# Anabolic steroids and erectile dysfunction: what a 2026 Danish study found > Men sanctioned for gym steroids in Denmark had triple the risk of starting ED meds: 24% vs 8% over 15 years. What the 2026 Danish cohort shows and limits. Published 2026-11-15 · Updated 2026-11-15 · revns editorial **Men sanctioned for using anabolic-androgenic steroids (AAS) in Danish public gyms were about three times more likely to start prescription erectile-dysfunction (ED) medication in the years that followed, according to a 2026 cohort study in the *Journal of Sexual Medicine*.** Researchers led by Magnus Middelboe at Copenhagen University Hospital matched each user to 50 men of the same age from the general population and followed national prescription records until the end of 2022. The adjusted hazard ratio for a first ED prescription was **3.2**, and the estimated **15-year risk of redeeming ED medication was 24% among users versus 8% among controls** (figures reported by PsyPost from the peer-reviewed paper). For someone who trains, the takeaway is blunt: illicit steroids are not a shortcut to a better body. They are linked to long-run sexual health problems that may need medical care. **TL;DR** | Point | Detail | | --- | --- | | Study type | Longitudinal cohort, Denmark, national registries | | Who was included | Males sanctioned by Anti-Doping Denmark in public gyms, 2006–2018 | | Comparison | 50 age-matched men from the general population per user | | Follow-up | To 31 December 2022 (about 10 years on average, per PsyPost) | | Main finding | **3.2×** higher adjusted risk of starting ED medication; **24% vs 8%** 15-year prescription risk | | Among those treated | Median **6** ED prescriptions for users vs **3** for controls (PsyPost) | | Mean age at sanction | About **27** (PsyPost) | | Causation? | No. Observational data; confounding possible | | Practical takeaway | Build muscle with training, food, sleep and [progressive overload](/blog/progressive-overload-in-plain-words), not illicit AAS | ## What did the researchers study? Anabolic-androgenic steroids are synthetic versions of testosterone. Doctors sometimes prescribe them for specific conditions. Outside medicine, some men use them to add muscle mass or improve gym performance. The authors cite an estimated **lifetime prevalence of about 6% among men worldwide**, so the problem is not limited to elite sport. The Middelboe team asked a narrow question: **among men already caught using AAS in Danish fitness centres, how often did they later collect prescription drugs used for erectile dysfunction**, such as sildenafil or tadalafil, compared with men who were not sanctioned? They used **Anti-Doping Denmark**, which tests in public gyms. Anyone sanctioned between **2006 and 2018** entered the user group, including men with positive urine tests and men who refused testing and were treated as suspected users. For each sanctioned man, statisticians drew **50 male controls** from the Danish population, matched on **age and the date of sanction**. Follow-up ran from the sanction date until **death, emigration or 31 December 2022**. Outcomes came from the **Danish National Prescription Register**: new prescriptions for ED medicines and, among users who filled them, total prescriptions and cumulative dose. The work was approved by Danish data-protection and health authorities. Individual doses and years of illicit use before sanction were **not** available, which matters when you interpret the numbers. ## What did they find? PsyPost’s November 15, 2026 report on the paper gives these results (the full article is in the *Journal of Sexual Medicine*, DOI [10.1093/jsxmed/qdag223](https://doi.org/10.1093/jsxmed/qdag223)): - **15-year risk** of redeeming an ED prescription: **about 24%** in the AAS group versus **about 8%** in controls. - **Unadjusted:** users were **3.6 times** more likely to start ED medication. - **Adjusted** for age, education and employment: **3.2 times** more likely. - Among men who sought treatment, **median prescription count was 6** for users versus **3** for controls. - **Median cumulative dose** was higher in users (interquartile range **16–300** versus **12–136** in controls), PsyPost reports. Those figures describe **pharmacy records in Denmark**, not a survey of every gym member. They still paint a consistent picture: sanctioned AAS users disproportionately needed medical help for erections years later, and when they did, treatment tended to be more intensive. The study cannot prove that steroids **caused** every prescription. Men who break anti-doping rules may differ in other ways: other recreational drugs, alcohol, smoking, psychological stress or reluctance to see doctors until problems are severe. The authors adjusted for socioeconomic status but **did not have lifestyle data** on smoking or drinking, PsyPost notes. ## Why might steroids link to erectile dysfunction? The paper’s introduction, visible on the Danish research portal, describes a mechanism many endocrinologists already worry about: **HPGA suppression**. The **hypothalamic-pituitary-gonadal axis** (HPGA) controls natural testosterone. When blood levels rise because