Athletes who use anabolic steroids most commonly turn to testosterone, nandrolone, stanozolol, and methandienone. These are the core substances, but the full list extends well beyond them, with different drugs chosen for different goals, sports, and phases of training. Here’s what each one does and why athletes select it.
The Most Common Steroids in Sports
Anabolic-androgenic steroids fall into two broad categories: oral and injectable. Oral steroids are swallowed as pills or capsules and tend to act faster but carry greater liver toxicity. Injectable steroids are delivered into muscle tissue, typically last longer in the body, and are generally easier on the liver.
The oral steroids used most often include stanozolol (widely known by its brand name Winstrol), methandienone (Dianabol), oxandrolone (Anavar), oxymetholone (Anadrol), and methenolone acetate (Primobolan). Among injectables, the most frequently used are testosterone enanthate, testosterone cypionate, nandrolone decanoate (Deca-Durabolin), boldenone undecylenate (Equipoise), and blended testosterone products like Sustanon 250.
Testosterone itself, in various forms, is the foundation of nearly every steroid regimen. It’s the hormone the body produces naturally, and synthetic versions simply deliver it in higher, sustained doses. Other compounds are then layered on top depending on the athlete’s specific objectives.
Why Different Sports Favor Different Drugs
Sports that demand explosive, short-burst power are the most susceptible to anabolic steroid use. Sprinting, throwing events, boxing, wrestling, and collision sports like football all reward the kind of rapid muscle mass and strength gains that androgens provide. Athletes in these disciplines tend toward potent mass-building compounds like testosterone and nandrolone.
Endurance sports operate differently. Long-distance running, cycling, and cross-country skiing depend more on oxygen delivery than raw muscle size. Athletes in these sports may still use steroids for recovery, but the bigger performance lever is blood doping, which uses methods like EPO (a hormone that increases red blood cell production) or blood transfusions to boost how much oxygen reaches working muscles. A lean build is an advantage in endurance events, so packing on muscle mass can actually hurt performance.
Growth hormone also circulates in athletic doping, primarily for its reputation as a recovery aid. The idea is that it speeds tissue repair after hard training or injury, though the scientific evidence for a clear performance boost from growth hormone alone remains thin.
How Stacking and Cycling Work
Athletes rarely use a single steroid in isolation. The standard approach is “stacking,” which means combining two or more compounds at the same time to amplify their effects. A typical stack pairs a long-acting injectable testosterone with one or two additional compounds chosen for specific properties.
These stacks are organized into “cycles,” periods of use that usually last several weeks, followed by time off to let the body recover. A case study of competitive bodybuilders illustrates how drug selection shifts with training goals. During a bulking phase, when the priority is adding as much muscle as possible, athletes commonly used testosterone enanthate, boldenone, nandrolone, and trenbolone. During a cutting phase, when the goal shifts to stripping body fat while preserving muscle, they switched to faster-acting compounds like testosterone propionate, stanozolol, drostanolone, and oxandrolone. The logic behind these choices is that certain drugs are believed to promote a harder, leaner look with less water retention, making them better suited for fat-loss phases.
How Steroids Build Muscle
All anabolic steroids work through a similar basic mechanism. They bind to androgen receptors inside muscle cells, which then activate genes that drive muscle protein production. This process, called nitrogen retention, was one of the earliest observed effects of testosterone: the body holds onto more of the building blocks it needs to construct new tissue.
At a cellular level, testosterone triggers hypertrophy (growth) of both slow-twitch and fast-twitch muscle fibers. It also increases the number of muscle progenitor cells, essentially the stem cells that develop into new muscle tissue. It does this by steering multipotent cells down a muscle-building pathway instead of a fat-storage pathway, and by stimulating existing muscle cells to multiply faster. The net result is that an athlete on supraphysiologic doses of testosterone can build muscle mass and recover from training at a rate that is not achievable naturally.
The Expanding Drug Menu
The landscape has grown well beyond traditional pharmaceutical steroids. Athletes now use designer androgens, compounds specifically engineered to be difficult to detect in drug tests. Pro-hormones like androstenedione and DHEA serve as precursors that convert into active androgens in the body. Selective androgen receptor modulators (SARMs) represent a newer class of non-steroidal drugs that target androgen receptors in muscle and bone while theoretically sparing other tissues, though they remain banned by the World Anti-Doping Agency.
WADA’s 2025 Prohibited List classifies all anabolic agents, including traditional steroids, SARMs, and any substance with a similar chemical structure or biological effect, as banned both in and out of competition.
How Common Is Steroid Use Among Elite Athletes
Honest numbers are hard to come by, for obvious reasons. A confidential survey of nearly 1,400 U.S. elite athletes subject to WADA-code testing found that between 6.5% and 9.2% reported using at least one prohibited substance or method in the previous 12 months. Athletes classified as moderate-risk reported the highest rates at roughly 13%. These figures cover all prohibited substances, not steroids alone, but they give a sense of the baseline.
It’s worth noting that athletes in major U.S. professional leagues like the NFL, NBA, and MLB are tested under their own collectively bargained agreements, not under the WADA Code. Their testing protocols, penalties, and transparency vary significantly from Olympic-level programs.
Health Consequences of Long-Term Use
The performance benefits of anabolic steroids come with serious tradeoffs, particularly at the doses athletes use, which typically far exceed what would be prescribed medically.
Cardiovascular damage is the most concerning long-term risk. Supraphysiologic steroid use is linked to high blood pressure, unfavorable cholesterol shifts (higher LDL, lower HDL), left ventricular hypertrophy (thickening of the heart wall), and accelerated atherosclerosis (plaque buildup in arteries). Some of these effects, like blood pressure and cholesterol changes, can reverse after stopping use. Others, particularly atherosclerosis and cardiomyopathy, may be irreversible.
Oral steroids that are chemically modified to survive digestion (known as 17-alpha alkylated compounds) carry specific liver risks. These include a rare but serious condition where blood-filled cysts form in liver tissue, bile flow obstruction, and in uncommon cases, liver tumors. Injectable testosterone and other non-alkylated steroids are far less toxic to the liver, though not entirely without risk.
Steroid use also suppresses the body’s natural hormone production. When a cycle ends, the hypothalamic-pituitary-testicular axis, the signaling chain that controls testosterone production, can remain shut down for weeks or months. This temporary state of low testosterone often brings fatigue, loss of libido, mood disturbances, and in some cases major depression. Prolonged or repeated suppression can lead to lasting fertility problems, as sperm production depends on the same hormonal signaling that steroids disrupt.