By Lilian Nazibanja
As pressure to look “perfect” grows on social media and in local gyms, many young Ugandans are turning to anabolic steroids, often without understanding the serious long-term health risks behind the quick gains. Health experts warn that the pursuit of the ‘perfect body’ may be triggering life-threatening hormonal complications.
Think of anabolic steroids as synthetic versions of testosterone, the hormone responsible for muscle growth, energy, and mood regulation. Medically supervised use can benefit patients with specific deficiencies or health conditions. But misuse in healthy young adults can profoundly disrupt the body’s hormone systems. Natural hormonal production can shut down, and the imbalance may persist even after steroid use stops.
In Kampala, Entebbe, and other urban centres, gym culture has exploded in recent years. Influencers flaunting sculpted physiques, six-pack challenges, and dramatic transformation videos have created a new beauty currency—one where appearance often overshadows health. As a result, some young men, and increasingly women, are bypassing proper training and nutrition, instead opting for injections and pills marketed as shortcuts to rapid body transformation.
The cultural drivers behind this trend are complex. Body image pressures, unemployment, peer influence, and the desire to appear successful intersect in a society where many feel left behind. For some, building a muscular body becomes a way to reclaim confidence or social status. Yet without proper education about the dangers, many are unknowingly gambling with their long-term health.
Behind the glossy photos and dramatic “before-and-after” shots lies a hidden crisis. Clinicians are beginning to see the consequences: young men presenting with reduced fertility, severe acne, gynecomastia (breast tissue development in males), dangerously high blood pressure, liver damage, and even psychotic episodes linked to hormone imbalance. “Some of these boys come in with complications we usually see in middle-aged adults. The body pays a price for those muscles,” one clinician observed.
Many of these substances are bought informally from gym instructors, dealers, or online platforms with no regulatory oversight. Few users are aware that these drugs—often unlabelled or counterfeit—can disrupt the endocrine system, shut down natural testosterone production, trigger mood disorders, cause infertility, and increase the risk of heart disease.
Uganda currently lacks strong policies regulating the sale and distribution of performance-enhancing drugs, leaving young people exposed. From a hormonal health perspective, urgent public health action is needed: education campaigns, regulatory oversight, mental health support, and accessible fitness guidance are critical to prevent further harm.
The pursuit of aesthetics should never come at the cost of overall health and well-being. As gyms continue to grow and social media drives ever-higher expectations, empowering youth with knowledge may be the most critical tool in breaking this dangerous cycle.
The writer is an Endocrine Clinical Nurse Specialist at University College London Hospital.
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