Anabolic steroids in women

Women have certain particularities regarding the use of anabolic androgenic steroids (AAS), the most logic one, is the dosing, with women requiring smaller doses than men do, as women DO naturally produce testosterone in their bodies (in the adrenal glands) but being produced in smaller quantities than in males, which have testicles (the main testosterone producing organ).

But now we will see some other specific topics about women and AAS.

How common is anabolic steroid use in women?

Truth is that no one knows exactly, but a national survey made by the CDC (centers of disease control and prevention), showed a 2.2% lifetime prevalence of use in girls. [1]

Do women that use steroids tend to use other substances?

YES, women that use AAS tend to use other substances for improving physique, citing a 2010 article that states “female AAS users practice polypharmacy and are motivated to use AAS to increase muscle mass, increase strength, and improve appearance. Female AAS users tend to use lower doses and fewer AAS agents at a time compared with their men counterparts.” Showing that female AAS users use lower less steroids than males but use more substances than non-AAS users (including any kind of supplements). [2]

Another interesting study showed that AAS users tend to abuse illegal substances more often and, including marijuana and cocaine, and abuse legal substances more often, like cigarettes and alcohol. [3]

Are female AAS users more prone to psychiatric illness (or viceversa)?

As in males, it appears that females with psychiatric disorders are prone to use AAS linked to body dissatisfaction, citing a 2009 article “body dissatisfaction, weight and shape preoccupation, strict dieting and vigorous exercise, binge eating, anabolic steroid use and a history of bulimia nervosa was highly prevalent in competitive female bodybuilders” [4]

What are the expected endocrine changes in female physiology?

Most changes in females are the same as expected in males, but an interesting finding is that women using AAS can get to testosterone levels much higher than the normal levels in a male, suggesting that excessive AAS use can lead to excessive levels of testosterone, increasing the adverse effects exponentially (see Figure 1). [5]

Another common endocrine change are irregular menstrual cycles, increased estradiol levels [5].

Other expected changes are decreased SHBG (sex hormone binding protein), HDL (high density lipoprotein), and thyroxine binding proteins. Also it is expected to find increased LDL, ALT, AST and creatine kinase. [5]

What are the expected side effects in female AAS users?

The ACOG (American College of Obstetricians and Gynecologists) summarized the adverse effects in a great paper published in 2011, these are:

⦁ Acne
⦁ Hirsutism
⦁ Deepening of the voice
⦁ Male pattern balding
⦁ Clitoromegaly
⦁ Breast atrophy
⦁ Irregular menstrual cycles
⦁ Infertility
⦁ Significant muscle growth
⦁ Depression
⦁ Mood instability

Some other may be found, but these are the most relevant. [6]

Bibliography
1-. MMWR Surveill Summ. 2010 Jun 4;59(5):1-142. Youth risk behavior surveillance – United States, 2009. Eaton DK, Kann L, Kinchen S, et al.
( http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5905a1.htm )
2-. Clin J Sport Med. 2010 Nov;20(6):475-81. doi: 10.1097/JSM.0b013e3181fb5370. Women and anabolic steroids: an analysis of a dozen users. Ip EJ, Barnett MJ, Tenerowicz MJ, Kim JA, Wei H, Perry PJ.
( http://www.ncbi.nlm.nih.gov/pubmed/21079445 )
3-. Arch Pediatr Adolesc Med. 2007 Jun;161(6):572-7. Cross-sectional study of female students reporting anabolic steroid use. Elliot DL, Cheong J, Moe EL, Goldberg L.
( http://www.ncbi.nlm.nih.gov/pubmed/17548762 )
4-. Eat Disord. 2009 May-Jun;17(3):200-10. doi: 10.1080/10640260902848485. Body image, disordered eating and anabolic steroid use in female bodybuilders. Goldfield GS.
( http://www.ncbi.nlm.nih.gov/pubmed/?term=19391019 )
5-. Am J Obstet Gynecol. 1991 Nov;165(5 Pt 1):1385-90. Endocrine effects in female weight lifters who self-administer testosterone and anabolic steroids. Malarkey WB, Strauss RH, Leizman DJ, Liggett M, Demers LM.
(http://www.sciencedirect.com/science/article/pii/S0002937812907681 )
6-. Obstet Gynecol. 2011 Apr;117(4):1016-8. doi: 10.1097/AOG.0b013e3182192281. ACOG Committee Opinion No. 484: Performance enhancing anabolic steroid abuse in women. American College of Obstetricians and Gynecologists Committee on Gynecologic Practice.
(http://www.ncbi.nlm.nih.gov/pubmed/21422881 )