Women and Steroid Blues

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"Nobody knew or could agree on what women wanted or needed to be. Not even women themselves…. Up close and dressed in anything feminine, female bodybuilders started looking like something God had made suffering from a divine hangover and caught in delusional terrors beyond human imagination."¹

In 1990 Harry Crews accurately predicted the dilemma of female bodybuilding in his book "Body." Although the use (or, more appropriately, ‘abuse’) of steroids is prevalent throughout the entire sports world, nowhere is it more controversial than in female bodybuilding. In a sport where the main goal is to build large and massive muscularity, a large number of competitive bodybuilders, both male and female, have resorted to using anabolic steroids to augment their competitive edge.

For women, the dilemma is multi-faceted. Maria Lowe states:

"Whereas the physical dynamics of consuming anabolic steroids might be fairly well understood, the social aspects remain unclear – particularly for women."²

Indeed, recent detraction away from female bodybuilding and increased attention to women’s fitness competition perhaps signifies the end of the ‘amazon’ female physique that has reigned for the past two decades. Perhaps the primary cause of the inevitable demise is the leadership of the bodybuilding industry’s notions regarding muscularity and feminism. Judges, officials and media in the bodybuilding industry increasingly discourage extreme muscularity in women because it is seen as unfeminine. While on the contrary, men and extreme muscularity are seen as compatible. Therefore, the lines are now drawn between fitness competitions and hardcore professional female bodybuilding.

A thorough examination of the social aspects of female bodybuilding and related issues of gender pushing are not the focus of this column. Nevertheless, these issues may be of interest to readers, who may find excellent relevant discourse in several sources. Several books and articles are included at the end of this column for further reference. I will, however, address some issues here as they pertain to the average female weightlifter.

Steroid use amongst female bodybuilders (fbbs) has had several trickle-down effects on women and weight lifting. Many times have I heard unknowing women state that they do not want to partake in weight training because they "don’t want to get ‘big’". They equate weight lifting with the extreme muscle mass of the professional fbbs they see in many of the muscle magazines. They hear the taunts of their boyfriends or husbands claiming these fbbs look like men and are undesirable. Does this sound like an invitation for the average woman to weight train? Not all women are aware that these fbbs acquire their massive physiques with the aid of male hormone drugs. I have had to assure many women that they can’t get ‘that’ big unless they, too, use specific drugs and train like animals.

On the other hand, many of the average gym-going women are sometimes daunted by the size of fbbs and think they are doomed to never gain any muscle mass unless they too use steroids. This is the primary impetus behind this column. In the last several months, I have received several emails requesting information on how to use steroids to gain muscle mass and lose bodyfat. These requests have come from young women and from boyfriends and husbands who want to put their wives/girlfriends on steroids. Most of the women had been weight training for only three to six months.

Let’s look at why professional female (and male) bodybuilders use drugs to enhance their physiques. As in any sport, the elite athletes make it to the top competition levels. These are athletes who have several factors in their favor. First, they posses the genetics that enable them to excel at the sport that is particularly suited to their physical attributes. It is well known in sports science that athletes who have a body type suited to performing a particular sport will most likely succeed over one who does not. Most professional bodybuilders have genetics that are well suited to weightlifting. They utilize training and nutritional programs for many years that develop their genetic potentials. It is not until they reach the limit of their genetic potential that they utilize drugs to take them beyond that level in order to stay competitive.

Another reason professional bodybuilders use steroids is to enhance their recovery during intensive training. Granted that steroid use may increase muscle mass without an increase in weight training, yet the gains will be minimal. To maximize the effects of steroids, trainees are able to increase the intensity and volume of their weight-training program to gain the large increases in muscle mass. Many of the training regimes presented in the muscle magazines by the big bodybuilders are used while they are on performance enhancement drugs. Thus, these regimes are falsely represented to the average weightlifter as training programs that anyone can adopt and gain similar results. Nothing could be more misleading.

