Metabolic & Cardiometabolic
anabolic-androgenic steroids worsens cognitive function
In plain terms: Do anabolic steroids impair cognitive function?
Part of: 💊 anabolic-androgenic steroids
Leans yes — long-term high-dose users show poorer cognition and brain changes on imaging, so the evidence points to real cognitive harm, with the caveat that much of it comes from a single research group.
🧭 Read this score with how it was built in mindStudies we had treated as independent turned out to share a research group
Four studies filed under separate labels are all from the same Oslo research group studying the same population of weightlifters.
📅 Last reviewed: 2026-07-14 ⓘ
Evidence ladder
How far up the ladder this claim has climbed. A high consensus on a low rung means "consistent so far," not "proven in people."
Top evidence so far: Population patterns (Observational)
How the studies fall
What the evidence shows
Causal-review pass (2026-08-14) — `causal_basis: association-only`. Cannot be randomised (dosing healthy people with supraphysiological androgens for a cognitive endpoint is not an ethical trial), so every human appraisal is observational and self-selected.
The evidence (14)
| Source | Grade | Stance | Quality | Finding |
|---|---|---|---|---|
| Buhl LF, Lehmann Christensen L, Diederichsen A, Lindholt JS, Kistorp CM, Glintborg D, Andersen M, Frystyk J 2024 · BMJ open | observational | tested-null | low | Human protocol paper (FIDO-DK, Denmark) for a cross-sectional cohort study of illicit AAS users vs matched controls; cognitive function is listed among planned mental-health outcomes assessed via validated questionnaires, but this is a stud |
| Bjørnebekk A, Scarth M, Neupane SP, Westlye LT, Hullstein IR, Thorsby PM, Halvorsen B 2023 · Neuroendocrinology | observational | supports | low | High-dose androgen use was associated with reduced brain-derived neurotrophic factor, a biomarker linked to cognitive function. |
| Bjørnebekk A, Kaufmann T, Hauger LE, Klonteig S, Hullstein IR, Westlye LT 2021 · Biol Psychiatry CNNI | observational | supports | moderate | Prolonged AAS use was associated with accentuated (deviant) brain aging on MRI-based age prediction. |
| Tungesvik HM, Padrela B, Groote I, Bjørnerud A, Geier OM, Hisdal J, Mutsaerts HJ, Bjørnebekk A 2025 · Drug Alcohol Depend | observational | mixed | moderate | Long-term AAS users showed altered cerebrovascular indicators versus non-using weightlifters, though cerebral blood flow findings were not uniformly impaired. |
| Bjørnebekk A, Walhovd KB, Jørstad ML, Due-Tønnessen P, Hullstein IR, Fjell AM 2017 · Biol Psychiatry | observational | supports | moderate | Long-term AAS users showed thinner cortex and smaller subcortical volumes, a candidate neural substrate for cognitive deficits. |
| Coliță D, Zăgrean L, Coliță CI, Hermann D, Popa-Wagner A 2025 · Current health sciences journal | observational | supports | low | Human-focused narrative review of doping/AAS in elite athletes: cites behavioral and neuroimaging evidence that prolonged AAS use impairs visuospatial memory, executive functioning, and attentional control, linked to prefrontal-limbic alter |
| Kaufman MJ, Hudson JI, Kanayama G, Muse S, Schnabel J, Sokoll R, Pope HG 2024 · Am J Drug Alcohol Abuse | observational | contradicts | moderate | Cross-sectional comparison of 76 middle-aged weightlifters (age 37-60): 51 with at least 2 years cumulative supraphysiologic AAS use vs 25 non-users, CANTAB battery (visuospatial and verbal memory, executive function, emotion recognition, response inhibition). 'Contrary to our a priori hypotheses, we did not detect any statistically significant group differences on any test after False Discovery Rate correction' (4 of 56 comparisons nominal P<0.05, none <0.01); no association with cumulative duration of use. Equivalence-style bound: effects larger than d = 0.56 excluded. Contrasts with the same McLean group's earlier younger cohort, which found visuospatial deficits. Small n, self-selected users. (Prior extract stated the opposite result.) |
| Zelleroth S, Stam F, Nylander E, Kjellgren E, Gising J, Larhed M, Grönbladh A, Hallberg M 2024 · Hormones and behavior | animal | supports | moderate | Animal (male rat) study comparing decanoate esters of nandrolone, testosterone, and trenbolone at supratherapeutic doses (15 mg/kg): only nandrolone decanoate caused impaired recognition memory on the novel-object-recognition test, indicati |
| Kanayama G, Kean J, Hudson JI, Pope HG 2013 · Drug Alcohol Depend | observational | mixed | moderate | Long-term AAS users showed deficits on visuospatial memory but performed comparably on several other cognitive measures. |
| Bjørnebekk A, Westlye LT, Walhovd KB, Jørstad ML, Sundseth ØØ, Fjell AM 2019 · Neuropsychology | observational | supports | moderate | Long-term AAS-exposed weightlifters showed poorer cognitive performance with correlated structural brain differences versus non-exposed weightlifters. |
| Hauger LE, Westlye LT, Fjell AM, Walhovd KB, Bjørnebekk A 2019 · Addiction | observational | mixed | moderate | AAS-dependent users showed greater structural brain differences than non-dependent users, consistent with dose/exposure-related brain effects. |
| Mhillaj E, Morgese MG, Tucci P, Bove M, Schiavone S, Trabace L 2015 · Front Neurosci | observational | mixed | low | Animal/in-vitro work indicates supraphysiologic AAS can trigger neuronal apoptosis and reward-system changes, a mechanism for cognitive impairment. |
| Çınaroğlu M et al 2025 · Frontiers in psychiatry | observational | supports | moderate | Human observational study (n=285 gym-goers: 87 long-term PED/AAS users, 95 short-term, 103 non-users): long-term users showed significantly poorer Stroop interference (executive function) than short-term users/non-users, alongside higher de |
| Kaufman MJ, Janes AC, Hudson JI, Brennan BP, Kanayama G, Kerrigan AR, Jensen JE, Pope HG 2015 · Drug Alcohol Depend | observational | supports | moderate | Long-term AAS users displayed cognitive dysfunction alongside brain abnormalities on imaging. |
Disagree, or know a study we missed?
We grade by evidence, not opinions. The way to weigh in is to point us to a study we haven't cited (check the evidence table above first), or to flag a problem with one we have. Every submission is reviewed; if it holds up, the grade updates and shows in Science Changes Its Mind.
Opens a short form. You'll sign in with Google so submissions are tied to a real account — we don't display your identity, and we only accept a link we can verify (PubMed, DOI, ClinicalTrials.gov).
Educational only, not medical advice. Grades and scores reflect published evidence weighted by study design and quality; see the methodology.