PEDs in Combat Sports: What Fighters Use, the Health Risks and the Rules

Short answer: there is no “safe” way to use PEDs in a tested combat sport. Anabolic steroids, SARMs, growth hormone and peptides such as BPC-157, EPO and many stimulants are all banned under WADA-based rules, and labs can detect most of them for days to weeks. The health risks are well documented: the Endocrine Society links performance-drug use to a higher risk of death and to heart, mental-health, hormonal, liver and kidney problems. This guide explains what fighters use and report, what it does to the body, how testing works, and the legal ways to perform better.

It merges our two older articles on PEDs in combat sports, including the one on fighters’ experiences. For SARMs specifically, see SARMs for MMA.

Understanding Performance-Enhancing Drugs

Performance-enhancing drugs (PEDs) are substances used to improve athletic performance, boost endurance, and accelerate muscle growth.

They include anabolic steroids, stimulants, human growth hormone (HGH), and other compounds designed to give athletes a competitive edge.

The use of PEDs dates back centuries, with early forms of performance enhancement seen as far back as ancient Greece, where athletes used herbal stimulants to improve strength and stamina.

However, modern PEDs gained traction in the mid-20th century when scientists developed synthetic testosterone and anabolic steroids.

Initially, these substances were created for medical purposes, such as treating muscle-wasting conditions.

However, they quickly caught the attention of athletes and bodybuilders who recognized their potential for increasing strength, speed, and recovery.

As competition in sports intensified, more athletes turned to PEDs to stay ahead.

As expected, over time, their benefits became widely recognized—but so did the risks and ethical concerns, leading to stricter regulations in professional sports.

The Most Common PEDs Used in Combat Sports

We’ve already touched on some PEDs in the previous section, but now let’s take a closer look at their benefits and side effects, especially in combat sports and other athletic competitions.

Anabolic Steroids

The most infamous PEDs in any sport are anabolic steroids like testosterone, trenbolone, and nandrolone.

These drugs help fighters pack on muscle, recover faster, and boost aggression.

Plus, it gives fighters the ability to train harder, hit stronger, and bounce back quicker.

But the downside? Severe hormonal imbalances, liver and heart issues, and the risk of getting flagged by drug tests.

SARMs (selective androgen receptor modulators)

Marketed as a “safer” alternative to steroids, SARMs like Ostarine, Ligandrol, and RAD-140 have become a go-to for fighters chasing muscle growth without the extreme side effects.

But since they’re still relatively new, don’t expect a free pass—risks are definitely in the mix.

While some users report milder effects, SARMs can still mess with testosterone levels, especially if you skip post-cycle therapy.

Erythropoietin (EPO) and Blood Doping

In a fight, endurance is everything. That’s why some fighters turn to EPO—a hormone that boosts red blood cell production, supercharging oxygen delivery to muscles.

The result? Better cardio, greater stamina, and the power to push through exhaustion.

But there’s a catch: It also thickens the blood, ramping up the risk of cardiovascular issues.

So if you’re considering it, just practice extra caution and know exactly what you’re getting into.

Human Growth Hormone (HGH) and Peptides

Next in the list are HGH and peptides. For fighters chasing faster recovery and a touch of anti-aging magic, HGH and peptide hormones like IGF-1 are popular go-tos.

These compounds work behind the scenes to speed up muscle repair, heal injuries, and even torch body fat.

Though this sounds great, long-term use can come with some heavy baggage, including joint pain, organ enlargement, and insulin resistance.

Stimulants (Amphetamines, Ephedrine, Clenbuterol)

Last but not the least, we have stimulants.

For sharper focus, increased aggression, and an energy boost, some fighters rely on stimulants like amphetamines, ephedrine, and clenbuterol.

These substances keep them mentally locked in and physically explosive.

Risks, especially when taken in high amounts would include heart palpitations, anxiety, and dehydration in weight cuts.

What PEDs are used for in combat sports

PEDs give fighters a competitive edge by enhancing essential physical attributes needed in combat sports like boxing, MMA, and wrestling.

Here’s a full breakdown of their key benefits:

More Strength and Power

Anabolic steroids like testosterone and trenbolone help build muscle and increase strength by boosting protein synthesis.

In a fight, this means harder punches, stronger grappling, and better control in clinches.

Better Endurance and Stamina

Substances like EPO and clenbuterol increase red blood cell production, improving oxygen flow to muscles.

This helps fighters maintain a fast pace and push through intense rounds without gassing out.

Faster Recovery

HGH and IGF-1 speed up muscle repair and reduce recovery time, allowing fighters to train harder and more often without dealing with excessive soreness or injuries.

More Explosiveness and Speed

Stimulants like amphetamine and modafinil improve reaction time, focus, and overall neuromuscular coordination.

