Looking for the Best Way to Come Off Steroids Safely? Exploring Post-Cycle Therapy, Cessation, and Recovery Discourse and Practice in Australian Steroid Consumer Forums

Abstract

Introduction: Anabolic-androgenic steroid (AAS) use is rising in Australia; however, discontinuation poses challenges due to withdrawal symptoms and a lack of clinical guidance. Therefore, the aim of this study was to explore online discourses around post-cycle therapy (PCT), including perceived health risks, benefits and barriers, among people who use AAS. Methods: This study employed a digital ethnographic approach to explore Australian ‘steroid forums’ discussing PCT. Data were collected by extracting posts containing relevant keywords across four selected forums, with analysis guided by the Health Belief Model to identify barriers, facilitators and perceptions related to PCT. Results: A total of 150 threads and 5059 posts from 580 unique forum users were analysed. Key barriers to PCT engagement included social influences, aggressive anti-PCT discourse and regulatory constraints. Benefits of PCT were recognised in preventing side effects and preserving muscle gains. Consumers shared concerns about hormonal imbalance, sexual health and long-term damage, which were driving forces behind seeking advice on PCT. Discussion and Conclusions: This study highlights the role of online forums in shaping AAS consumers' understanding of PCT, where peer-driven knowledge networks facilitate harm reduction. However, inconsistent advice and the lack of clear clinical guidelines, compounded by the lack of prospective studies, contribute to uncertainty and risk. This underscores the need for evidence-based, non-stigmatising support in healthcare.