of synthetic androgens, the brain reduces signals to the testicles. Natural production falls. Testicular volume can shrink. When the drugs stop, some men cannot restart production quickly. That state is called **[hypogonadism](/dictionary/hypogonadism)** when testosterone stays low with symptoms such as low libido, fatigue, lost muscle or erection difficulty. Hypogonadism after AAS is not always short-lived. Clinic reports and smaller studies have described men who need specialist hormone care years after their last cycle. This Danish registry study adds **population-scale, long-term** evidence that sexual health often shows up in medical records. Other pathways may matter too. AAS can affect lipids and blood pressure in some users. Psychological factors, including shame about sexual problems, can make men delay care until pharmacy data show a clear gap versus peers. ## What should gym trainees do instead of steroids? If your goal is muscle, performance or confidence, the evidence-backed levers are boring and slow. They work. 1. **Train with resistance at least twice a week.** WHO recommends muscle-strengthening activities on **two or more days** for adults 18 to 64, on top of aerobic work. A simple [split that tracks muscle groups](/blog/workout-split-tracker-muscle-groups-due-next) beats copying a pro’s drug cycle. 2. **Use progressive overload.** Add a rep, a small load or a harder variation when the current set feels solid. Our [beginner strength guide](/blog/strength-training-for-beginners) and [plain-language overload explainer](/blog/progressive-overload-in-plain-words) walk through the first weeks. 3. **Eat enough protein from food.** Most trainees benefit from spreading protein across meals. Vegetarian, vegan and non-vegetarian examples live in the [protein per day guide](/blog/how-much-protein-per-day) and the [protein calculator](/tools/protein-calculator). 4. **Protect sleep.** Short sleep is linked to lower testosterone in small lab studies in young men; lifestyle is not a cure for true deficiency, but sleep supports recovery. See [testosterone and lifestyle](/blog/testosterone-and-lifestyle-sleep-weight-training). 5. **Log training and recovery.** Trends in sessions, resting heart rate or subjective energy help you deload before you break down. revns tracks workouts, sleep and optional mood scores; it does not diagnose hormones or prescribe drugs. **Creatine** is often confused with steroids online. It is **not** an anabolic steroid and is not what this study measured. Decide on creatine using the [evidence guide](/blog/creatine-evidence-dose-and-myths), not gym lore. Competitive athletes should follow their federation’s anti-doping rules. This post is not legal advice about sanctions. ## Do steroids cause erectile dysfunction in everyone who uses them? No study says every user will have ED. This cohort looked only at **men already sanctioned**, mostly in their twenties, in **one country’s health system**. Some users never appear in registries because they buy drugs without testing, or they treat ED outside pharmacies. Even so, the **gap between 24% and 8%** over 15 years is large enough that a regular trainer should treat illicit AAS as a high-risk gamble, not a nutrition tweak. If you **already used steroids** and your erections or libido are poor **months after stopping**, treat that as a medical question. Online “post-cycle therapy” kits are not a substitute for repeated morning blood tests and a clinician who understands andrology. ## What does this study not show? Be clear on limits so you do not over-interpret headlines: - **Prescriptions are a proxy**, not a diagnosis. ED drugs are sometimes prescribed for other conditions, though that is uncommon in young men. - **Under-reporting:** many men never discuss sexual problems with a doctor; both groups may be underestimated. - **Sanctions may have changed behaviour.** Some sanctioned men may have quit AAS; they stayed in the user group, which can dilute the association. - **No dose or duration data** before the positive or refused test. - **Denmark is not everywhere.** Access to gyms, prescribing rules and cultural attitudes differ. Association is not destiny. It **is** a reason to choose legal, proven training habits. ## What should I do this week? 1. **If you are tempted by gym steroids,** write down the goal (muscle, weight, sport) and one legal plan for the next eight weeks: sessions per week, protein at meals, bedtime. 2. **If you lifted without drugs,** keep a simple log of sets and loads. Use the [one-rep-max calculator](/tools/one-rep-max-calculator) only as a planning aid, not as a score to chase with drugs. 3. **If you used AAS in the past** and sexual function feels off, book a clinician. Ask about **morning total testosterone** on two separate days, symptoms, blood pressure and mental health. 4. **If a training partner uses AAS,** you do not need to preach. Know the risk data and protect your own choices. 