In combat sports, quick reflexes and fast movements can make all the difference between landing a strike or getting caught off guard.

The size of these effects varies hugely between drugs. High-dose testosterone with training added 6.1 kg of fat-free mass and 22 kg to the bench press in 10 weeks in one classic trial; SARM trials found about 1–1.5 kg of lean mass and no significant strength change in 21 days. For SARMs, the evidence is in our SARMs database.

What fighters report (anecdotal)

When it comes to performance-enhancing drugs (PEDs) in combat sports, athletes alhave a lot to say.

Let’s delve into some firsthand accounts to understand how specific PEDs influence performance and the sensations they evoke.

Anabolic Steroids: Power and Aggression

Anabolic steroids are renowned for their muscle-building prowess.

Fighters often report significant increases in strength and a heightened sense of aggression, which can be advantageous in the heat of competition.

However, these benefits come with notable side effects, including hormonal imbalances and cardiovascular issues.

The Nevada Athletic Commission highlights that athletes caught using steroids face public humiliation, negative media exposure, and potential loss of income due to suspensions.

SARMs

Selective Androgen Receptor Modulators (SARMs) like Ostarine and Ligandrol are often marketed as safer alternatives to traditional steroids.

Athletes using SARMs report experiencing lean muscle gains and improved recovery times.

However, it’s important to keep in mind that SARMs can still come with risks like testosterone suppression, which is why post-cycle therapy (PCT) is often recommended.

Erythropoietin (EPO): Enhanced Endurance

EPO is a hormone that increases red blood cell production, thereby enhancing oxygen delivery to muscles.

Athletes using EPO often report improved endurance and reduced fatigue, allowing them to maintain high performance levels throughout extended bouts.

Despite this, the use of EPO carries significant health risks, including an increased likelihood of blood clots and strokes.

Discussions within the MMA community have highlighted concerns about the ethical implications and health dangers associated with EPO use.

Human Growth Hormone (HGH): Recovery and Regeneration

HGH is reputed for its role in promoting tissue growth and repair.

Fighters who have used HGH often describe faster recovery from injuries and intense training sessions.

While the regenerative benefits are appealing, potential side effects include joint pain, and swelling.

It’s also worth noting that the efficacy and safety of HGH use in sports remain subjects of ongoing debate.

Stimulants: Heightened Alertness and Energy

Stimulants are used to boost energy levels, focus, and aggression.

Athletes report feeling more alert and capable of sustaining high-intensity efforts during training and competition.

Then again, as expected, these substances can lead to adverse effects too such as increased heart rate, anxiety, and dependency issues.

The use of stimulants is also heavily scrutinized and penalized in professional sports.

These are accounts, not evidence: they can’t separate the drug from training, diet or expectation, and they skip the side effects people don’t talk about.

Legal and Ethical Considerations

When it comes to PEDs in combat sports, the rules are pretty clear—most major organizations strictly prohibit them.

But despite the bans, the reality isn’t always black and white.

What Are the Rules on PEDs in Combat Sports?

Governing bodies like USADA (United States Anti-Doping Agency) and WADA (World Anti-Doping Agency) have strict regulations against PED use.

Fighters competing in organizations like the UFC, Bellator, and boxing commissions are subject to random drug testing, and failing a test can lead to suspensions, fines, or even bans.

However, some organizations have looser regulations or don’t test as aggressively, making PED use harder to track in certain promotions.

Do Athletes Still Use PEDs?

Yes—despite the rules, PED use still happens.

Some fighters take the risk because of the competitive advantage, while others find ways to avoid detection by using substances that clear the system quickly or microdosing (taking small amounts to stay under the detection threshold).

There have been numerous cases of high-profile fighters testing positive, but at the same time, many believe that a good number of PED users never get caught.

If It’s Banned, Why Does It Seem So Common?

The reality is that PED use has been around for decades, and in some ways, it has been normalized in elite-level sports.

Many fighters believe they’re at a disadvantage if they don’t use PEDs, especially when they suspect their opponents might be on something.

As previously mentioned, not all promotions enforce strict testing, and some fighters compete in countries with little to no regulation, making it easier to get away with using PEDs.

At the end of the day, while PEDs offer undeniable performance benefits, they also come with risks—both to health and career longevity.

That being said, if you’re a fighter considering PEDs, you should be fully aware of the potential downsides before making a decision.

How testing catches them

Anti-doping tests are more sensitive than most fighters assume. In controlled studies, a single 1 µg dose of ostarine (a tiny fraction of a capsule) was found in urine for up to 9 days; a single 50 µg dose of RAD-140 for up to 29 days; and an LGD-4033 breakdown product for more than 40 days after five 50 µg doses. That is also why contaminated supplements can cause positive tests. See SARMs and WADA and SARMs drug test.