Many athletes with less than perfect genetics use drugs because they are compelled to stay in competition at all costs. However, the drugs will not guarantee winning. Even with an increment of improvement, they may still not reach the caliber of those who are at the top competitive levels. Then there are those who are merely looking for the ‘magic pill’ to replace the effort required in training and nutrition to attain optimal results. For the average weightlifter who is not targeting the next NPC or Olympic competition, is it worth the health risks to use steroids?

Most commonly, women complain that they can not increase their muscle mass and lose body fat. First, understand that these two processes are contradictory. Only beginners to weight training will be able to increase their muscle mass and lose bodyfat simultaneously. Even then, beginners will eventually reach a plateau where muscle gains will decrease. The body must be in a state of anabolism to grow. In other words, conditions must be optimal for the body to build tissue.

The main criteria for increasing muscle mass are:

a sound training regime,
a diet that supplies the caloric level and right macro/micronutrients for anabolic growth,
recovery and rest.

If these factors are not optimal, no supplement in the world will add on muscle mass like magic. Steroids will not compensate for poor training and nutrition.

Gaining appreciable muscle mass and dropping bodyfat at the same time is not optimal. One needs to concentrate on one or the other. Most of the claims of the muscle magazines and supplement companies that they or their products can increase muscle mass while losing body fat are false and merely a sales gimmick. The laws of thermodynamics demonstrate it is simply not possible, unless one is a very beginner. Trainees have to accept some gain in bodyfat along with the gain in muscle mass. The bodyfat can be lost later with a sensible diet.

Generally, women, more than men, tend to overtrain and not eat enough. Most women bodybuilders spend hours on the cardio deck in addition to weight training 2 hours four to six days a week. Many women weightlifters follow training regimes they see in their favorite muscle magazine entailing 10 or more sets per body part. Because women have lower baseline levels of testosterone than men, women possibly may require less volume than men for better recovery. Adding numerous hours of cardio on top of that most likely leads to overtraining. As well, most women do not eat enough for muscle growth for fear of gaining body fat.

What are steroids?

All sex hormones are technically termed steroids. However, another class of related compounds, glucocorticoids (cortisol, cortisone), is also called steroids. Be sure not to confuse the two; they elicit different physiological effects. Androgens are commonly called ‘male’ hormones. Testosterone and dihydrotestosterone (DHT) are the two most commonly known androgens. Both men and women have testosterone circulating in their bodies, just as both have estrogen. The gender difference is the ratio of these hormones. Women normally have 1/10^th the level of testosterone level of men and more estrogen.

The most common androgen, testosterone, is anabolic and androgenic. Simply put, androgenic properties are the differentiation and maintenance of androgen-dependent tissues of the male reproductive system. They are also responsible for secondary male sex characteristics, such as body hair, deep voice, and increased libido. This is commonly called virilization. The anabolic properties facilitate protein synthesis in androgen-sensitive tissues such as bone and muscle. This is the effect that bodybuilders are mainly interested in.

Anabolic/androgenic steroids (AAS) are synthetic derivatives of testosterone. There are more than 25 different compounds in varying forms and with varying effects. Although they were designed to be anabolic they are not without some degree of androgenic effects. Some AAS have significantly greater anabolic actions than androgenic effects; however, an athlete who takes AAS gets the entire package. AAS are therapeutically used in replacement or maintenance therapy in men who have androgen deficiencies. The goal in replacement therapy is to restore normal levels of testosterone.

Bodybuilders generally use much higher levels of AAS than considered safe (by therapeutic standards) to increase muscle mass. Depending on the compounds used, high levels may induce a multitude of physiological effects. Bodybuilders also may use multiple forms of AAS, called ‘stacking’, in varying time lengths (‘cycles’). Although much is known about physiological effects in men at therapeutic dosages, less is known about effects in women. One fact is known for sure: because women have lower baseline levels of testosterone than men, the response to AAS is much greater in women. AAS stimulate greater muscular development in women than men with the same dose. However, there are also several side effects that can accompany AAS use in women.

