What does using steroids (as in sports) do to your bones?

Anabolic steroids (AAS) used by athletes are derived from androgens, the male sex hormones. Those hormones play a genuine role in bone formation: they stimulate bone building and inhibit bone breakdown. On paper that sounds beneficial, but the situation with sports misuse is more complicated than that.

In medical use, meaning low doses in older patients with bone loss, anabolic steroids can indeed slow bone breakdown, with limited side effects. Whether that also prevents fractures, however, has not been demonstrated: no reliable fracture figures are available to confirm it. In recovery after hip surgery, the only available study showed no improvement.

At the high doses athletes actually use, the effect on bones has barely been studied. We simply do not know whether the bones of a healthy athlete who misuses steroids improve, stay the same, or sustain damage over time. That lack of knowledge is itself a warning.

What has been well studied are the risks in other areas. AAS use raises blood pressure, lowers good cholesterol (HDL), and disrupts the body's own hormone production, sometimes for months after stopping. Add to that aggression and mood swings. This is not a minor caveat: these are serious, reasonably well-supported risks.

DHEA, a steroid the body produces naturally, declines with age and is associated with bone density. DHEA supplementation shows bone-building signals in small studies, but the evidence is too limited for firm conclusions. This is separate from the heavy AAS used in sport.