How Anabolic Steroids and Corticosteroids Differ

Corticosteroids refer to a class of drugs used to treat inflammatory arthritis and other inflammatory conditions. Because they are commonly referred to as “steroids,” people often believe them to be the same thing as anabolic steroids, which are used to boost strength and physical performance. However, while they share some molecular properties, the two are quite different.

Overview

The word “steroid” is a broad-ranging term used to describe any compound with a specific molecular structure—in this case, composed of four fused rings of 17 carbon atoms. The function of steroids is to either maintain the integrity of a cell’s membrane or activate a receptor on a cell’s surface to regulate how it behaves.

There are many different types of steroids found in nature, broadly classified as:

• Sex steroids, including estrogen, progesterone, and testosterone
• Corticosteroids, including glucocorticoids (such as cortisol), which regulate the immune function, and mineralocorticoids (such as aldosterone), which regulate electrolyte balance
• Secosteroids (such as vitamin D), which help regulate numerous biological functions
• Neurosteroids (such as DHEA), which aid in the synthesis of male and female hormones
• Sterols, also known as steroid alcohols, a subgroup of steroids. The most common type of animal sterol is cholesterol, which helps maintain cell membrane integrity.

Anabolic Steroids

Anabolic steroids are synthetic variations of natural male sex hormones (androgens). They are used to promote the growth of skeletal muscle (the anabolic effect) and the development of male sexual characteristics (the androgenic effect).

Anabolic steroids are available by prescription and are used to treat conditions that result in abnormally low testosterone levels (hypogonadism). The causes may include undescended testicles, testicle injury, pituitary disorders, obesity, and advanced HIV infection.

Because of their anabolic effect, the drugs are often abused by athletes or persons wanting to improve their physical appearance. The majority of people who misuse steroids are male weight lifters in their 20s or 30s. Steroid misuse is much less common in women.

The long-term abuse of anabolic steroids can lead to serious health consequences, including:

• Severe acne
• Development of breasts in men (gynecomastia)
• Facial and body hair growth in women (hirsutism)
• Stunted growth in youth
• High blood pressure
• Dramatic mood changes (“roid rages”)
• Manic behavior
• Shrinkage of testicles
• Male pattern baldness in both sexes
• Irregular menstruation
• Infertility
• Increased risk of blood clots
• Yellowing of the eyes or skin (jaundice)
• Liver tumors or cancer
• Kidney problems or kidney failure

Corticosteroids

Corticosteroids refer to either naturally occurring compounds produced by the adrenal cortex or synthetic versions that mirror their molecular structure. Corticosteroids act on the immune system by blocking the production of substances that trigger allergic and inflammatory responses.

These drugs can be delivered orally, nasally, topically, or by injection to treat such health conditions as allergies, Crohn’s disease, ulcerative colitis, autoimmune disorders (such as rheumatoid arthritis or lupus), and blood disorders (such as lymphoma and leukemia).

Corticosteroid drugs commonly prescribed in the United States include:

• Betamethasone
• Budesonide
• Cortisone
• Dexamethasone
• Hydrocortisone
• Methylprednisolone
• Prednisolone
• Prednisone
• Triamcinolone

These drugs are available under various brand names and formulations.

Benefits and Risks

Corticosteroids are powerful drugs that can quickly reduce inflammation while enhancing recovery. With that being said, the overuse of the drugs can cause serious and sometimes contradictory side effects, including:

• Weight gain
• Acne
• Muscle weakness
• Thinning of the skin
• Tendon rupture
• Hypertension
• Worsening of diabetes
• Osteoporosis
• Cataracts
• Increased susceptibility to infection
• Stomach irritation
• Depression

To maximize benefits, corticosteroids are prescribed in the lowest possible dose over the shortest period of time to achieve the best possible outcome.

A Word From Verywell

If your treatment plan involves the use of corticosteroid drugs, always weigh the benefits and risks with your healthcare provider. Depending on your health status, other options may deliver the same relief with far less risk.

In the end, it is often best to reserve corticosteroids for later use, when the need for the drugs may be far greater.