Anabolic steroid use is more common in gyms than most people assume. A large meta-analysis covering 271 studies found a global lifetime prevalence of 3.3% across all populations, but that number climbs to 6.4% among men. In gym-specific settings, the rates are higher still, and the true numbers are likely underreported because many users don’t disclose their use even in anonymous surveys.
Overall Prevalence Among Gym-Goers
The 3.3% global figure represents the general population, not just people who lift weights. When researchers narrow the focus to people who actually train with weights, the numbers shift considerably. A survey of gym users in Sweden found a lifetime prevalence of 3.9%, while a British survey across 21 gyms reported 8% of respondents had used steroids at some point. These self-reported figures almost certainly undercount actual use.
One study from Iran illustrated this gap dramatically. When bodybuilders were asked directly about steroid use, 24.5% admitted to it. But when researchers used an indirect questioning method designed to reduce the stigma of answering honestly, the estimated prevalence jumped to 56.8%. The difference suggests that in environments where steroid use is common but stigmatized, real usage rates may be roughly double what people will admit to on a straightforward questionnaire.
A post-COVID survey of over 3,600 resistance training practitioners found that 53% of men and 42% of women reported using anabolic steroids. That study sampled people who actively train with weights, which skews the numbers higher than a random gym membership survey would. Still, it reinforces that among dedicated lifters, steroid use is far from rare.
Who Uses Steroids
Men use steroids at significantly higher rates than women. The global meta-analysis found men were four times more likely to report lifetime use (6.4% versus 1.6% for women). The typical user profile skews young: 46% of resistance training practitioners in one large survey were between 18 and 29. Less education and being single were also associated with higher rates of use, though these are correlations rather than causes.
Competitive bodybuilders and physique athletes use steroids at much higher rates than casual gym members, but the majority of steroid users are not competitors. Most are recreational lifters who want to look more muscular, get stronger, or both. This distinction matters because it means steroid use isn’t confined to a small elite corner of the gym. It’s spread across the broader population of people lifting weights regularly.
Why People Start Using
The motivations split roughly into two categories: appearance and performance. People who start using steroids primarily for how they look tend to have more body image issues than those motivated by strength or athletic performance. Research links appearance-driven use to a condition called muscle dysmorphia, where someone perceives themselves as too small or insufficiently muscular regardless of their actual size.
Once someone begins using steroids, the reasons for continuing can shift. The body’s natural testosterone production gets suppressed during a cycle, and it doesn’t always bounce back fully afterward. This creates a biological pull to keep using, because stopping means dealing with low testosterone symptoms like fatigue, reduced sex drive, and loss of the muscle gains that motivated use in the first place. Users also report psychological reinforcement from increased strength and libido while on cycle, which makes the decision to stop harder.
The Social Media Factor
A 2024 study of over 1,500 boys and men from Canada and the United States found strong associations between viewing muscularity-focused social media content and symptoms of muscle dysmorphia. This held true for three specific types of content: images of muscular bodies, posts about muscle-building supplements, and posts about muscle-building drugs like steroids. The association was independent of total time spent on social media, meaning it was the type of content, not just screen time, that mattered.
Social media has created an environment where heavily muscled physiques are presented as naturally achievable, often by influencers who are using steroids but not disclosing it. For younger men especially, this distorts expectations about what’s possible without drugs and can push the decision to start using earlier than it might have happened in previous generations.
Typical Usage Patterns
Most recreational steroid users follow “cycles,” periods of use followed by time off. A study of athletes documented an average cycle length of about 6 weeks, with a total dose averaging around 2,928 milligrams across the cycle. About 85% of users in that study ran two cycles per year. In practice, patterns vary widely. Some users cycle on and off seasonally, while others transition to year-round use at lower doses, sometimes called “blasting and cruising.”
SARMs (selective androgen receptor modulators), marketed as a milder alternative to traditional steroids, have gained popularity in recent years. Estimated prevalence among athletes is 1% to 3%, lower than traditional steroids but growing. SARMs are sold online in a legal gray area in many countries, often labeled as “research chemicals,” which makes them more accessible to people who might hesitate to buy injectable steroids from underground sources.
Health Risks Users Face
Liver toxicity is one of the most frequently documented side effects, particularly with oral steroids that pass through the liver. Cardiovascular damage is another major concern: one review found that 3% of steroid users experienced a heart attack linked to accelerated artery disease. Hormonal disruption is nearly universal during use and can persist afterward, with suppressed natural testosterone production leading to symptoms that sometimes require medical treatment to resolve.
A less discussed risk is contamination. Over two-thirds of steroids produced in underground labs reportedly contain harmful or unidentified substances. Users themselves are aware of this problem. One participant in a testing trial noted that only about 60% of underground lab products are considered pure on average. Since most steroid use happens outside medical supervision, users are frequently injecting or ingesting substances without reliable knowledge of what’s actually in them.
Most Users Don’t Involve a Doctor
Only about 37% of steroid users seek any form of support from a physician. That means roughly two-thirds are managing their use entirely on their own, relying on self-research, online forums, and advice from friends or gym contacts. The reasons for avoiding medical care include fear of legal consequences, concern about being judged, and in some cases, the belief that doctors lack specific knowledge about steroid protocols.
This gap between use and medical oversight is one of the reasons steroid-related health problems can escalate quietly. Blood work that would flag early liver or cardiovascular issues often doesn’t get done, and symptoms of hormonal disruption after a cycle may go untreated because the user doesn’t want to explain the cause to a healthcare provider.