Health Effects of Doping

On this page

    Many athletes want to find a competitive edge to help them go faster, train longer, recover quicker or be stronger.

    That edge can be attained by eating well, good hydration, reliable recovery methods (i.e. rest and good quality sleep), measured training techniques and a whole lot of really, really hard work.

    But some athletes decide to cross that ethical line by trying something more.

    Whether it’s a suggestion from a coach or friend, or it’s a decision made solely for themselves – some athletes decide to cheat by taking banned substances, or using banned methods, putting them at risk of a four-year ban from all sport.

    Athletes that cross the line are risking more than just their reputation and their careers – they’re also putting their health at serious risk.

    Some athletes believe that since many substances on the WADA Prohibited List are legitimate medications that they must be safe to use. However, this couldn’t be further from the truth.

    Medications are for people with specific health issues – not for healthy athletes. These medications are not approved to be used by healthy people, in higher doses nor in combination with other substances. Taking them when your body doesn’t need them can cause serious damage to your body and destroy your athletic career.

    Some banned substances which athletes have also used are not medications. In fact, some banned substances that are marketed as the next big thing (often via word of mouth or on the internet) are not even approved for human use.

    Sport Integrity Australia, together with our anti-doping colleagues from around the world, have created the following resources for athletes and support people to get a better understanding of the risks involved with the use of performance enhancing drugs when they are abused or taken without medical supervision:

    • In collaboration with Drug Free Sport New Zealand, Sport Integrity Australia has released a free 'Health Effects of Doping App' which uses Augmented Reality (AR) to create a unique learning experience to explore the health effects of performance enhancing drugs. The app is available in both Google Play and the Apple App Store, just search for — ‘Health Effects of Doping’
    • In partnership with the United States Anti-Doping Agency (USADA), we have produced further information and videos to answer common questions about the health and safety risks associated with substances and methods on the WADA Prohibited List.

    Testosterone and Anabolic Agents

    The primary medical use of these substances is to treat delayed puberty, some types of impotence, and wasting of the body caused by muscle-wasting diseases. Some physiological and psychological side effects of anabolic steroid abuse have potential to impact any user, while other side effects are gender specific.

    The following list is not comprehensive but gives a snapshot of the effects that testosterone use can have in healthy athletes.

    Physiological Effects

    • Acne
    • Male pattern baldness
    • Liver damage*
    • Premature closure of the growth centres of long bones (in adolescents) which may result in stunted growth*
    • Increased aggressiveness and sexual appetite, sometimes resulting in abnormal sexual and criminal behaviour, often referred to as ‘roid rage’
    • Withdrawal from anabolic steroid use can be associated with depression, and in some cases, suicide.

    Gender Specific – Males

    • Breast tissue development*
    • Shrinking of the testicles*
    • Impotence
    • Reduction in sperm production.

    Gender Specific – Females

    • Deepening of the voice*
    • Cessation of breast development
    • Growth of hair on the face, stomach and upper back*
    • Enlarged clitoris*
    • Abnormal menstrual cycles.

    NOTE: *Effects may be permanent and can vary by individual.


    SARMs (Selective Androgen Receptor Modulators) are designed to work like Testosterone, however they are experimental and not approved for human use. For this reason, the full side effects are unknown, however given that SARMs act in a similar manner as steroids, similar health risks as those listed above for other anabolic agents would be expected. Initial research also shows that using SARMs puts users at risk of organ failure.

    Human Growth Hormones (HGH), Peptide Hormones, and Related Substances

    The primary medical use of these substances varies, but some are used in the treatment of cancer or medical conditions affecting growth or regulation of the endocrine (hormonal) system. The presence of an abnormal concentration of a hormone, its metabolites, relevant ratios or markers in your sample is deemed to contain a prohibited substance unless you can demonstrate the concentration was due to a physiological or pathological condition.

    Examples include human growth hormone (HGH), insulin, human chorionic gonadotrophin (HCG), and adrenocorticotrophin (ACTH). In Australia, treatment using these substances is only permitted for legitimate medical purposes, and only a doctor may source these substances with permission from the Therapeutic Goods Administration (TGA) – i.e. it is illegal for non-medical personnel to import these substances into Australia.

