Peptides: The New Steroids? A Gay Men's Doctor on Why You Should Think Twice

Apr 24

If you've spent any time on Instagram lately, you've probably seen them. Influencers posting before-and-afters, promising better skin, faster recovery, more muscle, sharper libido — all thanks to peptides. They're being sold as the cleaner, safer, smarter alternative to steroids. But are they?

In a recent episode of All Out with Jon Dean, I sat down with Jon to cut through the noise. What follows is a summary of that conversation — and the takeaways might surprise you.

So, What Actually Is a Peptide?

First, the basics. Peptides are short proteins — essentially the building blocks that make up larger proteins in your body. They act as signalling molecules, triggering various biological processes. And here's the thing: they're everywhere. Semaglutide (the active ingredient in Ozempic) is a peptide. So are many of your body's own hormones.

But when people talk about peptides in wellness culture, they're usually referring to synthetic peptides — compounds manufactured in a lab that don't naturally occur in your body — and then injected.

The most commonly discussed ones right now include:

BPC-157 — marketed for healing, gut repair, and injury recovery
TB-500 — promoted for tissue repair and inflammation
PT-141 (Bremelanotide) — used for libido and sexual desire
Ipamorelin / growth hormone secretagogues — aimed at muscle growth and fat loss
Retatrutide — a newer compound generating significant buzz as a "triple agonist" targeting weight loss, metabolic health, and potentially muscle preservation simultaneously
CJC-1295 — a growth hormone-releasing peptide, almost always stacked with Ipamorelin, and widely used for body composition, fat loss, and anti-aging, with no meaningful human trial data.
Melanotan II — targets the same melanocortin system as PT-141, marketed for tanning and libido, but has a notably concerning safety record including reports of unexpected changes to moles and skin pigmentation.
GHK-Cu (Copper peptide) — promoted for skin repair, collagen production, and anti-aging, available both as an injectable and in topical skincare products, and while it has more published research than most peptides, the studies remain largely small-scale or preclinical.

Not All Peptides Are Created Equal — The Regulated vs. the Unknown

This is the distinction I really want people to understand, because it's where a lot of confusion lies.

Some peptides have gone through rigorous, multi-year clinical trials and received regulatory approval. The GLP-1 drugs — semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro) — are the most prominent examples. These have been tested in tens of thousands of people, their side effect profiles are well understood, they're manufactured to pharmaceutical grade, and they're prescribed and monitored by doctors. Retatrutide is currently in late-stage clinical trials and may follow the same path — which is exactly how this process should work. There's also PT-141 (Bremelanotide), approved in the US for women with low sexual desire, which has similarly gone through proper scrutiny.

Then there's everything else. BPC-157, TB-500, Ipamorelin, and the dozens of other peptides circulating on Instagram and in gym changing rooms — these are a completely different matter. They are sold as "research chemicals," not medicines. They haven't been through meaningful human trials. They're not manufactured to pharmaceutical standards, so you often can't be certain what's actually in the vial, or at what dose. The distinction between an approved GLP-1 drug and an unregulated research peptide is not a technicality — it's the difference between something we understand and something we genuinely don't.

The Problem: We Just Don't Know

Only about 5% of drugs that showed promise in rats ever end up being approved as human drugs. And even those that do get approved sometimes get withdrawn years later because of risks that only became clear once large numbers of people were treated. I've seen it happen with drugs that passed rigorous testing — pulled from the market due to serious liver toxicity or other unforeseen risks. With most peptides, we're not even at the beginning of that process.

This means we don't fully understand how they work in humans, what the real benefits are, what the risks look like in the short or long term, or what a safe dose even is.

Side Effects and Long-Term Risks

Because PT-141 is the peptide I encounter most often in my sexual medicine practice, it's the one I can speak to most directly. Common side effects include flushing, nausea, and vomiting — manageable for some, not for others.

For growth hormone-stimulating peptides like Ipamorelin, the potential concerns are more serious. They can cause insulin insensitivity and raised blood glucose levels. They also stimulate blood vessel growth — which matters because this is exactly the mechanism we target with cancer treatments to stop tumours growing. We simply don't know what long-term stimulation of that pathway does to cancer risk. The effects on the liver, muscle, bone, and cardiovascular system over years and decades are similarly unknown.

We are genuinely at the very start of this. These aren't compounds that have been quietly used for decades and are only now becoming mainstream — many of them are new formulas, put together in a lab and sold directly to you, with no long-term safety record whatsoever.

If Something Feels Off, Please Get Properly Checked

This is something I feel strongly about and want to address directly. A lot of men are turning to peptides — or steroids, or testosterone — because they're experiencing something real: fatigue, low libido, poor erections, reduced drive, a general sense that something isn't right. And the wellness industry is very good at meeting that moment with a product.

But those symptoms matter. Fatigue, loss of sex drive, and erectile difficulties can be signs of underlying conditions that genuinely need investigating — thyroid problems, cardiovascular issues, sleep disorders, low testosterone, depression, diabetes, and more. Injecting a peptide won't diagnose any of those things, and it may mask symptoms that were trying to tell you something important.

If you're experiencing any of these symptoms, please see a doctor and ask for a proper workup. That means blood tests, a review of your cardiovascular health, and an honest conversation about what's going on — not a quick fix from an unregulated online supplier. The symptoms are worth taking seriously, and you deserve a proper answer, not a research chemical.

The Psychological Pull — and Why It Matters

Perhaps the most important part of this conversation, for me, isn't the clinical detail — it's the psychology behind why people are drawn to these products in the first place.

Gay men are particularly vulnerable to the anxiety that peptides (and steroids before them) exploit. The constant bombardment of idealised bodies on social media, the internalised voice that says I'm not enough, the belief that if only you looked a certain way, you'd be more attractive, more lovable, more likely to find connection.

These products exist in the same ecosystem — Instagram, social media, a barrage of images of what you should look like. And if you don't measure up, your inner critic comes in. Then there's a product that promises to solve that anxiety.

The problem is that using a peptide to quiet that voice doesn't actually silence it — it reinforces it. The message underneath is: I'm only acceptable if I change myself. And that, over time, pulls you further from real freedom, not closer to it.

This is something I see regularly in my practice. Men who are cycling through Cialis, then testosterone, then an injection into the penis, then PT-141 — each working for a little while, then stopping. Not because the drugs aren't doing anything, but because the underlying anxiety, the inner critic, the sense of not being enough — that never gets addressed.

Is it possible to be free, to live a fulfilling life with really great sex and great relationships, without taking a steroid or a peptide? Yes, absolutely. And for me, that's what real freedom looks like.

The Bottom Line

Peptides are not all the same, and they're not all dangerous — but the ones flooding social media are a very different beast from the regulated, clinically-tested drugs like Ozempic or Mounjaro. The absence of known risk is not the same as safety, and most of what's being sold online has nevebeen properly studied in humans.

If something in your body doesn't feel right, get it properly investigated. If you're thinking about peptides as a way to look better or feel more confident, I'd encourage you to pause first and ask yourself what's really driving that impulse — and whether there's a more honest path to what you're actually looking for.

If this resonates and you'd like to explore what's really going on — whether that's symptoms worth investigating or the psychological side of body image and sexual confidence — that's exactly the work I do. You can find out more about me here: About Me

Watch the full episode on All Out with Jon Dean on YouTube or listen on all major podcast platforms.