Erectile dysfunction and related variables due to anabolic steroid use. A review of reviews

Anabolic androgenic steroids are synthetic substances that mimic testosterone, promoting increased strength and muscle mass. Although they were initially used to achieve an increase in sports performance, nowadays most users are not professional athletes. Their use can cause various adverse effects, but despite these, they continue to be used to improve aesthetic and performance aspects. The purpose of this review of reviews was to examine the effects of anabolic androgenic steroids on male erectile function and related variables.

A systematised literature review was carried out in Medline, Scopus, Pubmed, Cinahl, ScienceDirect, SPORTDiscus databases in July 2025. The search terms were 'Anabolic Androgenic Steroids', 'Erectile Dysfunction' and 'Adverse effect'. The A Measurement Tool to Assess Systematic Review (AMSTAR-2) was used to assess the methodological quality of the selected reviews.

Six systematic reviews were valid. Assessment of methodological quality using the AMSTAR-2 scale revealed that four reviews had critically low confidence, one review had low confidence, and one review had medium confidence. Despite methodological limitations, the reviews showed common findings associating prolonged use of anabolic androgenic steroids with the reduction in hormone levels, testosterone levels and reproductive function, leading to erectile dysfunction, in young adults (28-33 years) involved in weightlifting, powerlifting or bodybuilding.

The use of anabolic androgenic steroids appears to have a negative impact on erectile function and male reproductive health, with evidence of hypogonadism and hormonal alterations.