Depending on the form of AAS, dose and duration, side effects in women may include male baldness pattern, cystic acne, decreased breast tissue, excessive facial hair, and disruption of the menstrual cycle. These are considered reversible and usually disappear not long after discontinued use. Some side effects are permanent, such as deepening of the voice and enlargement of the clitoris.

Another potential risk in men and women is combining use of AAS with cortisone or its derivatives. Recall that cortisone is also called a steroid. However, its actions are considered catabolic. It may actually cause muscle degeneration when used over a long period of time. It is frequently prescribed in sports to reduce inflammation caused by injury. Combining AAS with cortisone may predispose the user to severe connective tissue injuries. Several such sports injuries have been reported due to concomitant AAS and cortisone use.

There are other health risks related to AAS. The C-17 alkyl derivatives of testosterone are orally administered. Liver damage is associated with long term use of this form of AAS even though they are short acting and clear the body quickly. Other derivatives are injected into the muscle and stored in body fat. Thus they are released over a longer period and take several months to clear. Therefore, mixing different forms of AAS may lead to unpredicted side effects.

Burn patients, who experienced severe muscle wasting, were given AAS long term. Side effects, such as increased blood pressure, heart disease and liver cancer, appeared. Although direct extrapolation to similar use by bodybuilders has not been documented, some of these effects have been linked with AAS use in athletes. Several studies show AAS use may lead to premature hardening of the arteries. Salt and water retention is a side effect commonly experienced by AAS users.

Let’s look specifically at women and AAS use. Studies published to date on androgen replacement in women do not indicate detrimental effects on body composition, lipids or vascular function. The key words here are "replacement therapy". Testosterone derivatives have been developed for clinical hormonal replacement therapy in men. Thus, few forms of AAS are approved for women because the pharmacodynamics and efficacy in women have not been well researched. Therefore, less is known about the short-term and long-term effects of AAS in women. Consequently, even less is known regarding the supraphysiological doses that fbbs have been known to use. Women using the typical doses of fbbs to gain their extreme muscle mass are venturing into unknown health risks.

One risk I wish to address here is amenorrhea, which is the cessation of menstrual cycles for several months. Amenorrhea is resultant from a disruption in the body’s normal hormone status and is usually accompanied by a decline in estrogen levels. This may be disconcerting as it can significantly contribute to osteoporosis and osteopenia. These effects were thought to be short-term. On the contrary, an increasing number of studies demonstrate the effects are long-lasting even after resumption of menstruation. Low dose androgen use is now being integrated with estrogen replacement therapy in postmenopausal women to prevent or reduce osteoporosis. However, it is not known if long term AAS use negates the association of osteoporosis with amenorrhea.

Women considering steroid use should first ask themselves if they are willing to take the health risks that may be involved. First, examine your training and nutritional program and optimize that to gain muscle mass. Body fat can be lost later with a sound diet program. If you need assistance in optimizing your regime, consult with a knowledgeable person who has a credible background in physiology, exercise and nutrition. Educate yourself so that you can make informed decisions. If your friendly gym trainer suggests using steroids, he or she obviously doesn’t know how to train and eat correctly.

If you do decide to use steroids, find someone who knows what they are doing. Don’t rely on Big Ben in the gym to guide you. He may be big, but being big doesn’t guarantee a brain. Ideally, someone with a medical background would be able to minimize side effects, but that also can’t be guaranteed. Most of all educate yourself. It’s your body you are tinkering with. Most of all, ask yourself if you really want to take the risks especially if your goal is obtainable by other means.

My suggestion is this: train smart and hard, eat right and rest.

Body by Harry Crews, Simon and Shuster, 1990.
Women of Steel by Maria R. Lowe, New York University Press, 1998.

For information on drugs and sports: Drugs, Sport, and Politics by Robert Voy, MD, Leisure Press.