Steroids, SARMs and gay men: the mental health side
Why some gay men turn to steroids or SARMs, how they can affect mood, and how to get support without judgment.
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner and founder of Wellthy Psychiatry & Wellness
✓ Medically reviewed by Earl Johns, MSN, PMHNP-BC
Anabolic steroids and SARMs have become more common in parts of gay culture. Many people focus on the physical risks. The mental health effects matter just as much.
Why people use them
Pressure to look a certain way, muscle dysmorphia, dating app culture and wanting results faster are common reasons. Some people start with a cycle and find it hard to stop.
Effects on mood
Steroids can cause irritability, anxiety, mood swings and trouble sleeping. Coming off them often brings low mood, fatigue and low libido as natural hormone levels recover, which can lead people to keep using.
Physical risks to know
Steroids and SARMs can affect the heart, liver, cholesterol, fertility and hormone levels. Products bought online may not contain what the label says. Regular medical monitoring matters if you use.
Judgment-free support
You can talk honestly with an affirming provider without being lectured. Care can include support for body image, depression after stopping and a plan that fits your goals.
A gentle next step
A free 15-minute phone consult is an easy way to see if Wellthy Psychiatry feels like the right fit for you.
This article is for general education and isn’t medical advice. If you’re in crisis, call or text 988, the Suicide & Crisis Lifeline, or call 911.
About the author
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner · UCSF-trained · Founder of Wellthy Psychiatry & Wellness
Earl provides LGBTQ+ and neurodivergent-affirming psychiatric care, blending medication management, therapy and whole-person approaches. He sees clients in San Francisco and by telehealth across California.
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