Effects of Androgenic Steroids


Androgenic steroids mirror the effects of naturally occurring male sex characteristics commonly seen during puberty.  Zemlin (1998) describes these natural changes during puberty, as they pertain to the voice, as follows:

"During the pubertal period, the cartilaginous structure grows particularly rapidly.  In males, the vocal folds not only increase in length by about 10mm, but they also thicken, and, as a result, the lower range of the voice drops by about a full octave.  This change in the voice is known as mutation."

Zemlin also indicates that the layer structure of the vocal folds matures during adolescence, "Thus, voice mutation is associated not only with an increase in size of the vocal folds, but also with changes in the inner structure of the vocal fold mucosa."

Individuals (male and female) who have been exposed to androgenic steroids will experience and irreversible alteration in their vocal folds, including lengthening and thickening.  This, in turn, causes the natural frequency of their voice to lower.

It has also been reported that users of androgenic steroids have "hoarse" voices.  I hypothesize that this hoarseness is the result of asymmetrical changes in the vocal folds, i.e.: since the added androgen is unnatural and not regulated by body chemistry, the lengthening and thickening caused by the androgen did not occur to the same degree in each vocal fold as it normally does in puberty. (Colton & Casper, 1996)

A recent study in the Journal of Voice (Baker, 1999) examined the effects of virilizing agents in four females experiencing dysphonia.  It was determined that use of the androgenic substances caused significant alterations in vocal physiology, including muscle tissue changes, muscle coordination dysfunction, and proprioceptive dysfunction.  Descriptions of the voices included hoarse, croaky, powerless projection, glottal fry, marked instability, decreased pitch range (for singing) and rapid fatigue.    Both the projected speaking voices and the singing voices of these ladies proved to be very sensitive to the virilazation effects of drugs they had been exposed to.

Androgenic steroids also cause a water and electrolyte imbalance in the body, which result in increased storage of water and sodium in cells, tissues, or serous cavities of the body .  Known as edema, this storage of water  affects the superficial layer of the lamina propria by increasing the mass of the cover. (Colton & Casper, 1996). This affects the vocal folds by lowering the pitch level and adding hoarseness.  Extreme cases of vocal fold edema can cause shortness of breath due to the blockage of the airway by the engorged vocal folds.  

Furthermore, I assume that the increased development of skeletal muscle induced by exposure to androgens will affect the muscles of the vocal mechanism.

Click here to see the muscles of the vocal mechanism

Click here to see the actions of the joints of the vocal mechanism


General Effects of Androgenic Steroids courtesy of ESPN

  Men - Although anabolic steroids are derived from a male sex hormone, men who take them may actually experience a "feminization" effect along with a decrease in normal male sexual function. Some possible effects include:

Women - On the other hand, women often experience a "masculinization" effect from anabolic steroids, including the following:

With continued use of anabolic steroids, both sexes can experience the following effects, which range from the merely unsightly to the life endangering. They include:



What are androgenic/anabolic steroids?

Common uses for androgenic steroids

Implications of androgenic steroid use in voice therapy