Medical note: This is general education, not personal medical advice. ED can be related to cardiovascular disease, diabetes, medication effects, mental health, neurologic disease and other conditions. Persistent or new ED deserves appropriate medical evaluation.
- Anabolic steroids and SARMs signal the brain to shut down the body's own testosterone production. That suppression is the main reason erections and libido change.
- Problems often show up after a cycle ends, when outside hormones are gone and natural production hasn't recovered.
- The FDA lists sexual dysfunction and testicular shrinkage among serious reactions to steroid-containing bodybuilding products; SARMs are not FDA-approved for human use.
- Don't self-treat with more hormones. Get bloodwork and see a clinician, and be honest about what you used.
Men who use anabolic steroids or SARMs are often surprised by what happens to their sex lives. During a cycle, libido may be high. Then, weeks into the off-cycle or after stopping, erections soften, desire disappears and mood drops. Some men find it never quite comes back to where it was.
This article explains the hormone mechanics behind that pattern, what the FDA and medical sources say about these products, and what to ask for if you're dealing with it. It's written to be useful, not to lecture. If you've used these compounds, the goal is to get your hormones and erections checked properly.
How your body normally controls testosterone
Testosterone production runs on a feedback loop. The brain (hypothalamus and pituitary) releases signaling hormones, LH and FSH, that tell the testicles to make testosterone and sperm. When the brain senses enough androgen in the blood, it turns those signals down.
Steroids and SARMs hijack that loop. The brain senses the outside androgen and dials down LH and FSH. The testicles get little signal to work, so natural testosterone production drops and the testicles can shrink. MedlinePlus lists shrinking testicles, low sperm count and infertility, breast growth and baldness among the effects of anabolic steroids in men.
During a cycle
While the outside hormone is in your system, total androgen levels may be high, but erections don't always follow. Several things can interfere:
- Estrogen changes. Some steroids are converted to estrogen. Hormone imbalance can affect libido and erections, and breast growth is a visible sign.
- Blood pressure and cholesterol. Steroid use can worsen both, which affects blood vessels, including those in the penis.
- Mood. The FDA lists mood changes, irritability, aggression and depression among reported reactions.
- Compounds that don't convert normally. Some compounds and SARMs may not support every function natural testosterone does, despite suppressing it.
After a cycle: the crash
The most common time for problems is after stopping. Outside hormones clear out, but the brain-to-testicle signal can take time to restart. In that gap, testosterone can be low, sometimes very low. Typical symptoms include low libido, softer or less reliable erections, fewer morning erections, fatigue and low mood.
How long recovery takes varies widely and depends on the compounds, doses and duration of use, and on the individual. Some men recover in months; for others, recovery is slower or incomplete. The FDA notes that stopping steroid-containing products abruptly can cause dangerous withdrawal problems, and advises consulting a healthcare professional first.
What about SARMs?
SARMs (selective androgen receptor modulators) are often marketed as a "safer" alternative to steroids. The facts don't support that:
- The U.S. Anti-Doping Agency notes SARMs are not approved by the FDA for human use and remain investigational.
- USADA reports that studies have found serious side effects including testosterone suppression, and case reports link SARMs to drug-induced liver injury and other harms, with increased heart attack and stroke risk reported.
- The FDA has issued public warnings about SARMs. Products sold online as "research chemicals" or supplements may not contain what the label says.
Because SARMs suppress testosterone too, the same post-cycle crash can happen.
The bigger picture from the FDA
The FDA warns that some bodybuilding products illegally contain steroids or steroid-like substances. It reports serious reactions including liver injury, sexual dysfunction, testicular shrinkage, acne, hair loss and mood changes, plus life-threatening reactions such as kidney damage, heart attack, stroke and blood clots. Combining multiple products ("stacking") may increase the risk. Many of these products are sold as dietary supplements even though they don't qualify.
Bloodwork to ask for
If erections or libido have changed during or after steroid or SARM use, the most useful step is testing, ideally with a clinician who knows what you used. Common tests include:
| Test | Why it matters |
|---|---|
| Morning total testosterone | The AUA recommends morning testosterone for men with ED. Low levels suggest suppression hasn't recovered |
| LH and FSH | Show whether the brain is signaling the testicles again |
| Estradiol | Checks for estrogen imbalance |
| Lipid panel, blood pressure | Steroids can worsen cardiovascular risk factors that affect erections |
| Liver tests | Liver injury is reported with some products |
| Hematocrit / blood count | Androgens can thicken the blood |
A semen analysis matters if fertility is a concern. Our sexual health bloodwork panel explains the standard tests in more detail.
Treatment: what to avoid and what to ask about
Going back on, or self-prescribing "post-cycle therapy" drugs bought online, keeps the cycle going and adds unregulated products to the mix. Recovery options exist, but they need a clinician to choose and monitor them.
- Tell the clinician the truth. They can't interpret your labs without knowing what you used, and they've heard it before.
- Ask about recovery of natural production versus medically supervised testosterone treatment. Which makes sense depends on your labs, age and fertility plans. A urologist or endocrinologist experienced with androgen use is ideal.
- Treat the erections themselves if needed. A PDE5 inhibitor may help while hormones recover, if your heart health and medication list allow it.
- Look after mood. Low mood after a cycle is common. If you have thoughts of harming yourself, seek help immediately (in the U.S., call or text 988).
Our articles on testosterone's real role in ED and ED in fit men and gym-goers cover related causes.
Prescribed testosterone is different, but not risk-free
Medically supervised testosterone therapy for diagnosed low testosterone uses replacement doses, monitored with regular bloodwork. It's a different situation from cycling steroids at performance doses. But it still suppresses the brain's signal to the testicles, which can reduce sperm production, so men who want children should raise fertility before starting. Our article on testosterone and ED covers when replacement is and isn't appropriate.
Sources
- FDA: Caution: Bodybuilding Products Can Be Risky
- MedlinePlus: Anabolic Steroids
- USADA: Selective Androgen Receptor Modulators (SARMs)
- American Urological Association: Erectile Dysfunction Guideline (2018)