Research suggests that a smaller number of adult females use AS than males (Korkia and Stimson, 1993; Lenehan et al., 1996). As yet there are no studies that provide reasons for this difference, and studies regarding the prevalence of AS use among females are scarce. It may be that societal issues such as perceptions of the ‘ideal’ female body image are related to the lower frequency in the population of female AS users. Other factors that may be related to the lower use of AS may include the reluctance of females to be seen as using methods of doping, particularly those methods, such as use of AS, that are associated with potentially masculinizing side-effects.
Since AS were first synthesized, the roles of women have undergone a series of changes. The 1960s saw a new attitude towards many ‘old’ values. It is speculated that the first females to use AS for enhancement of sporting performance were elite-level athletes from the Eastern Bloc countries (Yesalis et al., 1993b). Positive tests for AS have been reported for a number of females in sporting competitions ( Jennings, 1996; Wallechinsky, 1996). However, studies into use of AS by women are infrequent. The number of women that want to be involved in research might be small as a result of reluctance of women to admit to drug use (Strauss et al., 1985; Korkia et al., 1996), and it might be that this is related to issues of child care and the traditional feminine image (Duda, 1986b).
Conventional and media representations of the ‘ideal’ female body tend not to be well muscled (Lenskyj, 1986; Cashmore, 1990). Muscles are generally equated with masculinity (Rosenkrantz et al., 1968) and females involved in
stereotypically masculine sports are not viewed positively (Kane and Snyder, 1989). However, since the 1960s women’s roles have become more varied and the women’s movement has been influential in the struggle against the
stereotyping of females. Women are now able to compete in a wide variety of sports and to pursue careers that were previously restricted to males.
A range of occupations in which strength and muscularity are desirable have now become viable career options for women. These women are now under the same pressure as men not to be tempted into using AS to improve their ability to perform in their job. Occupations such as the armed forces, in which females may now be in active combat, and the security business, where females may be employed as door staff and security guards, are pertinent examples.
The medical uses of AS in the treatment of women are diverse. These drugs have been used to treat female to male transsexuals (Westaby et al., 1977), and for the treatment of a variety of disorders. Anabolic steroids and other testosterone-derived treatments carry the risk to females of permanent sideeffects such as deepening of the voice, clitoral enlargement, increased growth of facial and body hair and reduction in breast size (Strauss et al., 1985; Korkia et al., 1996), and this has led to their limited use in the treatment of women. The principle behind the use of testosterone and testosteronederived drugs is that these substances may neutralize the effects of oestrogen. Hoberman and Yesalis (1995) report that advertisements for male hormone treatment have been included in medical journals since the early 1920s, when these treatments were used in attempts to alleviate female conditions such as menstrual problems and breast conditions, including tumours.
Testosterone therapy was used to treat women in the 1940s with breast cancer. These treatments are still used today for women suffering from post-menopausal androgen-dependent breast cancer (Hoberman and Yesalis, 1995). A consequence of the research in the 1940s was that it was observed that the testosterone treatment served to increase the women’s sex drive, appetite and general feelings of well-being. Testosterone therapies were also used to increase the libido in women, but this type of treatment is not current standard medical practice.
As mentioned previously, the number of adolescent females using AS appears to be increasing at a faster rate than any other group of AS users (Yesalis et al., 1997). Other studies of the prevalence of AS use among adolescents have also documented the use of AS by female adolescents (Handelsman and Gupta, 1997; Faigenbaum et al., 1998; Lambert et al., 1998). This is particularly worrying because this group of users may be at a high risk of developing adverse symptoms as a consequence of their AS use, some of which may be irreversible, such as deepening of the voice and clitoral enlargement (Strauss et al., 1985). It has been claimed that females are more sensitive to AS than males (Buckley et al., 1988); the basis of this claim stems from the fact that AS are derivatives of the male hormone testosterone, and this hormone is responsible for the development and maintenance of male secondary sexual characteristics and is found only in very small amounts in women.
Korkia and Stimson (1997) conducted a prevalence study involving 21 gyms in England, Scotland and Wales. They found that 2.3% of the women (N = 1667) had used AS in the past and 1.4% were currently using AS. A study of AS use in the north-west of England (Lenehan et al., 1996) showed that of the 386 respondents interviewed, all of whom were attending gyms in the area studied, seven were women. This is a small percentage of the total number of AS users, although it is representative only of those women that admitted to using AS. All of these women were involved in competitive body-building.
Body-building is frequently perceived to be a sport closely related to the use of AS (Ryan, 1981; Duda, 1986b; Tricker et al., 1989), and public perceptions of body-builders tend to be varied (Klein, 1984; Kane, 1988). The first female body-building competition was held in 1977 in Ohio, USA (Duff and Hong, 1984), and female body-building competitions are now held in many countries around the world. There are a limited number of studies about female body-builders but ‘underground’ steroid handbooks, generally written by and for those involved in the AS-using culture, seem to suggest that AS use is not restricted to male body-builders (Duchaine, 1989; Hart, 1993). Often these texts suggest that women use lower doses of AS than men.
A study of needle exchanges in the Merseyside and Cheshire regions of England showed that the number of female AS users attending needleexchange schemes had decreased between 1992 and 1996 (Birtles, 1998). This reduction in attendance presents a cause for concern as it may be representative of women feeling excluded from drug agencies. However, it may also reflect a reduction in the number of females using AS. Awiah et al. (1990) have also reported that many women drug users are reluctant to attend drug agencies. Studies have shown that certain females do inject AS (Strauss et al., 1985; Korkia et al., 1996), and thus the needle-exchange figures may be a misrepresentation of the actual numbers of females injecting AS.
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