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This challenging case suggests that effects of anabolic steroids on the female voice previously thought to be permanent could potentially change years after withdrawal. Steroid treatment The researchers note that this research has been controversial: some researchers argue that the findings show it's not only natural estrogen that is at risk, and that the women who used steroids before their voices began to change "are just as vulnerable a woman today to those who started taking them years earlier". However, the study is not without support. Professor Richard Evans, at the University of Toronto, and colleague, Dr Elizabeth McNeil-Kellogg, and colleagues, have reported that the long-term, low dose use of testosterone in postmenopausal women can cause hair loss, and may also cause a reduction in libido. These changes have not been observed in women who were taking other types of testosterone - so the findings may have more to do with testosterone effects than steroid treatment. How long should steroid treatment take? The study suggests that long-term steroid treatment may change the vocal quality for some people for as long as five years after stopping, but some people might need to take longer. As well as the use of a drug, many women prefer to go for advice about how to manage their voice over the internet. You could get treatment from your GP, or your local vocal health clinic. The researchers say there aren't any other studies of long term effects on women's voices from steroid treatment - though, in an email to NHS Choices, the British Lung Foundation said they have experienced some adverse effects from testosterone, including "loss of hearing and shortness of breath" in one man. "There are also some short-term side effects of testosterone treatment which can include low libido, headaches, low blood counts and irregular heartbeat," it said. This was "not something which happens often for long-term use," it added. What is the safety of steroid treatment? The researchers say there have been only a handful of cases of harm in other parts of the world related to steroid use: a 25 year old Australian died of respiratory failure while taking steroids, and in 2010 in Thailand a woman died from a blood clot in her lung. However, there are currently no controlled studies involving large numbers of people. Professor Evans, in an email to NHS Choices, said: "The risk of hearing loss, heart disease and death from any drug use or overdose was small and unlikely to be the result of long term use. "The risks of sexual disease and suicide also appear unlikely to be from long Related Article: