Performance enhancement drugs
Disclaimer: This self-check questionnaire is for educational purposes only and does not provide a medical diagnosis. If you have concerns about performance enhancing drugs (PEDs), anabolic steroids, stimulants, or hormone-related substances, consult a licensed healthcare professional. In case of severe symptoms (chest pain, shortness of breath, severe mood changes), seek urgent medical care.
Performance enhancement drugs may include anabolic-androgenic steroids, testosterone boosters, growth hormone, stimulants, fat burners, nootropics, and certain prescription medications used without medical supervision. While some are legally prescribed for specific conditions, non-medical use may increase health risks.
Questionnaire
Check any statements that apply to you in the past 12 months:
- □ Have you used anabolic steroids, testosterone, growth hormone, or other hormone-based substances without a doctor’s prescription?
- □ Have you increased the dose or combined multiple performance enhancing drugs (“stacking”) to improve muscle mass, endurance, or weight loss?
- □ Have you experienced rapid muscle gain or weight changes over a short period?
- □ Do you notice mood swings, irritability, aggression, anxiety, or depressive symptoms since starting these substances?
- □ Have you had acne outbreaks, hair loss, or changes in skin texture?
- □ Have you experienced changes in libido, erectile function, or menstrual irregularities?
- □ Do you have elevated blood pressure, headaches, or episodes of heart palpitations?
- □ Have you noticed breast tissue enlargement (in men) or voice deepening (in women)?
- □ Do you feel dependent on these substances to maintain your physical appearance or performance?
- □ Have you used stimulants or “fat burners” that cause insomnia, tremors, or rapid heartbeat?
- □ Do you avoid medical check-ups or blood tests while using performance enhancing substances?
- □ Is there a family history of heart disease, liver disease, or hormonal disorders?
- □ Have you experienced yellowing of the skin/eyes, abdominal pain, or unusual fatigue?
- □ Are you under 25 years old and currently using hormonal performance enhancers?
- □ Do you participate in competitive sports where drug testing may apply?
If you are also focused on optimizing training naturally, you may find guidance in our review of 10 Best Fitness and Exercise Apps for 2025 or structured plans like The 10 Best Bodyweight Workout Programs 2026. Nutrition tracking can also support safe progress — see 11 Best Nutrition Tracking Apps of 2026.
How to interpret answers
This checklist is not a diagnostic tool. It helps you reflect on potential risks associated with performance enhancing drugs.
Low reason to seek help
- Checked 0–2 boxes
- No physical or psychological symptoms
- No hormone or stimulant use without supervision
What it means: Your current risk appears lower, but routine medical check-ups are still recommended if you use supplements or train intensively.
Medium reason to seek help
- Checked 3–6 boxes
- Mild symptoms (acne, mood changes, sleep issues)
- Occasional unsupervised use of PEDs or stimulants
What it means: Consider scheduling a non-urgent appointment with a primary care physician or sports medicine specialist for evaluation and lab testing.
High reason to seek help
- Checked 7+ boxes
- Cardiovascular, liver-related, or severe psychological symptoms
- Dependency patterns or escalating doses
What it means: You may benefit from prompt medical assessment. Seek professional evaluation, especially if experiencing chest pain, jaundice, severe depression, or suicidal thoughts.
Next steps: what to do
- Track your symptoms. Record physical and mental changes (sleep, mood, blood pressure, libido, skin changes).
- List all substances. Include prescription drugs, over-the-counter supplements, pre-workouts, SARMs, steroids, and energy boosters.
- Schedule lab tests. Ask about liver enzymes, lipid profile, hormone levels (testosterone, LH/FSH), kidney function, and blood pressure monitoring.
- Consult the right specialist. Start with a primary care physician. You may be referred to an endocrinologist, cardiologist, psychiatrist, or sports medicine doctor.
- Ask specific questions. What are the short- and long-term risks? How can I discontinue safely? Are there withdrawal concerns?
- Discuss mental health. Mood swings, aggression, and depression can be related to anabolic steroid use and should be addressed.
- Explore safer alternatives. Structured training programs, recovery strategies, adequate protein intake, and evidence-based supplements under supervision may support performance without high-risk substances.
Situation → urgency → action
| Situation | Urgency | Action |
|---|---|---|
| Mild acne or sleep disturbance after stimulant use | Low–Moderate | Stop use; monitor; consult doctor if persistent |
| Elevated blood pressure or persistent headaches | Moderate | Schedule medical evaluation and lab tests |
| Severe mood swings, aggression, or depression | Moderate–High | Consult healthcare provider; consider mental health support |
| Chest pain, shortness of breath, fainting | High (Emergency) | Seek immediate emergency care |
| Yellowing of skin/eyes, abdominal pain | High | Urgent liver function assessment |
FAQ
1. Are anabolic steroids always dangerous?
They have legitimate medical uses but carry significant risks when used without supervision or at supraphysiologic doses.
2. Can performance enhancing drugs affect the heart?
Yes. Some are linked to high blood pressure, altered cholesterol levels, cardiomyopathy, and increased cardiovascular risk.
3. Do PEDs affect mental health?
Research shows associations with mood swings, irritability, aggression, depression, and in some cases dependency.
4. Are “natural” testosterone boosters safe?
“Natural” does not guarantee safety. Supplements may contain undisclosed ingredients or interact with medications.
5. Can stopping steroids suddenly cause problems?
Yes. Abrupt cessation may lead to hormonal imbalance, fatigue, depression, and low endogenous testosterone. Medical supervision is recommended.
6. Are SARMs safer than steroids?
Selective androgen receptor modulators (SARMs) are not FDA-approved for bodybuilding use and may pose similar hormonal and liver risks.
7. How can I improve performance safely?
Focus on progressive training, adequate sleep, evidence-based nutrition, hydration, and recovery strategies. Certified coaches and healthcare professionals can guide safe optimization.
8. Should athletes worry about drug testing?
Yes. Many sports organizations prohibit PEDs. Even contaminated supplements may result in positive tests.
Sources
- National Institute on Drug Abuse (NIDA) — Anabolic Steroids and Other Appearance and Performance Enhancing Drugs Research Reports.
- U.S. Food and Drug Administration (FDA) — Information on Steroid and Bodybuilding Products.
- Endocrine Society Clinical Practice Guidelines on Testosterone Therapy.
- World Anti-Doping Agency (WADA) — Prohibited List and Health Consequences of Doping.
- American Heart Association — Cardiovascular Risks of Anabolic Steroid Use.