Doping in fitness bikini and bodybuilding
Bodybuilding and fitness bikini are disciplines where the result is determined by the appearance of the body on stage. That is precisely why the pressure on athletes to get «into shape faster» is extremely high, and the topic of doping is discussed here more openly than in Olympic sports. The editorial team examines how anti-doping control works in these disciplines, which substances are most common and why for women the consequences can be irreversible.
Features of bodybuilding disciplines
Unlike weightlifting or running, in bodybuilding there is no stopwatch and no barbell. The judging assesses muscle mass, proportions, symmetry, definition and overall impression. In women's categories — fitness bikini, wellness, body fitness — the criteria emphasise harmony, tone and aesthetics, but the essence is the same: the body is judged on a specific day.
Such a model creates specific incentives. An athlete needs to simultaneously have as much muscle as possible and as little subcutaneous fat and water as possible precisely at the moment of stepping on stage. Naturally this combination is achieved slowly, and the limit of genetic possibilities is reached quickly.
Another feature is a very broad amateur base. Thousands of people step on stage once or twice in their lives, often without experience, without a sports doctor and under the guidance of «prep coaches» whose qualifications are in no way verified. It is precisely in this environment that the risks of doping are least controlled.
Finally, the culture of preparation often normalises pharmacology. Discussion of «cycles» on social media creates the impression that competing without preparations is impossible, although in practice there are federations and categories with real testing.
Tested and untested federations
The bodybuilding world is split into two camps. Some organisations declare compliance with the World Anti-Doping Code or their own testing programmes, others conduct no doping control at all or do it formally. For an athlete this is a fundamental difference: both the competition and the risks depend on it.
| Model | How control works | What this means for a participant |
|---|---|---|
| Federations with anti-doping rules based on the WADA Code | Tests at competitions, sometimes out-of-competition; sanctions under the Code | The Prohibited List and the principle of strict liability apply |
| «Natural» federations with their own programmes | Urine tests, sometimes a polygraph, requirements for a «clean» period | The quality of control varies; it is worth studying the rules of the specific organisation |
| Untested federations and professional leagues | There is no doping control or it is selective (for example, only for diuretics) | Formally, pharmacology is not penalised, but the risks to health are at their maximum |
An athlete competing in a tested federation should remember: the rules apply for the entire time of membership, not only on the day of the start. Out-of-competition tests are possible, and the long-lived metabolites of some steroids are detectable for months.
Some athletes move between tested and untested structures. This is a dangerous strategy: prior use of preparations can show up in a sample, and the rules of many «natural» federations require a break of several years before participation.
The absence of testing does not make substances legal. The circulation of anabolic steroids and many other agents is regulated by national legislation regardless of a federation's rules.
Which substances feature most often
A meta-analysis by Sagoe and co-authors (2014), which summarised studies from various countries, estimated the global lifetime prevalence of anabolic androgenic steroid use at 3.3% overall — 6.4% among men and 1.6% among women. Among gym-goers and bodybuilders this figure is substantially higher than in the general population.
- Anabolic androgenic steroids(class S1 of the Prohibited List) — the basis for «bulking» and preserving muscle while dieting.
- Beta-2 agonists, in particular clenbuterol, used as «fat burners»; clenbuterol is classified under S1 as another anabolic agent.
- Thyroid hormones— not on the Prohibited List, but their abuse is dangerous for the heart.
- Growth hormone and insulin(S2 and S4) — with potentially fatal risks, in particular hypoglycaemia with insulin.
- Diuretics(S5) — for «dryness» before stepping on stage; always prohibited, because they also mask other substances.
- SARMs— unregistered substances sold as a «softer alternative», yet also prohibited (S1).
Diuretics pose an especially acute risk precisely in bodybuilding. Sharp dehydration and disturbance of potassium and sodium levels can cause cramps, arrhythmia and cardiac arrest. The death of Austrian professional bodybuilder Andreas Münzer in 1996 is often cited as an example of the combination of diuretics, anabolics and an extreme diet that led to multiple organ failure.
