Urologists are seeing more and more men whose difficulty in becoming a father is linked to consumption of the muscle-boosting drugs.
Many fit young men who believe they are at the peak of physical perfection don't believe it could be their fault when their wives or girlfriends find it difficult to become pregnant.
They are insulted when it is suggested that they undergo a sperm test, and horrified when the results of those tests show an absence of sperm in the sample.
Such men are then referred to a urologist, and undergo a blood test. If they have been using steroids, they often have what calls deranged levels of sex hormones.
Men who regularly go to the gym should avoid taking steroids to bulk up.
Acne, aggression and an unexplained, orange skin tone akin to a tan are also associated with use of steroids.
It is a very real risk that men who take anabolic steroids will become infertile. It's almost certain that steroids will have an effect of some sort on their fertility and, in the worst-case scenario, that sperm production will stop altogether.
These patients walk through the door looking like Arnold Schwarzenegger in his younger days. They are having fertility problems, and it suddenly becomes obvious where the problem may lie.
Some men who stop taking steroids never regain their reproductive capacity and for others it takes years for normal sperm production to resume.