What Age Can You Take Steroids?

There is no single age at which “taking steroids” becomes safe or appropriate, because the term covers radically different drugs used for radically different reasons. Corticosteroids like prednisone are routinely prescribed to children as young as infancy for asthma, croup, and other inflammatory conditions. Anabolic-androgenic steroids (AAS), the kind people associate with muscle building, are also prescribed to adolescents in narrow medical situations but carry serious developmental risks when used without supervision. The biological reasons those risks shift with age, and the medical contexts where steroids are given to young people anyway, are worth understanding in detail.

Corticosteroids Can Be Given at Almost Any Age

When most people hear “steroids,” they think of the muscle-building variety. But the steroids prescribed most often, especially to children, are corticosteroids. These are anti-inflammatory drugs like prednisone, dexamethasone, and budesonide, and they work by dampening the immune system rather than building muscle. Doctors prescribe them to kids for conditions like croup, asthma flare-ups, meningitis, and pneumonia. A large systematic review covering 45 studies and over 6,400 children found that the average age of pediatric patients receiving short-course corticosteroids was about five and a half years, and the most common reasons for prescribing them included encephalitis, croup, and pneumonia.¹

Short courses of corticosteroids in young children appear to be relatively safe. A separate systematic review focused on children under six with acute respiratory conditions found that short-term use of high-dose inhaled or systemic corticosteroids was not linked to increased adverse events across organ systems, though uncertainties remain about what happens with repeated courses and long-term growth.² The growth concern is the one parents worry about most, and it deserves its own discussion.

How Corticosteroids Affect Growth in Children

A few days of prednisone for a bad bout of croup is unlikely to stunt your child’s growth. But long-term corticosteroid therapy, the kind given for chronic conditions like nephrotic syndrome or severe asthma over months or years, is a different story. Corticosteroids interfere with growth hormone signaling, and the net effect on a child’s height is highly variable depending on the dose, the child’s individual sensitivity, and the severity of the underlying disease.³

One long-running study of children with cystic fibrosis who received alternate-day prednisone found that boys in the prednisone group were, on average, about 4 cm shorter than the placebo group by age 18, even after some catch-up growth occurred once treatment stopped. Girls, interestingly, showed no lasting height difference two to three years after discontinuing the drug.⁴ That sex difference is a useful reminder that individual biology matters enormously, and blanket statements about steroids and growth rarely hold up under scrutiny.

The key takeaway for parents is that short-course corticosteroids for acute illness are well supported by evidence and generally considered safe at any age. Long-term corticosteroid therapy has real trade-offs, especially for growing children, and pediatricians weigh those trade-offs on a case-by-case basis. This is a fundamentally different calculus from the question of anabolic steroids.

Therapeutic Anabolic Steroids in Adolescents

Anabolic-androgenic steroids are also prescribed to young people, though far less commonly. Two of the most established medical uses involve delayed puberty and severe burn recovery.

Boys who experience constitutional delay of growth and puberty, meaning they are significantly behind their peers in physical development with no underlying disease, are sometimes offered a short course of low-dose testosterone. Most clinicians who consider this treatment wait until the boy is at least 14 years old chronologically and has a bone age of about 12 years. The goal is not to push the boy through puberty artificially but to jump-start the process that his body would eventually begin on its own, and these short courses are generally well tolerated.⁵

In pediatric burn care, the anabolic steroid oxandrolone has a strong evidence base. Severely burned children lose enormous amounts of muscle and bone mass, and oxandrolone helps counteract that catabolic spiral. Multiple meta-analyses have shown it shortens hospital stays, reduces weight loss, and improves donor-site healing times.⁶ A five-year follow-up study of severely burned children found that oxandrolone-treated patients had improved height percentile and bone mineral content compared with controls, alongside increased lean body mass when combined with exercise.⁷ Separate research showed that oxandrolone improved the way muscles utilize amino acids in burned pediatric patients months after injury.⁸

These medical uses share a common thread: they are supervised, time-limited, and dosed carefully by specialists who are monitoring the child’s development. They are nothing like the unsupervised use of AAS for physique or performance goals.

Gender-Affirming Testosterone in Adolescents

Another medical context where young people receive anabolic hormones is gender-affirming care. Transgender adolescents on masculinizing regimens receive testosterone, typically after the onset of puberty and following a period of evaluation. Clinical guidelines generally state that once puberty has commenced, youth may be eligible for puberty-blocking medications, and post-pubertally they may begin hormone therapy.⁹ The specifics vary by country, clinic, and evolving clinical guidelines. This is a medically supervised process with its own set of monitoring protocols, distinct from both short-course therapeutic use and illicit performance-enhancing use.

