For Girls Only: The Steroids Double Standard

“He's on steroids.”

The rumors were heard nearly every time a track athlete set a new world record. They were heard again as the baseball homerun record was broken and re-broken over the past decade. Those rumors were transformed into concrete allegations last year when investigators stormed into the Bay Area Laboratory Co-Operative (called BALCO), a lab that had been providing steroids to a number of high profile athletes.

As the details unfolded, national interest in the story skyrocketed as it had all the ingredients for a blockbuster — celebrity athletes, covert drug deals, phenomenal athletic success and finally public shame. As a result, the BALCO steroid scandal was on the front of the sport pages for weeks, and spawned a number of spin-off stories chronicling the widespread steroid abuse in professional sports.

The steroid scandal even found its way to the halls of Congress.

This past spring, Congressional hearings were held on the matter and Congress threatened to impose testing programs on professional sports leagues if they didn't effectively eradicate steroid abuse on their own. For his part, President Bush spoke out against steroid abuse in professional sports during his State of the Union address.

To many, this expenditure of governmental effort to address steroid use in professional sports seemed like a colossal waste of time.

Doesn't Congress have more pressing issues than worrying about what pampered superstars do to their bodies? Why should the government get involved?

These are valid points, but the government didn't get involved in the issue out of concern for the well-being of professional athletes. Rather, the government was concerned about the effects steroid abuse in professional sports might have on American youth.

If steroids become an accepted part of the sporting landscape, steroid abuse will naturally filter on down to the high schools and junior highs across the country. Indeed, it already has, as just about any high school athlete can attest. Your average high school athlete most likely knows someone who is taking anabolic steroids, and he probably knows how to go about obtaining them for himself.

Given this widespread availability of anabolic steroids, coupled with their well-known health risks — increased risks of liver cancer, prostate cancer, testicular cancer, high blood pressure and infertility — it is no surprise that the government remains interested in combating anabolic steroid use among America's youth.

Not only have Congress and the president taken a hard stand on the issue but the National Institute of Health has gotten on board by actively funding research to combat the misuse and abuse of anabolic steroids. The effort has also been picked up at the state level, as education standards often mandate that high school health classes discuss the dangers of abusing anabolic steroids.

This concerted government effort to discourage predominately teenage boys from dumping hormones in their bodies should be commended.

However, as well organized and as scientifically sound as this approach is, it stands in stark contrast to the tactic taken with teenage girls.

While it is true that girls are likewise discouraged from taking anabolic steroids, they are not discouraged from taking related steroid hormones in the form of oral contraceptives. In fact, they are encouraged strongly to take these by any number of educators, health care providers and governmental agencies.

As early as junior high school, young girls are encouraged not only to get on the pill but they are encouraged to continue its use through adulthood, coming off only long enough to have their 1.4 kids. Once women hit menopause, they finally are given a reprieve from the pill but in its stead they are prescribed estrogen replacement therapy.

Given this medical approach, you might get the impression that the female body was poorly designed and is badly in need of hormonal intervention at all phases.

While this impression seems justified based upon current medical treatment, nothing could be farther from the truth. In reality, the woman's body is designed quite elegantly, and therefore faces serious risks as a result of all this hormone dumping. Unfortunately, society, for the most part, just prefers to sweep these risks under the rug.

That their are health risks associated with oral contraceptives is not junk science, nor is it something that is hidden deep in obscure journals. It's there for all to see — albeit one has to be willing to look. For example, a meta-analysis of 14 studies looking at the health effects of low-dose oral contraceptives was published this past spring and concluded that women on these oral contraceptives have double the risk of heart attack and stroke versus women not on oral contraceptives.

The researchers also found that the elevated risk for heart attack and stroke does not decline if you look at the newer and supposedly “safer” second- and third-generation oral contraceptives.

While heart attack and stroke are serious risks of the pill, they are by no means the only ones. Other studies have found that low-dose oral contraceptive use is associated with an increased risk of miscarriage. In addition, many women, roughly 3%, become pregnant inadvertently when on oral contraceptives. These women unwittingly expose the developing baby to oral contraceptives, exposure that has been shown to cause fetal defects in lab animals.

Another medical risk associated with the pill results from the fact that postponing pregnancy, the main use of oral contraceptives, puts women at risk for certain cancers, particularly breast and endometrial cancers. Women who have children in their 20s gain a major protective advantage against both of these types of cancers, a protective effect that many women who spend decades on the pill forfeit.

Given the severity and number of risks, one would expect to hear a public outcry, or at the very least a Congressional hearing as in the case of anabolic steroid abuse. It seems logical but when it comes to oral contraceptives, things don't work that way. Instead, many women are not told about the risks, being counseled instead about the modest reductions in ovarian cancer that occur with oral contraceptives and the beneficial effect oral contraceptives will have on their complexion.

Even more disturbing is that oral contraceptives are often prescribed to help “fix” young girls with irregular menstrual cycles. Rather than look at the underlying causes of the irregularity (maybe depression or a poor diet) which might actually demonstrate some concern about the individual, these girls are given a hormone that has well known dangerous side effects and sent on their merry way.

Given our society's different approaches to oral contraceptives and anabolic steroids, one might be tempted to think that we as a whole value the lives of young boys more than young women. Why else would we discourage young boys from ingesting steroids while actively encouraging young women to do the same?

It may be tempting to think that but the real reason for this difference is not that our society is sexist, but that it is sex-crazed. The risks of oral contraceptives are tolerated mainly because it allows for more sexual license. It just so happens that women have to bear these risks. As a result, the sexual liberation that is so championed by the radical feminist movement has been purchased with the lives of young women.

This is even more apparent if one looks at what has happened with estrogen replacement therapy (ERT). With ERT, postmenopausal women are given estrogen alone or in combination with progestin (these are the same hormones found in oral contraceptives) to combat the side effects of menopause. In 2003, estrogen replacement therapy received a lot of bad press when a National Institute of Health study revealed that estrogen replacement therapy caused anywhere from a 10-40% increase in breast cancer, heart disease and stroke respectively.

This sobering data caused the National Institute of Health to stop the study prematurely out of concern for the health of the women involved, a decision that caused all kinds of debate within the medical community.

Now it doesn't take an epidemiologist to notice that the risks associated with estrogen replacement therapy are very similar to those associated with oral contraceptives —breast cancer, stroke, heart disease, etc. Despite the similar risks though, the response of the medical community has been quite different. In the case of post-menopausal women and estrogen replacement therapy, these risks have caused the medical community to rethink the treatment, while in the case of pre-menopausal women and the pill no one has batted an eye. This is despite the fact that women on the pill are at least at a four- to five-fold greater risk than the women taking ERT. Where is the logic in that?

The reality is that there is no logic.

The fact of the matter is that what our society seems to value most is sex detached from love and responsibility, particularly the responsibility of conception. Since post-menopausal women don't have to worry about conception, it's quite proper to be concerned and entertain the possibility that they stop taking these steroid hormones. In the case of pre-menopausal women though, the premium is placed upon preventing pregnancy even if that means jeopardizing their lives.

This risk can be justified because in the end those women that don't die, become infertile or have miscarriages, will have more fulfilling sex lives. At least that's what they have been told.

Daniel Kuebler, Ph.D., is an assistant professor of biology at Franciscan University of Steubenville, Ohio.