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When chasing a buff physique or extra strength, it’s not uncommon for men to consider using anabolic-androgenic steroids (AAS). Bypassing traditionally slower methods, steroids can be a shortcut to growing the bigger, stronger, more defined muscles that’ll achieve both these goals. But like any drug, the list of pros is evenly matched with a list of cons. And, playing at the forefront of the list of side effects associated with steroid use is testicular atrophy. Or, in more casual terms, balls shrinking to the size of peanuts.

Don’t laugh. A study based on 500 anabolic steroid users found that two thirds suffered from testicular atrophy. And, you know what they say; “The bigger the biceps, the smaller the balls”. Now let’s find out the truth behind this expression.

First, what are steroids?

Anabolic steroids are a synthetic form of hormones created to mimic androgens, the male sex hormones, in the body. With over 100 variations of anabolic steroids, testosterone is the most powerful with its ability to grow muscle, repair muscle, and develop masculine traits during puberty. That’s exactly why steroids are classed as performance and image enhancing drugs (PIEDs). They’re often used by men with the intention of improving physical appearance and enhancing sporting performance. Steroids can remain in the body any time from a few days to 12-months.

How do steroids work?

With an almost identical chemical composition to testosterone, steroids have the capability to activate testosterone receptors. Following the stimulation of the receptors, a domino effect of metabolic reactions takes place as the steroids signal the body to increase muscle tissue production aka bulking up. There are three non-medical methods of steroid use:

  • Stacking, where several different types of steroids are used simultaneously
  • Cycling, where periods of steroid use are followed by an equal period of abstinence
  • Pyramiding, where a gradual increase of steroids reaches a peak before tapering down

So, how do steroids cause testicular atrophy?

You’re probably wondering how a substance that’s intended to build bigger muscles causes balls to shrink. The simplest explanation is that when steroids are introduced to the human body, testosterone levels are artificially increased, throwing the body’s hormone cycle out of whack. Consider it similar to a negative feedback loop. Once the body realises it has produced a sufficient level of a specific hormone, it’ll adapt by stopping its natural production. Hence, the tiny balls.

Can testicular atrophy be reversed?

Fortunately, when steroid use stops, the body will restart its natural production of testosterone. Hormonal balance will be restored (aka homeostasis), reversing the effects of testicular atrophy. Your balls will return to their former size again. Phew.