to six at a time.

Studies show that anabolic steroids are often taken in significantly higher doses that exceed natural levels of testosterone by 10–100 times. In one study, a 600-mg weekly dose of testosterone — three to six times a typical TRT amount — produced significant increases in lean muscle mass, even without exercise. These levels are considered supraphysiologic and come with a much higher risk of side effects.

Side Effects

Studies show that many effects of testosterone — including muscle growth, changes in fat mass, and shifts in blood chemistry — are dose-dependent. As testosterone doses and circulating levels rise, the potential for unwanted side effects tends to increase as well.

Side effects of TRT include:

• Swelling, bruising, or pain, if you use pellets or injections

• Skin irritation, if you use patches or gels

• Acne

• Allergic reactions

• Low sperm count and infertility

• Hair loss

Other, less common, but more serious risks include polycythemia (a high red blood cell count, which can lead to blood clots), worsening of sleep apnea, and an increased risk of developing or worsening prostate enlargement (but no increased risk of prostate cancer).

Anabolic steroid users have a higher risk of experiencing the side effects of TRT use, as well as:

• Testicular shrinkage 

• Prolonged testosterone suppression after stopping use

• Heart problems, including high blood pressure, arrhythmia, and heart attack 

• Increased LDL (“bad”) cholesterol and reduced HDL (“good”) cholesterol

• Liver damage

• Aggressive behavior, mood swings, and irritability (“’roid rage”)

• Addiction or dependence

One of the best ways to identify testosterone levels is by taking a hormone test. With Hims, you can check your testosterone from home using an at-home testing kit: Simply collect your sample, send it to the lab, and get your results reviewed by a healthcare provider. They’ll walk you through your results, discuss symptoms you’re experiencing, and talk about whether treatment is right for you.

Some common symptoms of low testosterone include:

• Low sex drive (libido)

• ED

• Mood changes

• Brain fog

• Decreased muscle mass

• Increased body fat

Alternatives to TRT

Anabolic steroids are never a good idea. And, for many men, especially those who are planning to have kids, TRT isn’t the right fit, either.

But there are other testosterone treatments you may want to explore instead. Enclomiphene is an oral medication that is not FDA-approved, but is sometimes prescribed off-label to help restore natural testosterone production by signaling the body to make more testosterone and sperm. It supports healthy hormone levels without messing with your sperm count, making it a fertility-friendly option for men with low T.

Hims offers access to two enclomiphene treatments: one that contains just enclomiphene and another that combines enclomiphene with tadalafil (generic Cialis^®). The 2-in-1 treatment is ideal for customers who need to boost testosterone production and improve erectile function (one of the most common side effects of low testosterone).

Testosterone is technically a steroid hormone — but that doesn’t make TRT the same as taking anabolic steroids.

TRT is a medically approved treatment designed to restore healthy hormone levels and improve symptoms of low testosterone, while anabolic steroids are high-dose, often illegal substances used to boost muscle and performance. The differences come down to purpose, dosage, and supervision.

If you suspect your testosterone levels are low, getting tested while under the care of a licensed provider is the safest first step. From there, you and your doctor can discuss the best treatment option for your needs.

Is testosterone considered a steroid?

Yes, testosterone is a naturally occurring steroid hormone that your body produces. It’s part of a group called anabolic steroids, but natural testosterone (and doctor-prescribed TRT) functions very differently from synthetic anabolic steroids used for performance enhancement.

Is TRT the same as steroids?

TRT isn’t the same as steroids. TRT is prescribed to restore testosterone to healthy levels in men who have clinically low testosterone. Anabolic steroids are typically used in much higher doses to build muscle and enhance performance — often taken without medical supervision, which can be dangerous.

What are the side effects of anabolic steroids?

Anabolic steroids can cause serious health issues, including testicular shrinkage, infertility, heart problems, liver damage, acne, mood swings, aggression, and dependence. They can also throw off your body’s natural hormone balance long after you stop use.

Should I take TRT to build muscle or enhance athletic performance?

TRT isn’t designed for bodybuilding or athletic enhancement. It’s an FDA-approved treatment for men with medically confirmed low testosterone. Using testosterone when your levels are normal can raise your risk of dangerous side effects.