Psychological and Behavioural Effects of Endogenous Testosterone Levels and Anabolic-Androgenic Steroids Among Males: A Review

by Michael S. Bahrke, Charles E. Yesalis III, and James E. Wright

10. Conclusions

The few investigations conducted, primarily in prisoner populations, have shown a significant positive relationship between endogenous testosterone levels and aggressive behaviour. However, the questions of the extent of the relationship and of the interaction between testosterone and aggression remain unanswered. Do elevated testosterone levels result in more aggressive behaviour or does more aggressive behaviour cause testosterone levels to increase? In addition, what effect does the interaction of physical activity and an emotionally-charged environment (which not only reinforces but demands high levels of direct physical, and often, verbal aggression) have on testosterone production and behaviour? We do not even know the frequency or extent to which males become androgen-deprived as they age or the consequences for longevity or quality of life. Future research will undoubtedly need to examine the positive psychological effects of anabolic-androgenic steroid use as has occurred in the majority of patient samples. There may be significant numbers of individuals whose mental health has been improved through anabolic-androgenic steroid use.

Both medical and legal concerns regarding the psychological and behavioural effects of anabolic-androgenic steroids have been raised. Unfortunately, objective evidence documenting the short term psychological and behavioural changes accompanying and following anabolic-androgenic steroid use by athletes is extremely limited and is inconclusive. As indicated, many of the studies in this area suffer from methodological inadequacies such as small sample size, use of nonstandardised psychological inventories, and lack of appropriate control groups, among others. No acute adverse effects on mood or behaviour have been observed in individuals self-administering or clinically treated exclusively with non-17µ -alkylated anabolic-androgenic steroids, suggesting that these effects may be unrelated to androgenic actions but rather the result of nonandrogenic properties arising from the 17µ -alkylation and/or from binding to other than androgen receptors (Bardin et al. 1990; Friedl 1990; Janne 1990), or from interactions with other drugs. As Yesalis et al. (1989b,c, 1990a,b) and Cicero and O’Connor (1990) have pointed out, extremely little is known about the long term health impact of anabolic-androgenic steroids and their interactions with other drugs including drugs of abuse. Consequently, the need for much additional research is strongly indicated.

Although some athletes and coaches believe that anabolic-androgenic steroids exert a positive effect by enhancing performance through altered psychological states, others point out the potential negative effects of violent and aggressive behaviour. With present estimates of a million or more users in the US, an extremely small percentage of anabolic-androgenic steroid-using athletes appear to experience mental disturbances which result in their seeking clinical treatment, and of those who do, some may already suffer from existing mental health and/or substance abuse problems. At this point a cause-effect relationship has yet to be established. Moreover, of the seemingly small population of individuals who do experience significant psychological and behavioural changes, most apparently recover without legal or other problems when the use of androgens is terminated.

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Originally appearing in Sports Medicine 10(5) 303-337. 1990.

Copyright © 1990 by Adis International Limited. All rights reserved. Reprinted by MESO-Rx with permission.  Any duplication of this document by electronic or other means is strictly prohibited.