Font size Font size smaller Font size normal Font size bigger

Testosterone, anabolic steroids and aggression

9 February 2023

Among doping substances, testosterone and anabolic steroids in particular are often associated with aggressive and impulsive behaviour, or so-called roid rage. Anabolic steroids, aggressive behaviour and violence are linked, but the causality is not clear. In animal studies in particular, testosterone has been found to be clearly linked to aggression. For example, removing an animal’s testicles may remove the aggression altogether. 

Studies reveal that anabolic steroid users describe irritability, aggression and hostility as the main psychological side effects. In some cases, the use of anabolic steroids has lead to violent behaviour, even when the person has no history of such behaviour. In addition, there is a higher incidence of intimate partner violence and criminal activities among anabolic steroid users.  

High doses of anabolic steroids potentially increase aggressive behaviour, especially in combination with intoxicants. Dependence on anabolic steroids appears to increase the risks significantly. However, it is important to highlight that anabolic steroid users react in individual ways, some more strongly than others. In other words, there is a lot of individual variation. 

Potential mechanisms of action 

It has been suggested that low levels of serotonin and high levels of testosterone in the central nervous system significantly influence a person’s aggressive behaviour. Testosterone appears to affect serotonin receptor activity in a way that has a direct impact on aggression, fear and anxiety. Testosterone also affects behaviour and aggression directly via the androgen receptor, but the exact mechanisms of action remains unclear. 

However, aggression and aggressive anti-social behaviour, to which criminal behaviour is also linked, are the sum of many factors. Hormones do not work in isolation; their effects depend on environmental factors. The effects hormones have are influenced by factors such as heredity, the social environment, psychological factors, brain structure and neurochemistry. It is too simplistic to say that aggressive behaviour is caused solely by one thing or one chemical and its effect on the brain. Testosterone and anabolic steroids play a role in aggression, but they alone do not cause aggression in humans.

Recent studies have found that, especially at high doses and over long periods of time, anabolic steroids cause structural changes in the brain, such as thinning of the cerebral cortex. Giant doses of testosterone and anabolic steroids have neurotoxic and neurodegenerative effects; in other words, they have a toxic and degenerative influence on nerve cells. Other possible effects on the brain include increased inflammation and oxidative stress, as well as circulatory disorders.These may partly explain changes in impulsivity, aggression and the ability to recognise emotions. 

On the other hand, one study found that a dose of testosterone can also cause a rapid (60 min) increase in aggression in dominant and impulsive men. Another study observed this effect within 30 minutes of taking the dose. 

Underlying factors in aggression 

People who have antisocial, aggressive and impulsive characteristics to begin with, as well as a tendency towards risky behaviour and substance abuse are more likely to start using anabolic steroids. Indeed, users’ so-called roid rage is a a combination of the effects of doping substances, the use of alcohol, drugs and medication, and a lifestyle that emphasises tough masculinity. One study found that testosterone increases aggression in men who have a high-risk personality profile (including high dominance and low self-control). 

In other words, if a person has no tendency to be aggressive, impulsive and violent and they don’t use other intoxicants, while keeping their dosage of anabolic steroids moderate, it is very unlikely that they will experience roid rage.  

However, it should be noted that anabolic steroids, especially in high doses, may increase pre-existing aggressive and impulsive behaviour. Mania-like symptoms have also been observed in healthy men if their doses of anabolic steroids have been high enough.

Positive and negative effects 

The use of anabolic steroids has been shown to have both positive and negative effects on the user’s mood. Usually at the beginning of use, the user’s self-esteem improves, their feelings of self-worth are enhanced and their concentration increases. As use continues, and especially when it stops, the negative effects often begin to outweigh the positive ones. Users may experience depression, mood swings, aggression, sleep disturbances and anxiety, among other symptoms. 

Depressive symptoms in anabolic steroid users may be caused by the shutdown of the body’s endocrine system, but studies have also found that concerns about one’s own body image contribute to depression. Anxiety related to one’s body image may predispose a person to develop a steroid dependence, to consume higher doses and indulge in other risk behaviours such as alcohol and drug use. 

Moderate doses of testosterone and dihydrotestosterone may even improve brain health. However, high doses of synthetic anabolic steroids do not have this effect. Natural levels of testosterone are beneficial for a person’s brain and mental health.

