Steroids in sports – how much of an edge?

Dr. Andrew Chappell BSc (hons), MSc, PhD

Sports physiologists, psychologists, coaches and the media often talk about the differences between winning and losing being only a couple of percent. But how much of an edge do anabolic steroids really give you? Secondly, once you’ve taken these drugs how long do their effects last? The short answer to that question to the first question is “a lot”. In fact even the most naturally gifted and diligent athlete can be outperformed by those less talented and committed should they decide to go down the performance enhancing route. For those taking performance enhancing drugs the goal posts are well and truly shifted, you’re not even running on the same track. With that in mind trainers and athletes should always be prepared to interpret the training protocols and dietary regimes of steroid users with caution.

The study of anabolic steroids is fraught with difficulty, not only do researchers have to obtain ethical consent to administer compounds that could be potentially harmful, but subject recruitment is problematic, studies in free living individuals are challenging and dosages rarely match the supraphysiological dosages commonly used by athletic and bodybuilder populations. Observational studies and retrospective cohorts are compounded by the problems that persist with such research. However, even where minimal dosages (50 – 100 mg of testosterone gel per week) are administered studies have reported significant increases of more than 2 kg more lean body mass gain compared to their placebo receiving peers in the same period (Kvorning et al. 2013). Anabolic steroids however are not without side effects and again even minimal dosages (a single shot 1200 mg of testosterone ever 12 weeks) have been shown to lower HDL Cholesterol and increase total cholesterol (Pelusi et al. 2010). Left ventricle hypertrophy, ventricle arrhythmias and remodelling of the heart muscle have also been reported amongst steroid abusers (Birzniece 2015). These factors and more contribute to the heart disease and higher deaths seen in professional bodybuilders and wrestlers, although a lifestyle synonymous with substance abuse should also not be excluded.

For muscle gain, anabolic steroids are extremely effective and many are willing to forgo the risks for the benefits of increased lean muscle mass and strength. The effectiveness of anabolic steroids is perhaps highlighted best by Bhasin et al. (1996). In this study subjects who received testosterone enanthate (600 mg per week for 10 weeks) and no exercise accrued 3.2 kg of fat free mass, compared to 1.9 kg in those weight training without testosterone. Those assigned to weight training and testosterone group gained on average 6 kg more fat free mass. Those in the no exercise and testosterone group also significantly increased their bodyweight, triceps and quadriceps circumference, and squat 1 RM despite doing no resistance training. Energy intake (36 kcal / kg / bw) and protein (1.5 g / kg / bw) were standardised and compliance was assessed with food diaries. Thus it is possible to see that even with minimal intakes and no exercise a person can surpass their peers fully committed to training. While the combination of weight training and steroids resulted in three times the muscle mass gains.

The effects of steroids may also persist long after the date the athlete has taken them. Anabolic steroids work by acting on androgen receptors expressed by myonuclei and muscle satellite cells, or by directly by acting independently of androgen receptors, both these pathways result in an increase in protein synthesis and the subsequent increase in muscle mass (Kadi 2008). Steroids have been shown to increase the number of muscle satellite cells and myonuclei, which play important roles in incorporating new protein into muscle fibres. This increase in the number of satellite cells which essentially act as workers within the muscle cells have been shown to persist for several years after a person ceases use of steroids (Kadi 2008). Furthermore, the number of satellite cells obtainable from steroid use is beyond those numbers achievable from the natural athlete. Athletes may still be deemed to have an unfair advantage when they have returned to “clean” training. Indeed studies in rats have found that positive adaptations from testosterone therapy are still present 3 months after their use is ceased. Given the animals relatively shorter lifecycle (between 1- 3 years) the same 3 month period is thought to be approximately equivalent to 10 years in humans (Harridge & Kadi et al. 2014). Although results from animal experiments should always be interpreted with caution, particularly when making extrapolations on this sort of time scale. There is convincing evidence that steroids can result in giving skeletal muscles “memory” which result in more adaptive responses when the drugs have worn off.

Thus any edge obtained from the use of steroids may persist over a lifetime, which raises questions about the current 2 year ban imposed by the IOC and WADA in athletics. This also raises questions about the grey area of prohormones and testosterone replacement therapy. Indeed, I’ll be watching this area closely over the next few years to see how it develops.


Bhasin. S., et al. (1996) The New England Journal of Medicine. 335, pp. 1 – 7.

Birzniece. V., et al. (2015) Internal Medicine Journal. 45, pp. 239 – 248.

Harridge. SDR., & Kadi. R.., (2014) Scandinavian Journal of Medicine & Science in Sports. 24 (6), pp. 869 – 870.

Kvorning. T., et al. (2013) Journal of the American Geriatrics Society. 61 (6), pp. 957–962.

Pelusi. C., et al. (2010) International Journal of Andrology. 34 (6), pp. 548 – 555.