Most men using steroids are not reckless. They are informed, motivated and making considered decisions about their bodies, and what is usually missing is a doctor who understands that. I do not moralise. I do good medicine, whether you are using, thinking about stopping, or dealing with the after-effects.
You do not have to be stopping, or planning to. If you are using and want proper monitoring and harm reduction, that is a perfectly good reason to come. I see competitive bodybuilders, recreational gym users, men using testosterone for body composition, and men dealing with the consequences of use that stopped years ago. First cycles through to decades of heavy use.
My job is to give you accurate medical information and to help you stay as healthy as possible, whatever you decide. You will get clinical honesty, risks included, but not a lecture.
I do not moralise. I do good medicine, whether you are using, thinking about stopping, or dealing with the after-effects.
Staying as safe as possible while you are using is a legitimate reason to be under a doctor, and it is a large part of what I do. The priority is cardiovascular, because that is where the real risk sits and a blood test will not show it: blood pressure, an ECG and an echocardiogram, and where it is warranted CT calcium scoring or a CT coronary angiogram.
Bloods depend on what you are actually taking rather than a generic panel, but usually testosterone, oestradiol, SHBG and haematocrit, plus lipids, liver and kidney function, HbA1c and PSA. A semen analysis too, if fertility matters now or might later. And an honest conversation about mood and how using is affecting you mentally, which is a real part of the risk and the part most easily left out.
Coming off wants a plan, and blood tests rather than guesswork. What post-cycle therapy looks like depends on what you have been taking, at what dose and for how long, and on what your bloods show. The HPG axis, the signal driving your own production, does not always come back predictably, so the sequencing matters. A badly managed PCT, or starting testosterone too early, can leave you worse off than doing nothing.
Your own production often recovers, though not always, and rarely on a schedule. How well the axis comes back varies from man to man, which is why recovery is tracked with repeated bloods over months rather than judged from one reading.
For most men around six months, though it can take longer and for some it does not fully come back. The published range is three to twelve months from the last dose, and the honest position is that the evidence is thin, because very little data follows men through recovery properly. What is more consistent is what makes it slower: how long you used, the dose, how many compounds at once, and which ones.
Yes. If your own production hasn't recovered after time and a proper trial of the medications that stimulate it back, what you have is a recognised diagnosis in its own right: testosterone deficiency caused by anabolic steroid use, sometimes called anabolic steroid-induced hypogonadism. At that point replacement, at replacement doses and within controlled limits, may well be right. I prescribe carefully, only where it is indicated, and with thorough monitoring.
A standard blood test will not tell you whether your heart has been affected. Cardiac assessment after significant use should include at least an ECG and an echocardiogram, and I can arrange a full workup and refer to a cardiologist if anything needs pursuing.
Blood pressure and routine bloods can look entirely normal while damage develops, and there are documented cases of young, outwardly healthy men with no warning signs. That is not meant to alarm you. It is why this is done by someone who knows what to look for rather than left to a general screen. Where more is warranted I can arrange 24-hour blood pressure monitoring, a Holter monitor or a cardiac MRI.
It is not only erections, either. Steroid-related erectile dysfunction usually has several overlapping causes, hormonal, vascular and psychological, and needs assessing rather than prescribing for. Testosterone suppression commonly causes loss of libido and difficulty ejaculating too, and these can persist long after stopping, which is often the part men do not connect to a cycle they finished years ago.
It may have. The same suppression that lowers your own testosterone affects sperm production, and for some men that persists after stopping, though it is recoverable in many cases with the right support. The way to find out is a semen analysis, done at home and repeated over time so we are reading a trend rather than one sample. Where fertility is the priority, hCG or clomiphene can be an effective alternative to replacement, or used alongside it.
I treat these. They are the side effects that affect how you look and feel rather than the ones that show up on a blood test, and they are often what finally prompts a man to book while being the last thing he raises in the room. Raise them early rather than living with them. There is usually something that can be done.
