side effects :Libido/Sexual Dysfunction

Anabolic/androgenic steroids may alter sexual desire and functioning. The nature of this alteration, however, can vary depending on individual circumstances.Testosterone is the primary male sex steroid, and is responsible for increasing sexual desire and supporting many male reproductive-system functions.264 Since all anabolic/androgenic steroids influence the same primary receptor as testosterone, abuse of these drugs (characterized by high levels of stimulation) is usually linked to strong increases in sexual desire, as well as copulation and orgasm frequency.265 The effect of steroid abuse on erectile function is more variable. In many cases, a significant increase in the frequency and duration of erections is noted. In other instances, however, periodic issues with having or maintaining erections are reported, even when steroid levels are high and libido is significantly increased. Sexual issues are also common after steroid discontinuance, when endogenous androgen levels are low.

Studies with dihydrotestosterone and aromatase inhibition demonstrate that estrogen is not necessary for the support of male libido and sexual functioning.266 Many non-aromatizable steroids are, therefore, capable of sustaining male sexual functioning given the right level of androgenic stimulation. Difficulties remain possible in many instances, however, especially when primarily anabolic compounds such as methenolone, nandrolone, oxandrolone, and stanozolol are used alone. These drugs many not provide sufficient androgenicity to compensate for the suppression of endogenous testosterone.267 Given the diverse nature in which sex steroids influence human psychology, the existence of other influencing factors during steroid abuse cannot be excluded, including estrogenic activity.268 The addition or substitution of testosterone during a cycle is usually regarded as the most reliable way to correct issues with male sexual interest and functioning, as it supplements the full spectrum of sex steroid activity.

Priallism:

In very rare instances, anabolic/androgenic steroids have been linked to priapism.269 270 271 This is a condition characterized by the development of an erection that will not return to its flaccid state within four hours. Priapism is a potentially very serious condition, which can require medical or surgical intervention. If left untreated, priapism can lead to permanent penile damage, erectile dysfunction, or even gangrene, which may necessitate removal of the penis. When priapism is linked to steroid use, testosterone is usually responsible. Furthermore, this condition appears to be more frequent in younger patients undergoing treatment for hypogonadism. This may be due in part to a rapid increase in androgenicity, in a male reproductive system that has not yet been exposed to high levels of stimulation. Priapism is very unlikely to develop in adult steroid abusers.