Health Risks and Side Effects of Using PEDs

We’ve talked a lot about how PEDs come with risks—not just for your fighting career but also for your health.

But what exactly are the potential side effects? Let’s break them down:

1. Cardiovascular Issues

• Increased risk of heart attacks and strokes due to elevated blood pressure and cholesterol imbalances.
• Some PEDs, like anabolic steroids and stimulants, can thicken the blood and strain the heart.

2. Hormonal Imbalances

• Testosterone suppression (leading to low energy, depression, and loss of muscle after stopping use).
• Gynecomastia (development of breast tissue in men due to hormonal fluctuations).
• In women, irregular menstrual cycles, deepened voice, and facial hair growth may occur.

3. Liver and Kidney Damage

• Oral steroids (e.g., Dianabol, Anadrol) are known for being hepatotoxic, meaning they can strain the liver and lead to long-term damage.
• Some PEDs, like SARMs, have been linked to elevated liver enzymes, which can be a sign of toxicity.
• Dehydration and increased strain on the kidneys, especially with diuretics or extreme weight-cutting PEDs.

4. Psychological Effects (“Roid Rage”)

• Aggression, mood swings, and irritability are commonly reported, especially with high doses of anabolic steroids.
• Long-term users may experience depression and anxiety due to hormonal crashes after cycling off PEDs.

5. Increased Risk of Injuries

• While PEDs improve muscle growth, they don’t always strengthen tendons and ligaments at the same rate, leading to a higher risk of tears and injuries.
• Joint pain and stiffness are often reported with growth hormone use.

6. Sexual Dysfunction & Fertility Issues

• Reduced sperm count and even infertility in men due to suppressed natural testosterone production.
• Erectile dysfunction has been reported in PED users, especially after stopping steroid use.

7. Acne and Skin Problems

• Increased oil production, leading to severe acne and cystic breakouts, particularly on the back and shoulders.

8. Increased Risk of Infections (for Injectables)

• Unsanitary injection practices can lead to infections, abscesses, or even bloodborne diseases like Hepatitis and HIV.

Note: These side effects vary depending on the type of PED, dosage, duration of use, and individual response. However, they can be minimized—or even prevented—if PEDs are not abused and if proper precautions are taken, such as cycling strategies, post-cycle therapy (PCT), and regular health monitoring.

SARM-specific risks

SARMs are often sold to fighters as the “safe” option. In trials, LGD-4033 lowered testosterone, FSH and HDL at 1 mg/day within 21 days, ostarine lowered testosterone and HDL, and RAD-140 raised liver enzymes in about half the patients in its trial. Case reports describe serious liver injury and, for RAD-140, heart-muscle inflammation. See SARMs side effects.

If you compete in a tested sport

Check your promotion’s and commission’s anti-doping rules, which usually follow the WADA Prohibited List. Use only batch-tested supplements, because contamination is a real cause of positive tests. If you have a medical condition that needs a banned medicine, the route is a therapeutic use exemption through your anti-doping organization, not self-treatment. And if you are already using something, bloodwork and an honest conversation with a sports physician are safer than guessing.

Alternatives to PEDs for Performance Enhancement

Before considering PEDs, you might want to explore other methods that can boost athletic performance with fewer health risks.

Below are several evidence-based strategies to enhance your abilities safely:

1. Optimize Nutrition

A well-balanced diet is fundamental for peak performance. Consuming whole foods rich in vitamins, minerals, and antioxidants supports overall health and energy levels.

Incorporating fruits, vegetables, lean proteins, whole grains, and healthy fats can reduce inflammation, combat fatigue, and improve agility during physical activities.

2. Hydration and Electrolyte Balance

Maintaining proper hydration is crucial for endurance and cognitive function.

Ensuring adequate water intake and balancing electrolytes helps prevent cramps and supports optimal performance during training and competition.

3. A few proven supplements

Certain supplements have been shown to enhance performance safely:

• Caffeine: Proven to improve endurance and reduce perceived exertion, caffeine can be a valuable aid when used appropriately.
• Creatine: Known to increase strength and muscle mass, creatine is beneficial for high-intensity, short-duration activities common in combat sports.
• Beta-Alanine: This amino acid can help buffer muscle acidity, potentially enhancing performance during intense exercise.
• Beetroot Juice: Rich in nitrates, beetroot juice has been shown to improve endurance by enhancing oxygen utilization during prolonged exercise.

4. Implement Post-Activation Performance Enhancement (PAPE) Techniques

PAPE involves performing high-intensity exercises to temporarily enhance muscle performance.

For combat athletes, incorporating PAPE protocols can lead to improvements in power and speed.

5. Prioritize Rest and Recovery

Adequate rest and recovery are vital for muscle repair and growth.

Incorporating rest days, ensuring sufficient sleep, and engaging in activities like stretching and massage can prevent overtraining and reduce injury risk.

