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Only very modest gains in muscle mass and strength are reported by most, even at relatively high doses. Healthcare settings must also be certified with the REMS Program and must have the resources to provide emergency medical treatment in cases of serious POME and anaphylaxis. Several other effects are gender- and age-specific: In men: shrinking testicles decreased sperm count baldness development of breasts increased risk for prostate cancer In women: growth of facial hair or excess body hair decreased breast size male-pattern baldness best anabolic steroids pills changes in or stop in the menstrual cycle enlarged clitoris deepened voice In teens: stunted growth (when high hormone levels from steroids signal to the body to stop bone best anabolic steroids pills growth too early) stunted height (if teens use steroids before their growth spurt) Some of these physical changes, such as shrinking sex organs in men, can add to mental side effects such as mood disorders.

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