Havnes · The International journal on drug policy 2021 · qualitative interview study · n=16

Anabolic-androgenic steroid use among women - A qualitative study on experiences of masculinizing, gonadal and sexual effects.

Cited 107 times in the scientific literature.

Level 4 - case-series / case-control

Qualitative interview study (observational/descriptive human data)

PubMed 32736958 · doi:10.1016/j.drugpo.2020.102876 · record verified 2026-08-29

What was done

Researchers conducted individual, semi-structured interviews with 16 women who were current or former users of anabolic-androgenic steroids (AAS). Audio recordings were transcribed verbatim and evaluated using thematic analysis to examine experiences surrounding masculinizing, gonadal, and sexual side effects.

What was found

No quantitative effect sizes or numerical rates were reported in the abstract. Qualitatively, almost all participants were introduced to AAS and guided on dosing regimens by trusted male partners, friends, or coaches. While reversible changes (e.g., body hair or breast volume loss) were managed with cosmetic interventions, irreversible changes like voice deepening caused marked shame and regret because they revealed steroid use. Amenorrhea and the resumption of menses were used as informal markers of physiological recovery between cycles. Clitoral enlargement caused distress and reduced self-esteem, though partner acceptance attenuated negative feelings. Libido increased commonly, leading to mixed experiences depending on relationship context.

Why it matters

This study highlights the specific psychosocial burden and unintended virilizing harms experienced by female AAS users, underscoring a need for gender-tailored harm reduction and clinical guidance.

Limits

The study is limited by a small qualitative sample (n = 16) and reliance on retrospective self-reports without objective physiological, hormonal, or compound-verification data. Selection bias is likely, and the findings cannot establish the incidence or causal dose-response relationships of specific masculinizing side effects.

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