University Park, Pa. -- Among teenage girls, anabolic steroid use has approximately doubled since 1991, whereas use among adolescent boys has remained nearly unchanged, according to a new study.
"While there were numerous public and private intervention efforts in the late 1980s and early 1990s, our society continues to greatly reward 'winning at all costs' and emphasize physical appearance over other traits," said Charles Yesalis, professor of health policy and administration and exercise and sport science.
"These negative messages constantly bombard our young people and are difficult to contradict. We may need to rethink our overall strategies and particularly redirect some of the focus to young girls, as well as strengthen our moral attitudes toward all kinds of cheating in sports, " Yesalis said.
The findings of the study are published in the article, "Trends in Anabolic-Androgenic Steroid Use Among Adolescents," in the December issue of Archives of Pediatric and Adolescent Medicine. The study analyzed trends in steroid use documented in state and national studies.
One national study, Monitoring the Future, reported trends for lifetime steroid use among 8th, 10th and 12th grade students. For 8th-grade girls, the percentage of lifetime users rose from 0.8 percent in 1991 to 1.4 percent in 1996. For 10th grade girls, the percentage rose from 0.5 percent in 1991 to 1.1 percent in 1996. Use among 12th-grade girls showed little significant change, from 0.4 percent in 1991 to 0.6 percent in 1996.
Another study, the National Household Survey on Drug Abuse, also reported a significant rise in use by 12- to 17-year-old female respondents: from 0.2 percent in 1991 to 0.6 percent in 1994.
For males, based on data from three national studies, steroid use has been generally stable since 1991.
The 1995 Youth Risk and Behavior Surveillance System data show that of ninth to 12th graders in public and private high schools in the United States, 4.9 percent of males and 2.4 percent of females have used anabolic steroids at least once in their lives. These prevalence rates translate to approximately 375,000 adolescent male and 175,000 adolescent female steroid users.
"The increase in female use could be attributed to several factors," Yesalis says. "Efforts to provide equity for female athletes have resulted in a greater sense of competitiveness, more opportunities at the collegiate, Olympic and professional levels; and higher financial rewards for winning. But we may be seeing the negative aspects as well: cheating, drug use, and pressure to win at all costs.
"Also, a lean muscular 'hard body' image is popular currently among actresses and models, prompting young girls to imitate those so-called 'ideals', " he adds. "Finally, many of the education and prevention programs are aimed at boys specifically, and young girls have not paid attention to those messages."
For women, the use of anabolic steroids, which is a male hormone, has a greater impact on their bodies and athletic performance than the drugs do on men. While they gain greater strength, young girls face possible permanent side effects of male hair growth or baldness, deepening of the voice, or the enlargement of the clitoris.
"This is addition to risks of heart and liver diseases associated with long-term anabolic steroid use," Yesalis says. "We don't know the long-term effect on women's reproductive systems. When a young teen takes these drugs, the possibility of permanent damage is significant because their bodies are still maturing."
Educational and legal intervention efforts of the late 1980s and early 1990s may have initially helped reduce anabolic steroid use, but these recent trends found among 8th, 10th and 12th grade students suggest that other prevention strategies may be needed as well.
"Previous programs are divided into those that detect use, punish users, educate potential users about the dangers, and help current users to stop abuse," Yesalis says. "No one method alone will be successful. It may be most important to teach teens specific refusal skills, such as resisting peer and media pressures to value only looking good and quick results regardless of the consequences.
"Competition itself is wonderful because it does teach important lessons about life," he adds. "The issues confronting athletes are no different from the ethical and moral issues facing the rest of society today, such as the apparent acceptance of cheating, lying or wrongdoing if the ends are justifiable.
"But if adults don't teach and support ethical beliefs and behaviors in sports, then America will continue to have a major problem at all levels, ranging from illegally recruiting student athletes to football coaches' teaching offensive linemen how to hold without getting caught," he adds.
One of the most effective lines of defense is the attitude of the coaches and parents, says Yesalis, a professor in the College of Health and Human Development.
"The wrong messages are too often being sent that it's OK to cheat to gain a sports advantage and that using chemicals to alter your body to play sports or look good is OK," he says. "Misguided parents, coaches and athletes will often rationalize such behavior by focusing on winning scholarships or achieving a pro career. No youngster should be forced to compromise morally for illusionary gains."
The study was conducted by Yesalis; Camille K. Barsukiewicz, doctoral candidate in health policy and administration at Penn State; Andrea Kopstein, National Institute on Drug Abuse; and Michael Bahrke, Human Kinetics.
Yesalis, who co-authored the first nationwide survey of anabolic steroid use among teen-age boys, is co-author of an upcoming book "The Steroids Game" by Human Kinetic Publishers, Champaign, Ill. The book provides up-to-date information on the use of anabolic steroids and their health consequences, and suggests approaches to combat their misuse by youths of all ages.
He also is editor of an earlier book, "Anabolic Steroids in Sport and Exercise," also by Human Kinetic Publishers.
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EDITORS: Dr. Yesalis can be reached at (814) 863 -7333 (office) or at (814) 238-0978 (home).
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Journal
Archives of Pediatrics and Adolescent Medicine