Steroid use among teen girls is not limited to those involved in competitive athletics and is associated with a cluster of other health-harming behaviors, including smoking and taking diet pills, according to results of a national survey published in the June issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
In 2004, the Centers for Disease Control and Prevention reported that 7 percent of ninth-grade girls reported ever using anabolic steroids, according to background information in the article. During the 1990s, three national surveys indicated dramatic increases in the prevalence of teen girls using steroids. Previous analyses of female steroid use have focused on older women and found an association with competitive athletics and bodybuilding.
Diane L. Elliot, M.D., of the Oregon Health & Science University, Portland, and colleagues assessed anabolic steroid use among teen girls using a nationally representative sample of U.S. high schools completed in 2003. A total of 7,544 female students in grades nine through 12 completed the survey, which included questions about sports participation as well as steroids, ecstasy use and other illegal or unhealthy behaviors.
A total of 5.3 percent of the participants reported prior or ongoing steroid use. "Participating in team sports was negatively related to anabolic steroid use, such that those who were members of sports teams were less likely to self-report prior or ongoing anabolic steroid use," the authors write.
"Adolescent girls reporting anabolic steroid use had significantly more other health-harming behaviors," they continue. "They were much more likely to use other unhealthy substances, including past 30-day use of cigarettes, alcohol, marijuana and cocaine." Young female steroid users were also more likely to:
- have had sexual intercourse before age 13
- have been pregnant
- drink and drive or have ridden with a drinking driver
- carry a weapon
- have been in a fight on school property in the past year
- have feelings of sadness or hopelessness almost every day for at least two weeks
- have attempted suicide
More than two-thirds of the teen girls surveyed reported trying to change their weight. However, those who used steroids were more likely to turn to extreme weight-loss techniques, including vomiting and laxative use. "Anabolic steroids are body-shaping agents and cause a loss in body fat and an increase in lean tissue; therefore, their association with unhealthy weight loss practices was not surprising," the authors write.
The findings highlight important associations among girls who use steroids, the authors conclude. "Across all grades, these seem to be troubled adolescent girls with co-occurring health-compromising activities in the domains of substance use, sexual behavior, violence and mental health," they conclude. "High-risk adolescent girls seem to have received less attention than adolescent boys, perhaps reflecting that their actions are less socially, albeit perhaps more personally, destructive. Anabolic steroid use is another marker for high-risk adolescent girls, and further study is needed to develop effective interventions for this population."
(Arch Pediatr Adolesc Med. 2007;161:572-577. Available pre-embargo to the media at www.jamamedia.org.)
Editor's Note: This study was funded in part by a grant from the National Institute on Drug Abuse. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.