The editorial team gives no usage regimens and stresses: combining several classes of preparations, typical of untested preparation, multiplies risks that are moreover poorly studied, since no clinical trials of such combinations have been conducted.
Fitness bikini: specific risks for women
The fitness bikini category formally requires a «softer», aesthetic shape without excessive muscularity. It might seem that the pressure regarding doping is lower here. In fact, many participants use so-called «female» steroids, clenbuterol or thyroid hormones, considering them safe in «small doses».
Any androgen in a woman's body can cause virilisation: deepening of the voice, growth of facial and body hair, clitoral enlargement, acne, male-pattern baldness. Voice change, caused by growth of the larynx and thickening of the vocal cords, often remains permanent, even after stopping the preparation. The effects depend on dose and duration, but there is no «safe» androgen for a woman outside medical indications.
Menstrual cycle disturbances, amenorrhoea and reduced fertility arise both from hormonal preparations and from the extreme diet itself with a very low fat percentage. These factors overlap, and recovery can take months.
An additional factor is psychological. Constant assessment of the body, «before/after» photos and sharp weight swings between seasons increase the risk of eating disorders and dissatisfaction with one's own body. Women who experience such problems should turn to specialists rather than seek solutions in preparations.
The cost to health and how to make a choice
The Endocrine Society scientific statement (Pope et al., 2014) systematised the consequences of using performance-enhancing preparations: cardiomyopathy, atherosclerosis, erythrocytosis, suppression of one's own hormonal system, psychiatric effects, dependence. A Danish registry study (Horwitz et al., 2019) showed that individuals found to have used anabolic steroids had higher mortality and morbidity compared with a control group.
A feature of bodybuilding is duration. Many athletes use preparations for years, often without breaks and with escalating doses. The cumulative load on the heart and vessels manifests not immediately but decades later, when the link to youthful competitions is no longer obvious.
Bodybuilding also has a widespread illegal market of preparations of unverified quality. Inconsistency of composition, contamination, non-sterile injection solutions add risks unrelated to the pharmacology of the substance itself.
For a person planning to step on stage, the editorial team advises choosing a tested federation, working with a coach who openly supports natural preparation, undergoing a medical examination before and after the season and setting realistic goals. Daily progress towards shape without pharmacology is slower but does not cost your health.
Editorial conclusions
Bodybuilding and fitness bikini are disciplines with a particularly high risk of doping owing to the nature of the judging and the culture of preparation. The split into tested and untested federations determines both the competitive environment and the legal consequences.
The most dangerous practices are combining several classes of preparations and using diuretics before a start. For women there is an additional risk — virilisation, some of whose manifestations are irreversible.
Choosing a tested federation, medical supervision and realistic goals are the most reliable strategy for those who want to compete without harm to health.
We also recommend reading our materials on prohibited supplements and positive tests, on doping in crossfit and on well-known doping cases in powerlifting.
References
- Pope HG Jr, Wood RI, Rogol A, et al. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocr Rev. 2014;35(3):341–375.
- Sagoe D, Molde H, Andreassen CS, Torsheim T, Pallesen S. The global epidemiology of anabolic-androgenic steroid use: a meta-analysis and meta-regression analysis. Ann Epidemiol. 2014;24(5):383–398.
- Horwitz H, Andersen JT, Dalhoff KP. Health consequences of androgenic anabolic steroid use. J Intern Med. 2019;285(3):333–340.
- Kanayama G, Pope HG Jr. History and epidemiology of anabolic androgens in athletes and non-athletes. Mol Cell Endocrinol. 2018;464:4–13.
- World Anti-Doping Agency. The Prohibited List. Montreal: WADA; чинна редакція.
- World Anti-Doping Agency. World Anti-Doping Code 2021. Montreal: WADA; 2021.
Andriy Melnyk
A strength-sports coach and author of programs for beginner and intermediate levels. Writes about training planning.