Why Non-Medical AAS Use Is Especially Dangerous for Adolescents

The question most people are really asking when they search “what age can you take steroids” is about non-medical AAS use for building muscle or improving athletic performance. The honest answer is that there is no age at which non-medical AAS use becomes “safe,” but the risks are categorically worse during adolescence, and here is why.

Growth Plates Close Prematurely

Androgens accelerate the maturation and closure of the growth plates (epiphyses) at the ends of long bones. This is part of normal puberty: rising testosterone levels gradually fuse those plates and determine your adult height. When a teenager introduces supraphysiological doses of androgens from the outside, the growth plates can fuse earlier than they otherwise would, permanently capping height. A position statement from the National Strength and Conditioning Association specifically warned that androgen use in pre- and peripubertal children may lead to premature epiphyseal closure and resultant adult short stature.¹⁰ This is essentially irreversible. Once the plates fuse, no amount of growth hormone or time will add inches.

The Adolescent Brain Is Still Under Construction

The human brain is not fully developed until the mid-twenties. During adolescence, it undergoes extensive remodeling of neural circuits involved in impulse control, emotional regulation, and reward processing. Introducing AAS during this window disrupts the process. Research in both humans and animal models shows that AAS exposure during adolescence alters brain remodeling, affecting structural development and neurotransmitter function.¹¹

Neuroimaging studies of long-term AAS users have found enlarged amygdala volumes, reduced connectivity between the amygdala and frontal brain regions, altered neurochemistry suggesting increased glutamate turnover, and poorer performance on cognitive tasks.¹² The amygdala is central to threat detection and aggression; its connections to the frontal cortex help keep impulsive behavior in check. Weakening those connections during a developmental period when they are actively being built could have lasting consequences.

Hormonal Recovery Takes Longer Than You Think

When you flood your body with external androgens, it shuts down its own production. This is called hypothalamic-pituitary-gonadal axis suppression. In adults, this system usually recovers within months to a couple of years after stopping. But recovery depends on age and degree of use, and it is not guaranteed. A scoping review of recovery from AAS-induced hypogonadism found that physical changes like testicular atrophy generally resolve over months to years, spermatogenesis is expected to recover over a similar timeframe, and libido typically returns to baseline over several months, though often not as strong as it was during AAS use. Gynecomastia (breast tissue growth in males), however, is unlikely to reverse on its own.¹³ For an adolescent whose hormonal system has not yet fully established its adult rhythm, the risk of prolonged or incomplete recovery is a serious concern.

How Common Is Adolescent AAS Use?

More common than most parents realize. Survey data from American high schools found that roughly 2.7% of students reported AAS use, with boys at about 4% and girls at about 1.3%. The mean age of first use was 14 years, and the youngest reported starters were as young as 8.¹⁴ Older survey data from the late 1980s found even higher rates among 12th-grade males, with one study putting steroid use at 6.6% among 3,400 students and two thirds of those users starting by age 16.¹⁵ Prevalence figures fluctuate over time with trends in sports culture, social media influence, and supplement marketing, but the consistent finding is that a non-trivial number of teenagers use these drugs before their bodies have finished developing.

The strongest predictor of adolescent AAS use, according to a machine-learning analysis of causal factors, is not athletic ambition. It is muscle dysmorphia symptoms, a form of body image disturbance where someone perceives themselves as insufficiently muscular regardless of their actual physique.¹⁶ This has implications for prevention: addressing body image and social media-driven physique standards may be more effective than anti-drug messaging alone.

Cardiovascular and Liver Damage

The heart does not care whether you are 18 or 38 when it is exposed to supraphysiological androgens, but the cumulative dose matters, and starting young means accumulating more exposure. A study comparing active AAS users, previous users, and non-users found a dose-dependent pattern: active users had the lowest heart pumping efficiency, the worst ventricular relaxation, and worsening strain measurements in both the left and right ventricles compared with people who had stopped using and those who had never used. These cardiac changes were consistent across men and women.¹⁷ The encouraging piece is that previous users showed values between active users and non-users, suggesting some recovery after cessation. But “some recovery” is not “full recovery.”

