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
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