“Can I get a testosterone shot?” Sustaining Masculinity: A mixed methods study of anabolic androgenic steroid use trajectories by older men in the UK

Hearne, E (2025) “Can I get a testosterone shot?” Sustaining Masculinity: A mixed methods study of anabolic androgenic steroid use trajectories by older men in the UK. Doctoral thesis, Liverpool John Moores University.

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Abstract

Background: Globally, the use of anabolic androgenic steroids (AAS) has been largely associated with younger males. However, some research has indicated a similar proportion of men under 25 and over 40 years using AAS, and that age of initiation may be increasing. There is considerable evidence of morbidity and mortality from long-term AAS use, particularly damage to the liver and cardiovascular health, hypogonadism, and cognitive decline. To improve healthcare and policy, more information is needed about older men who use AAS (OMAAS), many of whom who may have a long history of AAS as well as face age-related health risks.
Aim: To explore older men’s experiences of AAS use across the lifecourse and their healthcare and support needs.
Methodology: The research adopted a mixed methods exploratory sequential design across four studies. Study 1 comprised a scoping review which mapped the existing literature on the use of AAS by older men and informed the subsequent three studies of this PhD. Study 2 interviewed harm reduction workers (HRWs) who work with OMAAS. Study 3 carried out interviews with OMAAS. Study 4 was a cross-sectional survey of OMAAS. In the final stage all four studies were triangulated in relation to the research objectives.
Findings: The findings showed that OMAAS motivations and patterns of use changed over time in response to their need to sustain their youthful masculinity. Most use AAS for perceived testosterone replacement therapy. Healthcare and service provision improvements are required to enable HRWs to work effectively with OMAAS, thus, a holistic multidisciplinary healthcare model is proposed to guide all healthcare and medical professionals to develop healthcare pathways for OMAAS.
Conclusion: The findings suggest that motivations for use, harms from use, and craving symptomatology are not due to age of OMAAS but length of AAS use career. Overall, the research confirms that an older population of men are using AAS, however, we can only provide limited evidence for increased age of initiation.

Item Type:	Thesis (Doctoral)
Uncontrolled Keywords:	Anabolic androgenic steroids; Public Health; Older Men
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Public and Allied Health
Date of acceptance:	23 October 2025
Date Deposited:	29 Oct 2025 14:01
Last Modified:	29 Oct 2025 14:02
DOI or ID number:	10.24377/LJMU.t.00027407
Supervisors:	Hope, V, Atkinson, A, Boardley, I, McVeigh, J and Van Hout, MC
URI:	https://researchonline.ljmu.ac.uk/id/eprint/27407

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