5. **Track sleep and training load** for four weeks. A flat libido plus poor sleep and rising fatigue is worth mentioning to a doctor, whether or not steroids are involved. ## When should I see a doctor? Book an appointment if: - erections are weak or absent most of the time for more than a few weeks; - libido drops sharply and stays low; - you have testicular pain, breast swelling or unexplained fatigue after steroid use; - you have infertility concerns; - you are on **any** hormone or steroid product and did not get it from a clinician who is monitoring you. Seek **urgent or emergency care** for chest pain, fainting, a painful erection lasting more than four hours, or sudden neurological symptoms. If you feel **very low, hopeless or suicidal**, contact your local crisis line or emergency number. In the United States you can call or text **988** for the Suicide and Crisis Lifeline. Outside the US, use your national health service’s crisis page. An app does not replace that care. ## Related - [Testosterone and lifestyle: what sleep, weight and training can change](/blog/testosterone-and-lifestyle-sleep-weight-training) - [Strength training after 40: what changes and what to do](/blog/strength-training-after-40-what-changes-and-what-to-do) - [Creatine: what the evidence says, dose and myths](/blog/creatine-evidence-dose-and-myths) - [Heart health for men: the numbers to track](/blog/heart-health-for-men-the-numbers-to-track) - [Progressive overload in plain words](/blog/progressive-overload-in-plain-words) This is general training guidance, not medical advice. Sexual health, hormone treatment and erectile dysfunction need a qualified clinician. ## Sources - [Middelboe M et al. Anabolic-androgenic steroid use and erectile dysfunction. Journal of Sexual Medicine 2026;23(8):qdag223](https://doi.org/10.1093/jsxmed/qdag223) - [Capital Region of Denmark research portal entry for the same paper](https://research.regionh.dk/en/publications/anabolic-androgenic-steroid-use-and-erectile-dysfunction/) - [Karina Petrova. Steroid users face triple the risk of long-term erectile dysfunction. PsyPost, November 15, 2026](https://www.psypost.org/steroid-users-face-triple-the-risk-of-long-term-erectile-dysfunction/) - [WHO. Physical activity and adults 18–64](https://www.who.int/news-room/fact-sheets/detail/physical-activity) ## Questions ### Do anabolic steroids cause erectile dysfunction? A 2026 Danish cohort study in the Journal of Sexual Medicine does not prove cause and effect, but men sanctioned for anabolic-androgenic steroid (AAS) use were 3.2 times more likely to start prescription erectile-dysfunction treatment after adjusting for age, education and job status, and had a 24% estimated 15-year risk of redeeming such a prescription versus 8% among age-matched controls. That is a strong association in one country’s records, not a guarantee for any one user. ### Why do steroids affect erections? Anabolic steroids add synthetic androgens. The body’s hypothalamic-pituitary-gonadal axis often senses high testosterone and scales back natural production. Many users develop hypogonadism, where the testicles produce too little testosterone, sometimes for years after stopping. Low androgen levels are linked to erectile dysfunction, low libido and fatigue. Cardiovascular strain, stress and other drugs may also play a part; this study could not measure all of them. ### Does prednisone cause erectile dysfunction like gym steroids? Prednisone and other prescription corticosteroids are different drugs from the anabolic-androgenic steroids bodybuilders misuse. Short courses for asthma, allergies or flare-ups are not what this Danish paper studied. Long-term corticosteroids can have side effects that affect mood, weight and hormones; if you are worried about sexual function on prescribed steroids, ask the clinician who prescribed them, not a gym forum. ### Can erectile dysfunction after steroid use go away? Some men recover natural testosterone months or years after they stop illicit AAS; others have persistent hypogonadism that needs specialist care. This study tracked pharmacy prescriptions, not recovery rates. If erections or libido stay poor after you have stopped steroids, see a doctor or andrologist for morning testosterone tests repeated on another day, not a supplement stack. ### How can I build muscle without anabolic steroids? Progressive resistance training two or more days a week, enough protein from food, sleep of roughly seven to nine hours for most adults, and gradual load increases beat shortcut drugs for long-term health. WHO guidance for adults 18 to 64 includes muscle-strengthening on two or more days per week. [Creatine](/blog/creatine-evidence-dose-and-myths) is not an anabolic steroid and is a separate evidence story from illicit AAS. ### When should I see a doctor about erections or steroid use? See a clinician if erections are often weak or absent for more than a few weeks, if libido crashes, if you used illicit steroids and feel unwell, or if you have chest pain, fainting or sudden mood changes. If you have thoughts of harming yourself, contact your local crisis line or emergency number. This article is not a substitute for care. --- Canonical: https://revns.com/blog/anabolic-steroids-erectile-dysfunction-study-2026 Index of everything: https://revns.com/llms.txt revns gives training guidance, not medical advice.