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.
📅 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 et al 2024 · study_type: observational | 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 |
| Bjornebekk 2023 · Neuroendocrinology | observational | supports | low | High-dose androgen use was associated with reduced brain-derived neurotrophic factor, a biomarker linked to cognitive function. |
| Bjornebekk 2021 · Biol Psychiatry CNNI | observational | supports | moderate | Prolonged AAS use was associated with accentuated (deviant) brain aging on MRI-based age prediction. |
| Tungesvik 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. |
| Bjornebekk 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 et al 2025 · study_type: mechanism | 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 2024 · Am J Drug Alcohol Abuse | observational | supports | moderate | Long-term supraphysiologic-dose AAS users showed poorer cognitive function than non-using weightlifters in middle age. |
| Zelleroth S et al 2024 · study_type: animal | 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 2013 · Drug Alcohol Depend | observational | mixed | moderate | Long-term AAS users showed deficits on visuospatial memory but performed comparably on several other cognitive measures. |
| Bjornebekk 2019 · Neuropsychology | observational | supports | moderate | Long-term AAS-exposed weightlifters showed poorer cognitive performance with correlated structural brain differences versus non-exposed weightlifters. |
| Hauger 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 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 · study_type: observational | 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 2015 · Drug Alcohol Depend | observational | supports | moderate | Long-term AAS users displayed cognitive dysfunction alongside brain abnormalities on imaging. |
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Educational only, not medical advice. Grades and scores reflect published evidence weighted by study design and quality; see the methodology.