Massive multiple-input multiple-output (MIMO) promises improved spectral efficiency, coverage, and range, compared to conventional (small-scale) MIMO wireless systems. Unfortunately, these benefits come at the cost of significantly increased computational complexity, especially for systems with realistic antenna configurations. To reduce the complexity of data detection (in the uplink) and precoding (in the downlink) in massive MIMO systems, we propose to use conjugate gradient (CG) methods. While precoding using CG is rather straightforward, soft-output minimum mean-square error (MMSE) detection requires the computation of the post-equalization signal-to-interference-and-noise-ratio (SINR). To enable CG for soft-output detection, we propose a novel way of computing the SINR directly within the CG algorithm at low complexity. We investigate the performance/complexity trade-offs associated with CG-based soft-output detection and precoding, and we compare it to exact and approximate methods. Our results reveal that the proposed method outperforms existing algorithms for massive MIMO systems with realistic antenna configurations.