Liver damage is another well-documented risk, particularly with oral (17-alpha-alkylated) anabolic steroids. Case reports have documented significant cholestatic liver injury in young men after consuming anabolic steroids marketed as dietary supplements, with considerable illness before recovery.¹⁸ The dietary supplement angle is worth noting: some young people consume AAS without realizing it, because the products are labeled as workout supplements rather than steroids.

Fertility and Reproductive Consequences

AAS use suppresses sperm production and shrinks the testicles, and in women it causes menstrual irregularities, clitoral enlargement, and subfertility.¹⁹ Most men recover fertility after stopping, but not all. Case reports include men who developed irreversible gonadal failure and infertility after AAS use, with hormone levels still abnormal years after discontinuation.²⁰ A 20-year-old starting AAS is unlikely to be thinking about fertility, but this is one of the decisions most likely to haunt someone later.

For women, the masculinizing effects go beyond fertility. Prolonged use is linked to voice deepening, body hair growth, and cardiovascular complications, and medical societies discourage widespread use due to insufficient evidence supporting safety.²¹ Qualitative research with women who have used AAS found that many experienced irreversible masculinizing changes that negatively affected their self-esteem, social life, and sexual function both during and after use.²²

Behavioral and Psychological Effects

The stereotype of “roid rage” oversimplifies the picture, but there is real signal underneath the caricature. A meta-analysis of experimental studies found that AAS administration produced a small but statistically significant increase in self-reported aggression in healthy males, though the effect did not show up in observer-reported aggression or with longer-term dosing protocols.²³ Animal models of adolescent AAS exposure show more alarming results, including altered brain serotonin levels and escalated aggression in response to provocation.²⁴

Beyond aggression, AAS users as a group show higher rates of psychopathic traits, substance use risk-taking, sexual risk-taking, anger problems, and physical complaints compared with non-users. One study found AAS users had over twice the odds of exhibiting psychopathic traits and over three times the odds of engaging in substance-related risk-taking behaviors.²⁵ Whether the steroids cause these traits, whether people with these traits are drawn to steroids, or whether it is a feedback loop in both directions remains debated, but the association is consistent enough to be a red flag.

When Natural Testosterone Peaks

One of the strongest arguments against non-medical AAS use in young men is that their bodies are already producing androgens at or near peak capacity. Testosterone levels in males start rising around age 10, increase nearly sevenfold between ages 10 and 15, and reach adult levels of roughly 15 nmol/L between ages 16 and 17.²⁶ Total testosterone peaks on average around age 19 to 20 and remains relatively stable through age 40, with increased individual variation thereafter but no evidence of a dramatic decline in the average case.²⁷²⁸

This means a healthy 18-year-old is already near the hormonal peak of his life. Adding exogenous androgens on top of that does not “optimize” anything. It overwhelms a system that is already operating at full tilt, forces the body to shut down its own production, and introduces all the risks discussed above. For older men whose testosterone has genuinely declined, testosterone replacement therapy (TRT) may be medically appropriate, but guidelines generally restrict it to men with very low measured levels and clear clinical symptoms, with careful assessment of the risks and benefits.²⁹

SARMs and the Supplement Loophole

Selective androgen receptor modulators, known as SARMs, have gained popularity among younger users who believe they offer the muscle-building benefits of AAS without the side effects. This belief is largely unfounded. SARMs are investigational drugs that have not been approved for human use by regulatory agencies, and they are sold through legal gray areas as “research chemicals” or mislabeled supplements. One SARM studied in a clinical trial, LGD-4033, did increase lean body mass in healthy men by about 1.2 kg over 21 days, but it also suppressed endogenous testosterone production and lowered HDL cholesterol in a dose-dependent fashion.³⁰ In other words, the same hormonal suppression that makes AAS risky also shows up with SARMs, just alongside a far thinner evidence base for what else they might be doing. A teenager taking SARMs because they seem “safer” than injectable steroids is taking an under-studied drug with known hormonal effects and unknown long-term consequences.

The broader pattern here is that no class of androgenic compound, whether traditional AAS, SARMs, or prohormones, bypasses the biological reality that flooding a developing body with androgens disrupts the systems that are still being built. The specific molecule matters less than the fact that the androgen receptor does not distinguish between pharmaceutical-grade testosterone and a capsule ordered online. If it activates the receptor strongly enough to build muscle, it activates it strongly enough to suppress your natural production, accelerate bone maturation, and alter brain development during adolescence. The question is not really “what age can you take steroids” but rather which specific risks you are willing to accept and whether a doctor has determined that the medical benefit outweighs them.