What Happens when Bodybuilders Stop Taking Steroids?

Anabolic steroids are synthetic derivatives of testosterone, which has anabolic and androgenic activity. The use of AASs is prevalent in competitive athletics, professional sports, bodybuilding, weightlifting, amateur sports, etc. They are also popular for their purported ability to increase lean body mass (LBM) and muscular strength with minimal effects on fat mass.

Bodybuilders take large amounts of various AASs during training to achieve better results. However, there are cases where they have discontinued the usage or have been forced to discontinue the usage due to some reasons. Therefore, it is important to understand what happens when these individuals stop taking the drugs as this may provide valuable insight into how AASs work in normal physiological situations.

A study published in the New England Journal of Medicine has assessed the effects of AAS cessation on LBM, strength and hormones levels. The study was conducted with 14 experienced male bodybuilders (30 +/- 7 years) before, during and after 12 weeks of withdrawal from various AASs (stanozolol, methandienone, testosterone enanthate).

The major findings are summarized as follows:

1) Steroid discontinuation is associated with an increase in fat mass (+ 2 kg after stopping stanozolol and + 1 kg after stopping methandienone);

2) There were decreases in lean body mass (- 3 to -5%) after stopping most steroids; however, there was no significant decline for subjects who stopped testosterone enanthate.

3) Strength loss was observed only in the group that stopped stanozolol (- 40 to - 50%);

4) There were no significant changes in levels of total, free or bioavailable testosterone or luteinizing hormone during and after discontinuation (12 weeks); however, cortisol and estradiol did increase significantly;

5) During steroid usage, there was a positive correlation between LBM and strength. However, these correlations vanished 12 weeks after drug withdrawal;

6) The authors conclude that the effects on body composition and strength vary according to steroid used. In general terms, AASs such as stanozolol cause more harmful effects than steroids like methandienone or testosterone enanthate.

In summary, discontinuation of AASs in experienced male bodybuilders is associated with a decrease in LBM and strength. In addition, some subjects gain fat mass during the withdrawal period. The pattern of changes varies according to the type of steroid that was used during training. However, there are several points that should be addressed:

1) Many authors believe that it is necessary to use at least three previous AASs cycles before studying their effects when they are discontinued;

2) Since the duration of each cycle was 12 weeks in this study, we cannot say anything about what happens when these athletes stop taking steroids after completing longer cycles (e.g., 1620 weeks);

3) The subjects began the steroid treatment after a severe dietary restriction period of at least 4 weeks. It is difficult to extrapolate these results to individuals who use steroids during an ongoing resistance training protocol;

4) While this study suggests that there are some changes in various hormones levels (e.g., cortisol, estradiol, testosterone), it would be important to assess binding proteins (SHBG and CBG) as well as free/unbound fractions of these hormones;

5) This study had some limitations including small sample size, variation in AASs used between subjects and lack of control group; nevertheless, it provides useful information for researchers on this topic.

It has been suggested that losing muscle mass is due to large drops in protein synthesis. However, there is no evidence to support this claim and therefore the problem should be thought in a different way (e.g., increased protein degradation).

In our view, the biggest limitation of the study mentioned above is that it does not provide information about how long these changes last after stopping AASs. In addition, we think that many steroid-users use supraphysiological doses and various compounds simultaneously (e.g., injectable and oral AASs). Therefore, we must bear in mind while interpreting these data; future studies might address some of these limitations.

In conclusion, it appears that discontinuation of steroid use in bodybuilders who use these drugs during a training period is associated with increases in fat mass and decreases in lean body mass. However, it is not clear what happens after a longer steroid withdrawal period.