By Mike Kocsis | 7 minutes read | Last updated: May 8, 2025 Categories: Testosterone
Medically Reviewed by Dr. George Touliatos
Fitness enthusiasts, low testosterone men and athletes are often curious about the differences between anabolic steroids vs testosterone replacement therapy (TRT).
While both methods of increasing testosterone levels are seemingly similar yet they are totally different from each other on so many levels.
The key difference between anabolic steroids and TRT lies in their dosage, purpose of use, patient base and potential side effects. The latter is FDA-approved, while the former is typically illegally used for non-medical reasons.
This article highlights the main differences between anabolic steroids and TRT. It explains their uses, purposes, dosages, side effects and more so you can decide which one to choose.
What are anabolic steroids & what are they used for?
Anabolic steroids are artificial versions of the testosterone hormone that mimic the natural hormone’s function in the body and produce the same masculinising effects.
Anabolic steroids are also called performance and image-enhancing drugs (PIEDs) because of the nature of their use.
Millions of bodybuilders and athletes misuse them for their cosmetic benefits and physical performance enhancement.
Taking non-therapeutic steroid doses gives them the bulky, muscled look fast and boosts their sports performance for the time being.
No doubt, synthetic testosterone drugs do provide good short-term results but these effects come with long-term health risks that should never be neglected for temporary benefits.
What is testosterone replacement therapy (TRT) & what is it used for?
Testosterone replacement therapy (TRT) is an approved medical treatment that involves testosterone usage.
So what exactly sets it apart from anabolic steroids? It is the controlled and monitored use of the drug compared to the unregulated, often abusive use seen with anabolic steroids.
TRT is mainly prescribed to men having below normal testosterone levels (10 – 30 nmol/L or 300 -1000 ng/dL). Men with low testosterone experience troubling symptoms that can disturb all aspects of their lives in various ways.
Some of the most common low T signs and symptoms include:
- Fatigue
- Low sex drive (low libido)
- Erection problems like erectile dysfunction
- Brain fog
- Lack of contraction and focus
- Mood changes
- Low muscle mass and strength
- Low bone density
These signs can vary in severity based on how low your testosterone levels are.
The good thing is that testosterone treatment can help low T men get rid of these symptoms and feel like themselves again by bringing their serum testosterone levels back to normal.
It can help increase muscle mass, lose body fat, boost sexual function, and increase energy levels.
TRT is also approved for a few other health conditions, such as:
Primary hypogonadism – testosterone deficiency due to the inability of the testes to produce the hormone
Secondary hypogonadism – low testosterone levels because of a problem with the pituitary gland or hypothalamus
Delayed puberty
Testosterone replacement therapy can be administered in a variety of ways. The most common three are through injections, creams, and patches.
The most common overall are injections due to the convenience that they offer and the level of speed with which they administer testosterone injections into the bloodstream, which is almost instantaneous.
So what is the difference between anabolic steroids and TRT?
The following anabolic steroids vs testosterone replacement therapy (TRT) table highlights all the key differences between these two methods.
Aspect | Anabolic steroids | TRT |
Purpose | Increase athletic performance, build muscle mass rapidly | Treat clinically low testosterone levels |
Dosage | Supraphysiological (much higher than normal testosterone levels) | Physiological (mimics normal body levels) |
| Administration | Self-administered | Prescribed and monitored by a licensed healthcare provider |
Goal | Aesthetic or performance enhancement | Hormonal balance |
Legal status | Illegal without prescription; banned in sports | Legal with prescription for medical use |
Use duration | Often used in cycles | Long-term therapy based on individual need |
| Health risks | High | Lower |
| Monitoring | Absent or rarely done | Regular monitoring done by medical professionals |
Watch our video on steroids vs TRT:
TRT vs steroids dosage
As mentioned earlier, TRT is an approved technique used to treat medical problems. So, it is prescribed only to eligible patients after a complete evaluation.
Your doctor conducts testosterone blood tests and a few other tests to determine your hormone levels and identify the cause of the hormonal imbalance.
They prescribe a testosterone dose that helps bring the low T level within the normal range, not overshoot it (which is done during steroid abuse).
Your TRT dosage depends on the kind of formula you take and your needs. However, most men on TRT receive 100 – 200 mg of testosterone per week through injection.
On the other hand, anabolic steroids are abused in very high doses by men who do not need testosterone supplementation because their natural testosterone levels are already normal.
They usually take 400 to 1000 mg or more per week. Some even stack multiple steroids together to accelerate muscle growth.
This over-dosage may help them achieve temporary goals but it greatly increases the risk of severe side effects and long-term health complications.
Are there side effects of anabolic steroids?
Hormones are very delicate things that should be balanced whenever possible. The body does a decent job at balancing our hormones for us, but when we interfere by using anabolic steroids, it can do more harm than good.
