"The desire to achieve a thin physique has stemmed from women’s ideal bodies traditionally being considered ‘thin’ [1]. More recently, the ideal body type for women is changing and social influences (e.g. media) have been promoting athletic female beauty ideals alongside defined and muscular body shapes for women [2, 3]. These current body image ideals for women ascribe more muscular appearances relative to historical ideals [4, 5] and recent studies have documented a shift in the cultural ideal of physical attractiveness, with women subscribing to a visibly toned ideal [6]. Robinson et al. [6] have provided evidence for this cultural shift through women’s exposure to idealised fitness images—termed ‘fitspiration’. Specifically, participants who viewed athletic ideal images (muscular and toned) reported greater body dissatisfaction than participants who viewed traditional thin ideal images [6]. It has been suggested that the process through which this muscular ideal and body sculpting process occurs is not by female’s resisting cultural norms, instead they are hyper-conforming to them through over-identification with a hyper-idealised form of what constitutes ‘acceptable femininity [7].

"To achieve this muscular body ideal men and women engage in a range of behaviours including performance and image engaging drug (PIED)/anabolic–androgenic steroid (AAS) use [813]. The use of PIEDs among women is not new however, as evidenced by women historically striving for a thin ideal utilising diet pills [14, 15]. Further, research has reported women also utilise other PIEDs, such as tanning agents, in an effort to modify or enhance their appearance [16]. Given the emerging body ideal of women who are seeking to achieve more muscular physiques, this group may be at risk of engaging in PIED or AAS strategies more similar to those of men. The propensity for women to engage in these strategies has been previously sequestered to women’s bodybuilding [17, 18] and, more recently, figure and bikini competitions [19]. However, overall, little attention has been given to the broader context of women regarding PIED and AAS use."


Piatkowski T, Robertson J, Lamon S, Dunn M. Gendered perspectives on women's anabolic-androgenic steroid (AAS) usage practices. Harm Reduct J. 2023 Apr 25;20(1):56. doi: 10.1186/s12954-023-00786-x. PMID: 37098574; PMCID: PMC10127974.