Anabolic steroids are hormones synthesized from the cholesterol molecule, with different formulations and dosages. They are increasingly common among the population, especially males, both in the world of sport and fitness competitions for the high performance they provide, aswell as for the cult of the body and aesthetics that is increasingly prevalent nowadays. On the other side of the coin, anabolic steroids have a strong impact on the hypothalamic-pituitary-gonadal axis, causing a state of induced hypogonadism, causing a significant reduction in LH and FSH, which on one hand causes a decrease in testicular volume and a decrease in spermatogenesis, often culminating in infertility due to oligospermia or azospermia. On the other hand, there is also a decrease in testosterone production, which consequently leads to a decrease in the frequency, amplitude and rigidity of erections and a lower libido. [1, 2]

These types of substances are often sold in gyms from person to person and over the internet without the need for a medical prescription.[3] In addition, mainly due to the lack of regulation, companies selling gym and nutritional supplements often add pharmacologically active substances to make the product more effective, without the knowledge of the consumer.[4]

Anabolic steroids purchase, especially online, has been greatly boosted by social media and the permanent need it creates to achieve a perfect body model and to reach the peak of virility, often taking advantage of vulnerability and concerns, especially in relation to male sexual function, creating a utopia of strength, energy, libido and erections that, in the initial phase, may even correspond to the truth, but with the duration and number of steroid cycles begins to fade. [5]

It is therefore imperative to demystify and deconstruct the concepts of masculinity and the perfect body that are perpetuated on social media and the internet, and to thoroughly regulate websites selling anabolic steroids and other associated supplements. On the other hand, it is also crucial for doctors to always question and try to understand patients complaints about sexual function, libido and fertility, as these are often neglected topics, either due to lack of time or even shame, providing them with safe, effective pharmacological and non-pharmacological solutions based on the best scientific evidence. At last, it´s importante to explain to them that however much they may feel rapid improvements with this type of substances, the long-term adverse effects and the impact it will have on future quality of life will never outweigh the benefit of the moment.