Remember the possibility of anabolic steroid use when a young competitive athlete or a recreational power athlete seeks medical treatment for acne, infertility, loss of sexual desire, cardiac symptoms, depression, uncontrolled outbursts of rage or sleep disturbances. The physician should be particularly alert if the patient has in addition a strong musculature, and other side effects of anabolic steroids are apparent. Rule out the use of anabolic steroids before starting therapy for acne. Be alert to the possibility of heart diseases and even acute myocardial infarction in a steroid user.