Red flags

  • Use by a young person (<21) – high risk of irreversible complications even with short-term use.
  • Comorbidities (e.g., cardiovascular disease, hypertension, hypercholesterolemia, polycythaemia)
  • Post-use hypoandrogenism (deficiency in testosterone) which may be persistent.
  • Elevated prostate-specific antigen (PSA).
  • Liver and kidney abnormalities.
  • Features of anabolic-androgenic steroid (AAS) dependence.
  • Severe mood disruption (e.g., depression, (hypo)mania, aggression)
  • Risky injecting practises or risky sexual behaviours.
  • Concurrent alcohol and other drug (AOD) use disorder
  • Patients with a history of bipolar mood disorder or personality disorders.