The Combined Effect of Resistance Training and Anabolic Steroids on Body Composition and Muscle Function in Men and Women with Sarcopenia: A Systematic Review

Document Type : Original Article

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Department of Pathology, Faculty of Sports Sciences, Kharazmi University, Tehran, Iran

10.22091/arsnes.2025.14198.1037

Abstract

Objective: This systematic review aimed to evaluate the combined effects of resistance training and anabolic steroids on body composition and muscle function in men and women diagnosed with sarcopenia.
Methods: A comprehensive systematic search of databases was conducted up to 2025, identifying 18 eligible studies (14 randomized controlled trials and 4 controlled studies) with a total of 1247 participants. The methodological quality of the included studies was assessed using the ROB 2.0 and ROBINS-I tools. Data were synthesized using meta-analysis methods where applicable, with Standardized Mean Difference (SMD) calculated for key outcomes.
Results: The combined intervention demonstrated significantly greater improvements in lean body mass (SMD: 0.82), skeletal muscle mass (SMD: 0.74), and reduction in fat mass (SMD: -0.45) compared to resistance training alone. Meaningful enhancements were also observed in muscle strength (SMD: 0.56-0.61) and physical performance (SPPB: SMD: 0.52). Men showed superior responses compared to women, and oxandrolone was identified as the most effective anabolic steroid. Adverse effects were generally mild, with elevated liver enzymes being the most frequently reported (12.3%).
Conclusion: The combination of resistance training with anabolic steroids appears to be an effective therapeutic strategy for improving body composition and muscle function in patients with sarcopenia, though careful monitoring for potential adverse effects remains essential.

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