Common side effects of anabolic steroids include:
- Acne
- Mood swings
- Testicle shrinkage
- Steroid addiction
- High blood pressure
- Pain while urinating
- Low sperm count
- Changes in sex drive
- Increased risk of heart attack
- Infection from unknown substances (black market steroids)
- Liver damage
- Aggressive behavior (roid rage)
People experiencing hormonal imbalance due to performance-enhancing drugs often have long-lasting side effects. In the case of raised testosterone, this can even lead to death through a heart attack and other diseases.
Does TRT also have side effects?
TRT is an approved and safe way to increase your serum testosterone levels. You receive controlled testosterone doses and the provider evaluates your body’s response to these doses from time to time.
They may also adjust your low testosterone treatment plan based on your body’s response.
This regular TRT monitoring and evaluation make it a safe procedure. But still, just like other medications, TRT also has some side effects, including:
- Acne or oily skin
- Fluid retention (bloating or swelling)
- Increased red blood cell count (which can raise the risk of blood clots)
- Breast tenderness or enlargement (gynecomastia)
- Mood swings or irritability
- Decreased sperm production and fertility issues
Most of these side effects go away on their own as your body gets used to exogenous testosterone.
Are anabolic steroids legal?
Under the 1971 Act, anabolic steroids can only be bought with a doctor’s prescription. Buying testosterone supplements without a prescription is illegal and can lead to criminal charges.
They are also sold on the black market, where neither their quality nor dosage is regulated. Using them can increase the risk of contamination, incorrect dosing, and serious health complications.
Performance enhancing steroid usage is banned in various sports because it gives steroid abusers an unfair edge over others. That is why, in some sports, athletes are required to test their testosterone levels before game. If the results come out positive, they can face serious penalties.
Apart from that, it is socially frowned upon to use synthetic steroids, especially in the context of athletic competition.
Is taking TRT illegal in sports?
No, TRT is not inherently illegal in sports.
TRT is a legitimate medical treatment used to bring abnormally low testosterone levels back to normal in men.
However, athletes must be careful, as its usage requires a therapeutic use exemption (TUE) in many sports organisations.
This exemption confirms that the treatment is prescribed for a legitimate medical condition and not to enhance athletic performance.
If you use TRT without a proper TUE, it can be considered a violation of anti-doping regulations.
So what should you choose: TRT vs anabolic steroids?
If you want to restore normal testosterone levels under medical supervision, TRT is a safer and medically approved choice.
Trusted TRT providers like Balance My Hormones understand your health goals and needs to design a tailored treatment plan.
What makes TRT the safest is the fact that your testosterone dose and effects are carefully monitored. Any potential side effects or issues can be detected early, allowing for prompt adjustments to your treatment.
In comparison, self-administering anabolic steroids is not only dangerous but also illegal in many places. So, it is better to play it safe and stick to a medically supervised treatment.
The wrap up
The TRT vs anabolic steroids comparison is clear: TRT is the approved use of testosterone to treat low testosterone levels and similar medical issues, while anabolic steroid is the misuse of testosterone for aesthetic or performance enhancement purposes.
TRT side effects are manageable and not as dangerous as long-term, serious side effects of taking high doses of steroids without any supervision.
If you have low testosterone symptoms, choose the TRT route for hormonal balance. It is a safer, more controlled approach to getting back on track, and most importantly, it is done with your health in mind.
Get your testosterone levels checked today by clicking here, or talk to our professionals to learn more about our treatment plans.
References
Yassin, A., Alzubaidi, R.T., Kamkoum, H., Mahdi, M. and Abdallah, H., 2025. The Benefits of Testosterone Therapy (TTh) in Elderly Men. J Med-Clin Res & Rev, 9(2), pp.1-7.
Basheer, B., Ila, V., Barros, R., Mesquita, F., Lopes, L.S., Lima, V.F.N., Favorito, L.A. and Ramasamy, R., 2025. Management of Adverse Effects in Testosterone Replacement Therapy. International braz j urol, 51(3), p.e20259904.
Grant, B., Hyams, E., Davies, R., Minhas, S. and Jayasena, C.N., 2024. Androgen abuse: Risks and adverse effects in men. Annals of the New York Academy of Sciences, 1538(1), pp.56-70.
Thirumalai, A. and Anawalt, B.D., 2022. Androgenic steroids use and abuse: past, present, and future. Urologic Clinics, 49(4), pp.645-663.
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About the Author: Mike Kocsis
Mike Kocsis has an MBA with a focus on healthcare administration and is an entrepreneur and medical case manager for Balance My Hormones which offers medical services in the UK and Europe. Mike has over 20 years of experience in the healthcare sector, much of that working with people who have hormone imbalances. Mike has appeared on podcasts and radio and is an expert speaker on the subject of hormone imbalance. He specialises in Testosterone Replacement Therapy and Hormone Replacement Therapy (HRT) and has helped thousands of people suffering from hormone imbalances recover and regain control of their lives. You can follow him on LinkedIn and on the Balance My Hormones YouTube Channel.
Last update: May 8th, 2025
