So how do we fix this? The most obvious is to bring the issue into the open, creating a space for better regulation, education, and safety. This could start with recognizing that there are legitimate medical uses for steroids and hormones beyond simply enhancing athletic performance. Their therapeutic potential in treating conditions such as muscle-wasting diseases, severe burns, and hormone deficiencies is well established, but often overlooked in the moral panic over “cheating” in sports.
Of course, this is as much a marketing problem as it is a medical one. The distinction between “natural” and “enhanced,” for example, is often arbitrary and inconsistent. Over the course of a two-decade career in marketing, I’ve been paid to promote everything from stem cell injections (even getting them myself and making a documentary about it) to kratom powder. Most of us don’t bat an eyelid at these unconventional treatments, let alone caffeine consumption, dietary supplements, or even cosmetic surgery. We accept that a 70-year-old woman might take estrogen to alleviate menopausal symptoms. But as soon as someone mentions testosterone to a man of the same age, people react as if it’s fundamentally different.
“We accept that a 70-year-old woman might take estrogen to relieve menopausal symptoms. But as soon as someone mentions testosterone to a man of the same age, people react as if it is fundamentally different.”
This inconsistency extends to the way we regulate these substances. Current laws and regulations surrounding steroids are often not based on sound science. In 1989, then-Senator Joe Biden led the charge to reclassify anabolic steroids as controlled substances, against the advice of the American Medical Association. This decision, motivated more by a moral panic in sports, has done more harm than good by driving use underground, with users turning to unregulated black market sources, underground labs, and dangerous self-experimentation.
Biden’s crusade against steroids is a perfect example of how hysteria can lead to bad policy. In 1989, when he led the effort to restrict access to steroids and increase penalties for their distribution, he claimed, “The illegal use of steroids is a major drug abuse problem in this country. Steroids are dangerous drugs that threaten the physical and mental health of hundreds of thousands of young people.” There was, of course, no mention of their potential benefits when used under medical supervision. In 2004, when the Controlled Substances Act was made even stricter by removing the requirement that an anabolic steroid classified as a controlled substance actually “increase muscle growth,” Biden was the sponsor of that bill as well.
More than three decades have passed since then, and the current system treats them as if they’re nearly as deadly as opioids. This is despite the fact that you can’t overdose on testosterone like you can on fentanyl. Yet possession of anabolic steroids can lead to hefty fines and even prison sentences — punishments that far outweigh the potential harm caused by the drugs themselves.
So what’s the alternative? Imagine a world where men, instead of feeling embarrassed to discuss declining testosterone levels with their doctors, view hormone checks as a routine part of their health, just like checking their cholesterol or blood pressure. The fact that negligible numbers of men know that the normal range for male testosterone levels is between 300 and 1,000 nanograms per deciliter is criminal; such information should be as widespread as awareness of normal blood pressure. This is more than a matter of virility: low testosterone is associated with a host of health problems, including increased risk of heart disease, osteoporosis, and cognitive decline. By addressing hormone imbalances early, we could potentially prevent or mitigate these problems, improving overall health outcomes and reducing long-term health care costs.