Joni Askola, Master of Health Science, Dopinglinkki


Birger M, Swartz M, Cohen D, Alesh Y, Grishpan C, Kotelr M. Aggression: The testosterone-serotonin link. IMAJ. 2003; 5:653–658

Bjørnebekk A, Kaufmann T, Hauger L, Westlye L. Long-term anabolic androgenic steroid use is associated with deviant brain aging. Biol Psychiatry Cogn Neurosci Neuroimaging. 2021;6(5):579-589

Bjørnebekk A, Westlye LT, Walhovd KB, Jørstad ML, Sundseth ØØ, Fjell AM. Cognitive performance and structural brain correlates in long-term anabolic-androgenic steroid exposed and nonexposed weightlifters. Neuropsychology. 2019;33(4):547–559

Blankers S, Galea L. Androgens and adult neurogenesis in the hippocampus. Androg Clin Res Ther. 2021;2(1):203-215

Bontempi L, Bonci A. µ-Opioid receptor-induced synaptic plasticity in dopamine neurons mediates the rewarding properties of anabolic androgenic steroids. Sci Signal. 2020;13(647): eaba1169

Carré J, Geniole S, Bird M, Videto A, Bonin P. Exogenous testosterone rapidly increases aggressive behavior in dominant and impulsive men. Biol Psychiatry. 2017;82(4):249–256

Chegeni R, Notelaers G, Pallesen S, Sagoe D. Aggression and psychological distress in male and female anabolic-androgenic steroid users: a multigroup laten class analysis. Front Psychiatry. 2021; 12:629428

Chegeni R, Pallesen S, McVeigh J, Sagoe D. Anabolic-androgenic steroid administration increases self-reported aggression in healthy males: a systematic review and meta-analysis of experimental studies. Psychopharmacology. 2021;238(7):1911-1922

Christoffersen T, Andersen J, Dalhoff K, Horwitz H. Anabolic-androgenic steroids and the risk of imprisonment. Drug Alcohol Depend. 2019; 203:92-97

Corsini W, Esteves A, Rossi Jr W, de Almeida Hermes T, Damião B, Rodrigues M. Association between neuronal degeneration and supraphysiological doses of two types of anabolic steroids in rat brain. 2022; 188:109121. Steroids

Cunningham R, Lumia A, McGinnis M. Androgen receptors, sex behaviour and aggression. Neuroendocrinology. 2012:96(2):131-140

Ganson K, Jackson D, Testa A, Nagata J. Performance-enhancing substance use and intimate partner violence: a prospective cohort study. J Interp Viol. 2022:0(0):1-22

Geniole S, Procyshyn T, Marley N, Ortiz T, Bird B, Marcellus A, Welker K, Bonin P, Goldfarb B, Watson N, Carré J. Using a Psychopharmacogenetic Approach To Identify the Pathways Through Which—and the People for Whom—Testosterone Promotes Aggression. Psychol Sci. 2019:30(4):481-494

Griffiths, S, Brendan J, Degenhardt, L   Murray, S, Larance, B. Appearance concerns are uniquely associated with the severity of steroid dependence and depression in anabolic–androgenic steroid users. Drug and Alcohol Review. 2018 37 (5), 664-670

Haug E, Mørland J, Olaisen B, Myhre K. Androgenic-anabolic steroids (AAS) and violent behaviour. Report from Norwegian knowledge centre for health services. No. 04–2004

Hauger L, Sagoe D, Vaskinn A, Arnevik E, Leknes S, Jørstad M, Bjørnebekk A. Anabolic androgenic steroid dependence is associated with impaired emotion recognition. Psychopharmacology. 2019;236(9):2667–2676

Hauger L, Westlye L, Fjell A, Walhovd K, Bjørnebekk A. Structural brain characteristics of anabolis-androgenic steroid dependence in men. Addiction. 2019;114(8):1405–1415

Kaufman MJ, Janes AC, Hudson JI, Brennan BP, Kanayama G, Kerrigan AR, Jensen JE, Pope HG Jr.Brain and cognition abnormalities in long-term anabolic-androgenic steroid users. Drug Alcohol Depend. 2015; 152:47–56

Middleman A, DuRant R. Anabolic steroid use and associated health risk behaviours. Sports Mes. 1996;21(4):251–5

Neave N. Hormones and behaviour: A psychological approach.  2008; 22:1. Cambridge University Press

Nelson B, Hildebrandt T, Wallisch P. Anabolic-androgenic steroid use is associated with psychopathy, risk-taking, anger, and physical problems. Sci Rep. 2022;12(1):9133

Nelson R, Tranor B. Neural mechanisms of aggression. Nature Reviews Neuroscience. 2007; 8:536–546

Pomara C, Neri M, Bello S, Fiore C, Riezzo I, Turillazzi E. Neurotoxicity by synthetic androgen steroids: oxidative stress, apoptosis, and neuropathology: a review. Current neuropharmacology. 2015; 13:132-145

Pope HG Jr, Kouri EM, Hudson JI. Effects of supraphysiologic doses of testosterone on mood and aggression in normal men: a randomized controlled trial. Arch Gen Psychiatry. 2000;57(2):133–40

Sagoe D, Mentzoni R, Hanss D, Pallesen S. Aggression is associated with increased anabolic-androgenic steroid use contemplation among adolescents. Substance Use & Misuse. 2016;51(11):1462¬1469

Salasuo M, Piispa M. 2012. Kuntodoping: Näkökulmia dopingaineiden käyttöön huippu-urheilun ulkopuolella. Nuorisotutkimusseura/ Nuorisotutkimusverkosto, julkaisuja 120

Scarth M, Bjørnebekk A. Androgen abuse and the brain. Curr Opin Endocrinol Dioabet. Obesity. 2021;28(6):604-614