The risks associated with taking anabolic steroids are extensive and very well documented, with reported health problems ranging from infertility and erectile dysfunction to addiction and baldness. But despite these risks, steroid use is on the rise, especially in the bodybuilding scene, where they’re often known as ‘juice’, ‘gear’, ‘arnolds’, ‘gym candy’, ‘roids’, ‘hype’, or ‘stackers’. Now, a new study has found a strong link between a history of anabolic steroid use and psychopathic tendencies, such as risk-taking and aggression.

Do steroids turn bodybuilders into psychos or is it the other way around?

Steroids have been a part of the fitness world for decades, with some research estimating as many as 4 million Americans have used some sort of “anabolic-androgenic steroid,” but the rise of social media and fitness influencers may have exacerbated drug use in the gym as more and more men feel insecure about their bodies.

Anabolic steroids are artificial testosterone, the primary sex hormone in males, which plays a key role in the development of male reproductive tissues such as the testes and prostate, as well as promoting muscle and bone mass. Women also have testosterone in their bodies, but in much smaller amounts, just like men have estrogen in smaller amounts than women.

Steroids are sometimes used to treat hormonal problems, delayed puberty, and muscle loss owing to some crippling diseases. But the vast majority of people who use anabolic steroids employ them for non-medical reasons, mostly in the gym to dramatically improve their gains. The kind of anabolic steroids taken by bodybuilders, which are illegal without a valid prescription in many countries, including the US and the UK, can be 10 to 100 times more potent than medical-grade steroids.

Bodybuilders take these drugs to train harder and longer. The steroids also help them recover much faster from strenuous exercise, so they can hit the gym hard again the next day. The effect of synthetic testosterone in high doses is so strong that people can gain significant muscle mass even without training.

However, the downsides are just not worth it. Anabolic steroids are mostly used by men, which risk high blood pressure, heart problems and liver disease, including heart attack and cancer, kidney damage, low sperm count and infertility, shrinking of testicles, breast growth, and baldness. Prolonged use often leads to addiction, which is very hard to scrub off. Anabolic steroid withdrawal causes fatigue, loss of appetite, trouble sleeping, decreased sex drive, depression, and constant craving for steroids.

Now, a new study suggests that steroid use may also exacerbate psychopathic tendencies, which could partially explain the heightened aggression typically associated with ‘roid heads’.

Researchers at New York University surveyed 492 male bodybuilders from the U.S. with an average age of 22. The participants were asked to report any past use of anabolic steroids, or Appearance and Performance Enhancing Drugs (APEDs), as well as their training routine and dietary habits. Additionally, the men had to fill out a questionnaire in which they self-reported their history of psychological states, such as their frequency of depressive episodes, mood swings, and aggressive behavior, as well as whether they had engaged in risk-taking behaviors, such as unprotected sex, drinking alcohol, and using other drugs without a prescription.

Bodybuilders with a history of steroid use were more likely to score high on psychopathy, exhibit substance use or sexual risk-taking, have anger issues and depressive symptoms, behave in an impulsive manner, and exhibit general emotional stability issues when compared to the bodybuilders who had never used APEDs. Every additional type of APED used raised the likelihood of psychopathy traits by 19%.

These findings, the researchers argue, provide strong evidence that steroid use increases the risk of developing psychopathy. But since this is a cross-sectional study, it could be very well that people who already have psychopathic traits in the first place may be more likely to be drawn to anabolic steroids.

Cheating is a common psychopathic trait, for instance, and anabolic use is frowned upon as an unethical shortcut by ‘clean’ bodybuilders. Psychopathy is also connected with enhanced risk-taking, which makes such individuals prone to use and abuse all manner of substances, anabolic steroids included. What’s more, the participants involved in the study who said they’ve never used steroids but considered trying them scored higher on psychopathy traits than those with no history of drug use and no intention of ever trying such performance-enhancing substances.

“This study is among the first to directly assess psychopathy within anabolic–androgenic steroid (AAS) users. Our results on risk-taking, anger problems, and physical problems are consistent with prior AAS research as well as with existing frameworks of AAS use as a risk behavior. Future research should focus on ascertaining causality, specifically whether psychopathy is a risk associated with or a result of AAS use,” the authors wrote in their study.

The researchers say that psychopathic tendencies could thus explain the connection between steroids and anger issues, although longitudinal studies might be able to shed more light and untangle the complicated web of causality.

The findings appeared in the journal Scientific Reports.