Side-effects from the use of steroids are extremely common and can be quite significant. Most side-effects are reversible once the athlete stops usage although serious long-term side-effects and even death have occurred as a direct result of steroid use.
• Decreased sperm production and sex drive
• Increased aggression, irritability and mood swings
• Liver disorders
• Baldness (alopecia)
• Hypertension (high blood pressure)
• Raised cholesterol
• Gynecomastia (development of over-sized mammary glands in males)
• Menstrual irregularities (in women)
• Hirsuitism (excessive hair growth occurring in females which follows the pattern of male hair growth, . facial)
• Deepening of the voice
• Reduced immunity
• Possible development of tumors (wilm’s tumor, prostate carcinoma and leukemia have been reported, although a connection is not proven)
Dihydrotestosterone (DHT) (referred to as androstanolone or stanolone when used medically) can also be used in place of testosterone as an androgen. The availability of DHT is limited; it is not available in the United States or Canada, for instance, but it is available in certain European countries, including the United Kingdom , France , Spain , Belgium , Italy , and Luxembourg .  DHT is available in formulations including topical gel, buccal or sublingual tablets, and as esters in oil for intramuscular injection.  Relative to testosterone, and similarly to many synthetic AAS, DHT has the potential advantages of not being locally potentiated in so-called androgenic tissues that express 5α-reductase (as DHT is already 5α-reduced) and of not being aromatized into an estrogen (it is not a substrate for aromatase).
As a non-aromatizing androgen, dihydrotestosterone is extremely potent. Aromatization refers to the conversion of testosterone or anabolic steroids into estrogen. High estrogenic activity causes bloating, acne, water retention and oily skin. As dihydrotestosterone does not aromatize even at high dosages, users do not face the aforementioned side-effects. Lack of water retention also has a hardening effect on muscle tissue, in bodybuilders. Being a powerful androgen, dihydrotestosterone is also responsible for a shift in the estrogen-testosterone ratio in the body. Due to its predominant androgenic component, the steroid has a stimulating effect on the adreno-pituitary functions, and causes neurological excitation in the ‘sexual orientation areas of the brain’. This in turn, spikes sex drive in males.