Androgen Use Among Female Amateur Athletes: A Retrospective Analysis

Area of Science:

• Endocrinology
• Sports Medicine
• Public Health

Background:

• Research on non-prescribed androgen use disproportionately focuses on men, neglecting unique risks for women, including virilization and reproductive issues.
• Women using androgens are underrepresented in scientific literature, hindering a comprehensive understanding of their patterns and health consequences.

Purpose of the Study:

• To characterize the demographics, motivations, and patterns of non-prescribed androgen use among women.
• To identify commonly used performance- and image-enhancing drugs (PIEDs) in this female cohort.
• To compare usage patterns and potential risks with those reported in male cohorts.

Main Methods:

• Retrospective chart review of 41 female patients with a history of non-prescribed androgen use at a Dutch harm reduction clinic (April 2023 - August 2025).
• Data extraction included demographics, training background, motivations, androgen use, and other PIED use.
• Descriptive statistics were applied to analyze the collected data.

Main Results:

• The median age of participants was 33 years, with most being competitive amateur bodybuilders motivated by body composition and strength.
• Oxandrolone was the most frequently used androgen (88%), typically in intermittent oral cycles, with continuous use beyond one year being rare.
• Non-androgen PIEDs included clenbuterol, thyroid hormone, and growth hormone. Usage involved lower doses than in male cohorts, but oral administration increased risks of hepatotoxicity and adverse lipid effects.

Conclusions:

• Female non-prescribed androgen use in this cohort is characterized by lower doses, oral administration, and bodybuilding-focused motivations.
• While lower doses may mitigate some cardiovascular risks, reliance on oral androgens elevates risks of liver damage and lipid abnormalities.
• Prospective studies are essential for reliable data on the health risks of androgen use in women.