Psychiatric and medical effects of anabolic-androgenic steroid use in women

Background: Although numerous studies have documented the psychiatric and p hysiological effects of anabolic-androgenic steroids (AAS) in males, virtua lly no studies have investigated the effects of illicit AAS use in women. M ethods: We performed psychiatric and medical evaluations of 75 dedicated wo men athletes, recruited by advertisement primarily from gymnasiums in the B oston, Mass., area. Results: Twenty-five (33%) of the women reported curren t or past AAS use. Users were more muscular than nonusers and reported use of many other 'ergogenic' (performance-enhancing) drugs in addition to AAS. Some described a frank syndrome of ergogenic polysubstance dependence, oft en with significant morbidity. Fourteen (56%) of the users reported hypoman ic symptoms during AAS use and 10 (40%) reported depressive symptoms during AAS withdrawal, but none met full DSM-IV criteria for a hypomanic or major depressive episode. Nineteen (76%) users reported at least one adverse med ical effect associated with AAS use. Perhaps the most interesting findings were several unusual psychiatric syndromes reported by both the AAS users a nd nonusers. These included rigid dietary practices (which we have termed ' eating disorder, bodybuilder type'), nontraditional gender roles and chroni c dissatisfaction and preoccupation with their physiques (a syndrome which we have termed 'muscle dysmorphia'). Conclusions: Dedicated women athletes exhibit not only AAS abuse, but use of many other ergogenic drugs, sometime s associated with significant morbidity. In addition, these athletes freque ntly display several psychiatric syndromes which have not previously been w ell described. Copyright(C) 2000 S. Karger AG, Basel.