Well-being and body-related insecurity are associated with cycling status in anabolic-androgenic steroid users

Anabolic-androgenic steroid (AAS) use has been associated with adverse psychological outcomes, yet little is known about how psychological functioning varies across on- and off-cycle phases within individuals. Adult male AAS users (n = 19) and weightlifting controls (WLC; n = 25) completed biweekly assessments of well-being (WHO-5), psychological distress (HSCL-10), and ten AAS-related symptoms over 6 months. AAS observations were classified as on-cycle (≤ 21 days since last use) or off-cycle (> 21 days), with hormonal measures available in a subset.

Exploratory analyses indicated several phase-related differences, with the most consistent findings showing greater body-related insecurity (“feeling small”) and lower well-being during off-cycle periods. These patterns were also supported by within-subject sensitivity analyses, although only 10 participants contributed observations from both phases. Higher anxiety scores were also found in both on- and off-cycle AAS observations than in WLC observations, with no statistically significant difference between cycle phases.

Other findings included higher levels of paranoid thoughts and depressive symptoms during off-cycle periods, but these were less consistent across analyses. Little evidence was found for cycle-related changes in impulsivity, irritability, or short temper. These preliminary findings require replication in larger samples.

The authors gratefully acknowledge Lisa Evju Hauger, Anne Ravndal, Ingunn Bjørnebekk, Nadine Farnes and Franziska Rothe for their contribution to participant recruitment and data collection. This research was funded by Stiftelsen Dam through the Brain Council (Grant No. 453874), and South-Eastern Norway Regional Health Authority (Grant No. 2017025, and 2026056 [to Astrid Bjørnebekk]). Anabolic Androgenic Steroid Research Group, Section of Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway Astrid Bjørnebekk, Anna Maria Kaźmierowska, Jonas Slettemark Juel & Morgan Scarth Hormone Laboratory, Department of Medical Biochemistry and Endocrinology and Metabolism Research Group, Oslo University Hospital, Oslo, Norway Institute of Clinical Medicine, University of Oslo, Oslo, Norway Correspondence to Anna Maria Kaźmierowska.

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