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Prednisone Side Effects in Men

Prednisone Side Effects in Men

Prednisone in Men

Many men prescribed prednisone wonder: what are the prednisone side effects in men? How will the adverse effects in males differ from those in females?

I searched many articles, prescription drug databases, and patient support groups to compile this list of prednisone side effects in men.

Since prednisone is a steroid, it affects men differently than women.

Check out this video to explain in more depth which adverse effects of prednisone men might expect.

Watch now!

Find out what you can do to fight back!

Why Side Effects: The Chemical Structure of Prednisone

As an introduction into the reason why many of the side effects in men appear, we need to understand the basic science. Prednisone isn’t alone in the body. It looks like other structures, other signals, called hormones.

You see prednisone there below, and in the second image, below, on the left (cortisol). On the right in the second image below, you can see all the different hormones that are in our bodies, including steroid hormones.

Prednisone is mimicking cortisol on the top, or our “wear and tear” hormone, that affects our ability to deal with stress.

On the bottom, there are the sex hormones:

  • The female hormones, progesterone and estrogen
  • The male hormone, testosterone
  • They all look pretty similar: they all have these four six-sided circles  that connect and kind of match each other.

Prednisone mimics cortisol and sex steroid hormones like testosterone, estradiol, and progesterone. This explains many of the prednisone side effects in men.

Prednisone Chemical Structure is similar to Testosterone, Estrogens and Progesterone
prednisone mimics cortisol and testosterone

Our bodies can get confused when taking prednisone. It can interfere with the normal rhythm of these hormones and the cascade, how they switch between structures, can be messed up. That’s where the side effects come from.

Prednisone Side Effects in Men

Hormonal Issues

I’ll explain how prednisone affects men differently than women by first showing how changes in female hormones cause side effects, then how changes in male hormones cause prednisone side effects.

Female Hormones: Progesterone and Estrogens

  • Prednisone Side Effects from Female Hormones:
    • Breasts: bigger, tender
    • Penis: smaller
    • Hot flashes
    • Mood like a menopausal woman

Because prednisone looks like those female hormones progesterone and estrogen, some men report changes in their physical anatomy.

Breast Changes from Prednisone

This is very rare. Don’t think, “Oh no, my doctor prescribed prednisone. I’m going to get man boobs!” No; this is very, very rare. It’s possible that a man could have changes in his breasts.

Male breasts might become tender. They might get a little bit bigger. Often prednisone causes weight gain and fat redistribution, and that might happen in the breast area.

Penis Changes from Prednisone

Two men report that their penis is smaller while taking prednisone than it usually is. Usually, these things go back to normal when you stopped taking prednisone. Read below for details about sperm.

Like a Menopausal Woman

So even in men, hot flashes are possible. You think, “I’m a man, there’s no way I’m going to feel like I’m in menopause.” Prednisone can make you feel like you’re a menopausal woman and you can get hot flashes with the sweating, the redness, the flushing, and even the mood changes.

Testosterone-Related Changes from Prednisone

Because prednisone is structurally similar to testosterone, these next side effects are related to the level of the male hormone, testosterone, changing while on prednisone.

  • Male Hormones
    • Voice
    • Sperm
      • Dysmotility
      • Lower count
    • Sex Drive
    • Acne
Voice Changes from Prednisone

The male hormones like testosterone can change things like your voice. So you might get a little huskier voice than usual. It might give you a higher voice than usual. It’s just unpredictable and rare, but it’s possible.

Sperm & Fertility Changes from Prednisone

Either the sperm can have dysmotility, which means they can’t swim as well. They’re just not built to swim quite as well as they’re used to. Or the sperm might have a lower count. So it’s possible to have a little bit less fertility while on prednisone because essentially there’s not the right balance of hormones of the estrogen and the progesterone to the testosterone in the body to create the most fertile environment.

Sex Drive While on Prednisone

Men in support groups have shared that they have less sex drive at high doses of prednisone. They report that as the dose of prednisone gets lower, their drive tends to recover as well.

Acne from Prednisone

Prednisone is well-known for causing many skin issues. One of those may be hormonally-related to the testosterone, being acne.

Muscle Wasting from Prednisone

Prednisone is NOT an anabolic steroid, which would build muscles. Instead, it causes muscles to waste away. While not necessarily a male-specific side effect, for some men, this can be disheartening.

One man called to let me know that he was a competitive bodybuilder, and since taking prednisone, he’d lost so much muscle mass, he could no longer compete. I recommended he continue weight lifting (under his doctor’s supervision) and eat a diet rich in collagen and protein.

Here are some collagen supplements I recommend.

Psychiatric Side Effects

  • Men are less likely to have psychiatric side effects of prednisone.
  • But when they do, men are more likely to have these psychiatric side effects:
  • ‘Roid Rage

Mood changes and psychiatric side effects of prednisone are different in men and women. Men often have less overall psychiatric side effects than women. But when men do get psychiatric side effects, they can be more extreme.

prednisone side effetcts in men

Men are more likely to become psychotic, to have mania, and feel totally unlike themselves. 

Another possibility is a kind of crazy delirium; to just be incoherent and babbling and not “with it” at all.

Just not feel like your normal self. That is more typical in men than in women. And all of those changes are more likely when you’re on a higher dose.

So don’t worry: It’s not you. It’s the medicine. It’s a side effect!

So don’t feel like, “Oh no, I am going crazy!”

Because this medicine is making you feel crazy. While you do need to get legitimate treatment for it, take comfort that it’s not you. So don’t feel like you have a personal failing in any way; give yourself grace, get the help you need. And it will go away most of the time when you stop taking prednisone.

Read More…


  • Alopecia: Hair Loss
  • Hirsutism: facial hair changes

Now, what about hair? Hair loss is more common in women than men but it is possible in men as well.

A change in facial hair can happen in men as well.

Women notice that they start getting facial hair that they never had before. So it’s possible because of those strange hormonal changes that men can also have facial hair changes.


One of the most important things you can do for long-term consequences is preventing bone loss. Prednisone is the #1 drug that causes osteoporosis. According to the doctors who prescribed prednisone the most, anyone who’s taking doses over 7.5 mg a day should be taking vitamin D and calcium.

Men have less osteoporosis than women than post-menopausal women, but it’s still likely.

Avascular necrosis, a terrible prednisone side effect causing bone death in the hip, can happen to anyone, young or old, male or female. So if you’re ever having hip pain that wasn’t there before, make sure you talk to your doctor about it.

What can you do about all of these side effects?

I’ve got my best tips for you on the Prednisone Checklist.  Get the checklist by signing up in the form below!

Free Prednisone Checklist

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Dr. Megan Milne, PharmD, BCACP

Dr. Megan Milne, PharmD, BCACP, is an award-winning clinical pharmacist board certified in the types of conditions people take prednisone for. Dr. Megan had to take prednisone herself for an autoimmune condition so understands what it feels like to suffer prednisone side effects and made it her mission to counteract them as the Prednisone Pharmacist.

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