“Performance enhancement drugs”: options and how to choose the right one

Disclaimer: This article is for informational purposes only and does not replace professional medical advice. Performance enhancement drugs (PEDs) can carry significant health risks and legal implications. Always consult a qualified healthcare professional before starting, stopping, or changing any medication or supplement.

Who needs it and what goals are common

The term “performance enhancement drugs” covers a wide spectrum of prescription medications, hormonal therapies, and substances used to improve:

• Muscle mass and strength
• Endurance and aerobic capacity
• Focus and cognitive performance
• Sexual performance
• Recovery speed after training or injury

People who typically seek performance enhancement options include:

• Competitive athletes
• Bodybuilders and fitness enthusiasts
• Individuals with clinically diagnosed hormone deficiencies (e.g., low testosterone)
• Men with erectile dysfunction
• Patients with certain chronic conditions affecting energy or muscle mass

However, goals differ. Some seek medical treatment for a diagnosed condition, while others pursue non-medical performance optimization. The distinction is critical because it affects legality, safety, and the appropriate therapeutic approach.

Options

1. Anabolic-androgenic steroids (AAS)

When used: Prescribed in limited medical situations (e.g., delayed puberty, muscle loss due to disease). Often misused for muscle growth and strength enhancement.

Pros:

• Rapid increase in muscle mass and strength
• Improved recovery in some users

Cons:

• Hormonal imbalance
• Infertility and testicular atrophy
• Acne, mood swings, aggression

Limitations/risks:

• Cardiovascular disease (hypertension, dyslipidemia)
• Liver toxicity (especially oral steroids)
• Psychiatric effects
• Legal consequences in many countries

When to discuss with a doctor:

• Symptoms of low testosterone
• Post-cycle hormonal disturbances
• Signs of liver or heart problems

For more details about regulated access and medical supervision, see our Membership options section.

2. Testosterone replacement therapy (TRT)

When used: For men with clinically confirmed hypogonadism (low testosterone levels with symptoms).

Pros:

• Improved libido and sexual performance
• Better mood and energy
• Increased lean body mass (moderate)

Cons:

• Requires ongoing monitoring
• May suppress natural testosterone production

Limitations/risks:

• Polycythemia (increased red blood cells)
• Sleep apnea worsening
• Fertility suppression

When to discuss with a doctor:

• Persistent fatigue, low libido, depression
• Before starting therapy for “optimization” without diagnosis

3. Peptide hormones and growth hormone (HGH)

When used: Medically for growth hormone deficiency; misused for anti-aging and physique enhancement.

Pros:

• May increase lean mass in deficient individuals
• Potential fat reduction

Cons:

• High cost
• Injectable administration

Limitations/risks:

• Joint pain, edema
• Insulin resistance
• Carpal tunnel syndrome

When to discuss with a doctor:

• Confirmed growth hormone deficiency
• Metabolic abnormalities

4. Erythropoiesis-stimulating agents (e.g., EPO)

When used: Prescribed for anemia (e.g., chronic kidney disease). Illegally used to enhance endurance.

Pros:

• Increased red blood cell production
• Improved oxygen-carrying capacity

Cons:

• Increased blood viscosity
• Requires careful dosing and monitoring

Limitations/risks:

• Stroke and heart attack risk
• Blood clots

When to discuss with a doctor:

• Diagnosed anemia
• Symptoms of clotting or cardiovascular disease

5. Prescription stimulants and cognitive enhancers

When used: ADHD, narcolepsy. Sometimes misused for focus, weight loss, or productivity.

Pros:

• Improved attention and alertness
• Reduced fatigue (short term)

Cons:

• Insomnia
• Dependence potential

Limitations/risks:

• Elevated blood pressure
• Anxiety, arrhythmias

When to discuss with a doctor:

• Attention problems affecting daily life
• History of heart disease or substance use

Large comparison table

approach	for whom	effect/expectations	risks	notes
Anabolic steroids	Medical muscle-wasting conditions; misused by athletes	Rapid muscle/strength gains	Cardiovascular, liver, hormonal suppression	Controlled substances in many regions
Testosterone replacement therapy	Men with confirmed hypogonadism	Moderate muscle gain, improved libido and energy	Polycythemia, infertility	Requires lab monitoring
Growth hormone	GH deficiency	Lean mass increase (if deficient)	Insulin resistance, edema	High cost, injectable
EPO	Anemia patients	Improved endurance (oxygen delivery)	Thrombosis, stroke	Strict medical supervision required
Prescription stimulants	ADHD, narcolepsy	Short-term focus enhancement	Addiction, heart risks	Controlled medications

For pricing structures and transparency about licensed products, visit our Offers and updates page. Always review safe Payment methods when purchasing prescription therapies online.

Common mistakes and misconceptions when choosing

• “Natural means safe”: Some supplements interact with prescription drugs.
• Skipping lab tests: Hormone therapy without baseline labs is unsafe.
• Copying athlete protocols: Elite regimens may involve medical oversight and undisclosed risks.
• Ignoring cardiovascular screening: Many PEDs increase cardiac risk.
• Buying from unverified sources: Counterfeit products are common.

Mini-guide to preparing for a consultation

Before meeting a healthcare provider, prepare:

Documents:

• Recent blood tests (CBC, lipid profile, liver enzymes, hormone panel)
• List of current medications and supplements
• Medical history (heart disease, diabetes, mental health conditions)

Symptoms to record:

• Fatigue patterns
• Libido changes
• Mood swings
• Sleep disturbances

Questions to ask:

• Is my goal medical or cosmetic?
• What are short- and long-term risks?
• What monitoring is required?
• Are there safer alternatives?

Check our Regular update section for new clinical guidelines and safety alerts.

FAQ

1. Are performance enhancement drugs legal?

It depends on the substance and country. Many anabolic steroids and stimulants are controlled. Medical use requires a prescription.

2. Are there safe performance enhancement drugs?

“Safe” depends on indication, dose, and supervision. Medically necessary treatments under physician care are significantly safer than unsupervised use.

3. Can testosterone therapy replace steroids?

TRT treats deficiency but does not replicate high-dose anabolic steroid effects used in bodybuilding.

4. Do these drugs permanently improve performance?

Most benefits diminish after discontinuation, especially if not supported by training and nutrition.

5. What tests are required before starting?

Common tests include hormone panels, liver function tests, lipid profile, and complete blood count.

6. Are online purchases safe?

Only if obtained through licensed pharmacies. See our Uncategorized medical resources for guidance on verifying providers.

7. Can women use performance-enhancing hormones?

Some therapies are prescribed for specific conditions, but virilization and hormonal imbalance risks are significant.

8. Do supplements work as alternatives?

Most over-the-counter supplements produce modest effects compared to prescription agents and should not replace medical therapy when indicated.

Sources

• World Anti-Doping Agency (WADA) – Prohibited List and Medical Information
• U.S. Food and Drug Administration (FDA) – Drug Safety Communications
• Endocrine Society Clinical Practice Guidelines (Testosterone Therapy in Men with Hypogonadism)
• National Institutes of Health (NIH) – MedlinePlus Drug Information
• American Heart Association – Cardiovascular risks of anabolic steroid use