Women & Steroids: How common is it, really?

A new systematic review led by Dr Tim Piatkowski pulls together what we actually know.

The short version

Across 18 studies of adult women, lifetime AAS use was:

• 4% overall
  
• ~17% in female bodybuilders
  
• ~4% in athletes/recreational gym-goers
  
• ~1–2% in the general female population
  

So yes, most women don’t use AAS. But in some subcultures (especially bodybuilding), use is noticeably higher.

What are women doing?

The limited studies that listed specific compounds show women often gravitate to orals like oxandrolone and stanozolol. Injectables (e.g., nandrolone, boldenone) appear less common partly because injecting is a bigger psychological and social step and can carry more stigma.

Why the research gap matters

Here’s the problem: most steroid research is based on men. Women’s bodies respond differently, and side-effect profiles can be unique. Reported issues include voice deepening, increased facial/body hair, acne, menstrual changes, and mood effects. When women seek guidance, it often comes from male partners, coaches, or online forums built around men’s experiences. That mismatch can increase risk and lead to surprises nobody wanted.

Add to that another blind spot: women are under-represented in sports science studies more broadly. Translation? We don’t have enough high-quality, women-specific evidence to answer all the questions women are asking.

Why women start (and why that matters)

Motivations aren’t one-size-fits-all. Some women compete. Some want a certain look – leaner, more muscular, stage-ready. Others are influenced by social media ideals or gym culture. None of that is shocking but it does mean context matters. A bodybuilder’s risk profile and choices won’t look like a casual lifter’s.

What this means for you

• Reality-check the risk. AAS among women is not common overall, but higher in specific scenes. Don’t assume “everyone’s on.”
  
• Watch for red flags. Voice changes, menstrual shifts, breakouts, or new facial hair? These can be AAS-related – get proper medical advice early.
  
• Demand women-specific info. Advice copied from men’s protocols can miss key differences. Look for guidance built for women’s physiology.
  
• If you’re considering it, plan like an athlete. Baseline bloods, clear goals, exit plan, side-effect thresholds, and credible testing access (that’s where PEDTest can help).
  
• Harm reduction beats hush-hush. Confidential, non-judgmental support (like RoidSafe) and evidence-based education reduce harm far better than guesswork and DMs.
  

The bottom line

The best estimate right now: around 4% of adult women report ever doing AAS, with much higher rates in bodybuilding. The real risk driver isn’t just the drugs, it’s the information gap. When women have to borrow advice designed for men, side effects and regret become more likely.