    Physiological Effects

    • Hypertension
    • Heart attacks
    • Thyroid problems
    • Severe headaches
    • Loss of vision
    • Acromegaly (Protruding or enlarged jaw, brow, skull, hands and feet)
    • High blood pressure and heart failure
    • Diabetes and tumours
    • Crippling arthritis.

    Blood Doping and EPO

    Blood doping is the practice of misusing certain techniques and substances to increase the red blood cells in the body. There are three widely known substances or methods used for blood doping, namely, erythropoietin (EPO), synthetic oxygen carriers and blood transfusions*.

    The primary use of blood transfusions and synthetic oxygen carriers are for patients who have suffered massive blood loss, either during a major surgical procedure or caused by major trauma. EPO is used in the treatment of anaemia (low blood count) related to kidney disease. However, misuse of these substances and techniques could lead to a range of serious health effects.

    Physiological Effects

    • Increased stress on the heart
    • Blood clotting
    • Strokes
    • Heart attacks
    • Pulmonary embolism

    *With transfusions, there is an increased risk of infectious disease such as AIDS or hepatitis.


    The primary medical use of these compounds is to treat conditions such as attention deficit disorders (ADD/ADHD), narcolepsy (sleep problems), and obesity. Stimulants have also been found in supplements, like pre-workouts, found on supermarket and supplement store shelves.

    You should make a habit of only using batch tested supplements to reduce your risk of consuming a dangerous stimulant inadvertently.

    Physiological Effects

    • Insomnia
    • Anxiety
    • Weight Loss
    • Dependence and addiction
    • Dehydration
    • Tremors
    • Increased heart rate and blood pressure
    • Increased risk of stroke, heart attack, and cardiac arrhythmia.


    In small doses opioids have medical uses that include relieving severe pain. However, opioid overdose is a medical emergency and can lead to respiratory depression and even death. The misuse of opioids such as morphine, codeine and oxycodone can cause many health risks.

    Physiological Effects

    • Gastrointestinal problems like nausea, vomiting and constipation
    • Failure to recognise injury
    • Loss of balance, coordination and concentration
    • Suppressed respiratory system
    • Physical and psychological dependence; leading to addiction.

    The well-being approach

    Health professionals including sports physicians and sports dietitians advise that athletes can get the best performance results by maintaining a healthy diet for their training and competition needs, getting enough sleep, keeping hydrated and putting in lots of really hard work.

    It is recommended that athletes have a varied and nutritious diet filled with good amounts of protein, carbohydrates and fats. Bananas are a good source of energy helping to improve the digestive system and kidneys. Chicken and other protein sources are good for building and maintaining muscle mass and foods that are rich in vitamins such as broccoli help the body recover faster from injuries and muscle fatigue. 

    Sleep is vital for the health and performance of all athletes. Professionals recommend athletes get up to seven to nine hours of sleep per night. Inadequate sleep can result in fatigue, a lack of concentration, and can slow the recovery process.

    Adequate hydration is one of the most important parts of an athlete’s diet. Maintaining good hydration levels can help sustain body volume and regulate body temperature. It also helps reduce the risk of heat stress, maintain muscle function and prevent a decrease in performance and fatigue.

    But what about dietary or nutritional supplements? All natural! Pure! Fast results! Not quite.

    Beware! Supplements have often been found to contain ingredients not on the label – meaning you never know what you are taking. There could be a banned substance in your ‘all natural’ supplement. Beware of the risks.

    For more information on supplement risks and athlete nutrition, visit the Sport Integrity Australia Supplements page.

    To find out more about anti-doping rules and the WADA prohibited list, check out the Sport Integrity Australia eLearning website for free online courses and videos, plus further details on all of our education content can be found on the Sport Integrity Australia Education page.

    For substance specific questions please contact our science team via email:

    For education enquiries on anti-doping and all other sport integrity issues please contact the education team via email: