Anabolic steroids are synthetic derivatives of the male sex hormone, testosterone. They can be taken orally (in tablet, powder, or liquid form) or injected intramuscularly. Long associated with the world of sports and athletics, use has spread to the world of children and adolescents; 2.1% of Indiana 12th grade students reported having ever used anabolic steroids in 2005, and trend analysis indicates that use is declining. Most of the steroids found in the United States are obtained through illegal importation from Mexico and European countries. Acquiring steroids is not difficult, as they are sold illegally in a number of venues and can also be obtained through mail order. While anabolic steroids increase the efficiency of athletic training, side effects include severe acne, hostility, and aggressiveness in both sexes, ejaculatory problems, testicular degeneration, impotence, and breast development in males, and menstrual irregularities and uterine atrophy in women. Long term side effects include cardiovascular disease, hypertension, and stroke. Prevention of anabolic steroid use can be accomplished by increasing knowledge and awareness of the dangers of use, and by promoting healthy self-images.