“Performance enhancement drugs”: what it is and what your next step should be

Performance enhancement drugs (PEDs) are substances used to improve physical strength, endurance, appearance, or cognitive focus. People consider them for many reasons—from athletic competition and bodybuilding to work performance or recovery from fatigue. If you are thinking about using PEDs, already using them, or worried about side effects, this guide walks you step by step from your situation to clear, safer next actions.

Disclaimer: This article is for educational purposes only and does not provide medical advice, diagnosis, or treatment. Performance enhancement drugs can carry significant health risks. Decisions about their use should always be made with a qualified healthcare professional.

3 typical scenarios

Scenario 1: You feel stuck in training or performance and are considering PEDs

What this might mean:
Plateaus in strength, endurance, or concentration are common. They may be related to training load, nutrition, sleep quality, stress, or underlying medical issues such as hormonal imbalance—not necessarily a need for performance-enhancing substances.

What a doctor usually does:
A clinician may review your goals, training routine, diet, sleep, and stress levels. They may ask about supplements, caffeine intake, and previous drug use. Basic blood tests (for example, iron levels, thyroid function, or testosterone) may be considered before discussing any medical options. You can also explore general health education resources in our uncategorized health articles section.

Scenario 2: You are already using performance enhancement drugs and worry about side effects

What this might mean:
Concerns such as acne, mood swings, elevated blood pressure, sleep problems, or changes in libido may suggest your body is reacting negatively. Some effects appear slowly and may not be obvious at first.

What a doctor usually does:
Doctors typically take a non-judgmental history of what substances are used (type, duration, source), check vital signs, and order targeted tests (liver enzymes, lipid profile, hormones, heart health markers). Monitoring helps detect early harm and guide safer discontinuation or management strategies. Related discussions on harm awareness can be found in our general medical overview hub.

Scenario 3: You feel pressured by competition, peers, or work demands

What this might mean:
External pressure—sports competition, social media, or job performance—can push people toward risky choices. This is often a psychological and social issue as much as a physical one.

What a doctor usually does:
Healthcare providers may explore mental health, stress, anxiety, and motivation. Referral to a sports physician, psychologist, or counselor may help you develop safer, sustainable performance strategies without relying on drugs.

Decision tree

If you are only considering PEDs → then pause and assess sleep, nutrition, training load, and stress first.
If you have unexplained fatigue or poor results → then request a basic medical check-up before using substances.
If you are currently using PEDs without supervision → then arrange a confidential medical review.
If you notice new physical or mood symptoms → then stop self-adjusting substances and seek professional advice.
If your goal is long-term health and performance → then prioritize sustainable, evidence-based approaches.

When to seek help urgently (red flags)

Chest pain or shortness of breath: Possible heart complications.
Severe mood changes or aggression: May indicate hormonal or neurological effects.
Yellowing of skin or eyes: Possible liver injury.
Fainting or severe dizziness: Could signal blood pressure or heart rhythm issues.
Sudden swelling or severe headaches: Needs urgent evaluation.

Approaches to treatment/management (overview)

Management depends on individual goals, health status, and whether PEDs are being used or discontinued. Common approaches include:

Medical evaluation and monitoring: Blood tests and follow-up visits.
Lifestyle optimization: Training periodization, nutrition planning, sleep hygiene.
Psychological support: Addressing performance anxiety or pressure.
Medications: Only when clinically indicated and as prescribed by a doctor, for example to treat diagnosed hormone deficiencies or manage complications.

For broader discussions on managing health choices, see our health decision guides.

Prevention

Set realistic performance goals.
Use evidence-based training and recovery plans.
Avoid substances from unregulated or online sources.
Schedule regular health check-ups if training intensely.
Seek education about risks before experimenting.

Method	Who it suits	Limitations / risks
Optimized training & recovery	Most athletes and professionals	Requires patience and consistency
Nutrition planning	Those with performance plateaus	Results depend on adherence
Medical therapy (prescribed)	Diagnosed medical conditions	Needs supervision, possible side effects
Unsupervised PED use	Not recommended	High health and legal risks

Questions to ask your doctor

What could be causing my performance issues?
Are there medical conditions that should be ruled out?
What are the short- and long-term risks of PEDs?
Which tests should I have before making decisions?
Are there safer alternatives to improve performance?
How can I stop using PEDs safely if I choose to?
What symptoms should I monitor?
How often should follow-up testing be done?
Can you refer me to a sports medicine specialist?

Sources

World Anti-Doping Agency (WADA) – wada-ama.org
U.S. National Institutes of Health (NIH) – nih.gov
Mayo Clinic – mayoclinic.org
British Journal of Sports Medicine – bjsm.bmj.com