The distinction that matters is between peptides that have been through proper trials and everything else. The GLP-1 drugs, semaglutide and tirzepatide, have been tested in tens of thousands of people, are made to pharmaceutical standard, and are prescribed and monitored. BPC-157, TB-500, Ipamorelin and most of what circulates on Instagram are sold as research chemicals: no meaningful human trials, no pharmaceutical manufacturing, and often no certainty about what is in the vial or at what dose. Absence of known risk is not safety.
There is usually something real underneath. Men reach for peptides, steroids or testosterone because something genuinely is going on: fatigue, low libido, poor erections, a sense that something is off. Those symptoms deserve investigating rather than masking, and a compound bought online will not diagnose any of them.
Yes. Testosterone esters, Anavar, Deca, Trenbolone, Winstrol, Anadrol, SARMs, HGH, insulin, peptides, and the ancillaries including aromatase inhibitors, SERMs and hCG. You will not be spending the appointment explaining them.
Muscle dysmorphia, sometimes called bigorexia, is far more common in this world than it is acknowledged to be. It sits behind a great deal of use, along with disordered eating and compulsive patterns, and it is rarely what a man books an appointment to talk about. I can work with that alongside the physical side rather than treat it as someone else's department.
It matters because the compound tends not to settle the thing underneath. Men cycle through one drug and then another, each working for a while and then stopping, not because the drugs do nothing but because the inner critic never gets addressed. Using something to quiet that voice tends to reinforce it, since the message underneath is that you are only acceptable if you change yourself.
Cardiovascular effects in particular can persist long after stopping, so if you are concerned about the long-term effects of past use, a proper assessment is entirely reasonable however long ago it was.
Sixty minutes, and most of it is talking. I will want to know what you are taking or have taken, the compounds, the doses and how long for, and it helps enormously to bring that rather than reconstruct it on the spot. Then your symptoms, your medical and family history, and what you want out of it. Examination is sometimes useful and always optional. Very little will be new to me and you will not be lectured. You should leave with a plan.
Only with your consent, and everything here is confidential. I would recommend it, particularly if you are on anything long term, but it is entirely your choice and it does not change the care you get here.
The clinic is at Central Health London, 23 Devonshire Place, Marylebone, a quiet and discreet address a short walk from Regent’s Park. Most men arrive anxious and leave relieved. You will be welcomed by reception, offered tea or coffee, and given time to settle before we start.
A first consultation is usually an hour. We go through your symptoms, your medical and family history, and your sexual experience, relationships and lifestyle: the medical, psychological and relational picture together rather than one at a time.
I will ask you a lot of questions. You do not have to answer any of them: saying "I would rather not answer that" is a complete answer and nothing follows from it. A physical examination is sometimes useful, particularly for erection problems, and it is always optional. You stay in control of the appointment throughout.
If you have had recent blood tests, send them ahead. If not I will arrange them, and I will tell you which ones need taking before 11am.
If you are in your fifties or sixties, have no GP you know well, do not much like going to the doctor, but recognise it is time to take your health seriously, this is a reasonable place to start. I often find things that matter and have been missed.
If you want help but are wary of seeing someone who is not comfortable talking about gay or queer sex, you can come to someone who does not need it explained, and who will not judge or shame you.
Men who have tried quick fixes, or had a purely medical or purely therapeutic approach that did not help. I see a lot of men for second opinions. And men of any age and in any kind of relationship who want to understand what is going on rather than be handed a prescription.
I am a GP, a sexual medicine specialist and a COSRT-registered psychosexual therapist, working at 23 Devonshire Place, Marylebone, central London, alongside NHS general practice in Hackney.
Most men reading a page like this arrived from a search rather than my homepage, so this is probably the first you have heard of me. The short version: I hold the medical, the psychological and the relational picture together in one appointment, rather than sending you to three people who each see a third of it.
More about how I workThese rarely arrive on their own. If one of these sounds closer to what you’re dealing with, start there instead.
If something doesn’t feel right, it’s worth understanding why, before deciding what, if anything, to treat.
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