6. Explore Adaptogenic Herbs

Certain herbs, such as Rhodiola rosea, have been studied for their potential to enhance endurance and reduce fatigue.

Originally researched by the USSR for improving athletic performance, Rhodiola may offer benefits for combat athletes seeking natural performance enhancements.

7. Utilize Innovative Recovery Tools

Emerging technologies, like palm-cooling devices, have shown promise in aiding recovery and improving performance by rapidly reducing core body temperature and normalizing heart rates.

Incorporating such tools into your training regimen may enhance recovery times and overall performance.

Of the legal supplements, creatine monohydrate has the strongest evidence: the International Society of Sports Nutrition calls it effective for high-intensity performance and lean mass, and safe in healthy people. It is not banned. See supplements for jiu-jitsu and best supplements to build muscle.

Can You Compete Without PEDs? The Natural Fighter’s Approach

Let’s be real, PEDs are everywhere in combat sports.

From underground circuits to the big leagues, plenty of fighters turn to performance-enhancing substances to gain an edge.

But does that mean you have to? Not at all.

There are still fighters who go all-in on the natural route, proving that it’s possible to compete, and even succeed, without chemical assistance.

Now, let’s not sugarcoat it. Competing naturally is undeniably harder. You’re up against opponents who might recover faster, train longer, and carry an unnatural level of strength and endurance.

But on the flip side, staying natural means avoiding long-term health risks like hormone suppression, cardiovascular issues, or organ damage; problems that PED users often don’t worry about until it’s too late.

So, what’s the right call? If you’re on the fence about PEDs, it helps to ask yourself a few key questions:

• Are you willing to risk potential long-term health complications for short-term performance gains?
• How important is longevity to you—both in your sport and in life?
• Would you rather find ways to maximize your body’s natural potential through smarter training, nutrition, and recovery instead?

At the end of the day, PEDs are a personal choice, and no one can make that decision for you.

But if you’re serious about staying in the game for the long haul without relying on substances that could impact your health, know that plenty of fighters have done it before.

It’s not the easier path, but for many, it’s the one that leads to a longer, healthier, and more sustainable career.

The Future of PEDs in Combat Sports: What’s Next?

As combat sports continue to evolve, so too does the landscape of performance-enhancing drugs (PEDs) and the methods devised to detect them.

So, what’s on the horizon for PEDs in combat sports? Let’s dive in.

The Evolution of Drug Testing

Drug testing in sports has come a long way since its inception.

The International Association of Athletics Federations (IAAF) took the pioneering step of banning performance-enhancing substances in 1928, marking the beginning of formal anti-doping efforts.

Fast forward to today, and testing agencies employ a battery of sophisticated techniques to catch those attempting to gain an unfair advantage.

However, as testing methods have advanced, so too have the strategies employed by those looking to circumvent them.

Athletes and their support teams have become adept at tweaking dosages, timing, and even developing new substances designed to fly under the radar.

Will New PEDs Be Harder to Detect?

The arms race between doping and detection is relentless.

Recent advancements in pharmacology have led to the creation of novel PEDs that are more potent and more challenging to detect.

These substances often require the development of new testing methodologies, a process that can lag behind the introduction of the drugs themselves.

In addition, the emergence of gene doping—altering an athlete’s genetic makeup to enhance performance, poses a significant challenge for current detection techniques.

The Quest for PED-Free Combat Sports

Achieving a PED-free environment in combat sports is a noble goal, but is it realistic?

Despite stringent testing protocols and severe penalties, doping persists at unsettling levels.

A recent systematic review highlighted the prevalence of substances like anabolic agents and diuretics, particularly among athletes in heavier weight categories and those engaging in rapid weight loss.

Complicating matters further, some individuals are challenging the very foundation of anti-doping regulations. Enter the “Enhanced Games,” an audacious proposal for an Olympic-style event where athletes can openly use performance-enhancing substances without fear of testing or sanctions.

Proponents argue that this approach acknowledges the reality of doping in sports and prioritizes athlete autonomy.

Looking Ahead: A Balanced Perspective

For athletes contemplating the use of PEDs, the future presents a complex landscape.

On one hand, advancements in detection methods, including portable and rapid testing devices, promise to enhance the effectiveness of anti-doping efforts.

On the other hand, the continuous development of new substances and methods to evade detection suggests that the battle against doping is far from over.

Conclusion

PEDs do change performance, which is why they are banned, and they carry well-documented health risks. In a tested sport, the realistic outcomes are a positive test or a long-term health cost, often both. SARMs are not a safe middle ground: they suppress hormones, affect cholesterol and the liver, and are detected for weeks. The sustainable edge is in training, recovery, weight management and a few proven supplements. Related: SARMs for MMA · BPC-157 review · SARMs vs steroids