Female bodybuilders use a wide range of substances, from everyday legal supplements like protein powder and creatine to prescription-grade performance-enhancing drugs including anabolic steroids, growth hormone, fat burners, and diuretics. What someone takes depends heavily on whether they compete in tested (natural) or non-tested divisions, and the health tradeoffs escalate sharply as you move from supplements to pharmaceuticals.
Legal Supplements Most Competitors Use
Regardless of division, the supplement stack for competitive female bodybuilders is surprisingly consistent. A study of competitive women bodybuilders found that more than 50% used whey protein powder, multivitamins, creatine, energy drinks, fish oil, branched-chain amino acids, probiotics, and vitamin D across all training seasons. Some competitors reported using as many as 21 different dietary supplements during their contest prep phase.
Beyond those staples, plant-based protein powders, pre-workout formulas, ashwagandha, turmeric, and fat burners were also common. Dandelion root appeared frequently as well, likely because it acts as a mild natural diuretic to reduce water retention before a show. In-season competitors consumed significantly more protein and less overall calories, carbohydrates, and fat than those in the off-season, reflecting the extreme caloric restriction that defines contest prep.
Anabolic Steroids and “Mild” Androgens
In non-tested divisions, anabolic steroids are the most impactful category of drugs female bodybuilders use. Women tend to gravitate toward compounds considered “milder” because they carry a lower risk of masculinizing side effects at low doses. The most commonly discussed options in female bodybuilding include oxandrolone (sold as Anavar), which is favored for its ability to add lean muscle without significant water retention, and nandrolone (Deca), which some use in off-season phases to build size.
The doses women use are a fraction of what male bodybuilders take, but even small amounts of androgenic compounds change the body in ways that go beyond muscle. Excess androgens can cause facial and body hair growth, acne, a deepening voice, clitoral enlargement, breast shrinkage, male-pattern hair loss, and disruption or complete loss of menstrual periods. Some of these changes, particularly voice deepening and clitoral enlargement, are permanent even after stopping the drug. This is a major reason female competitors are cautious about which compounds they choose and how long they run them.
SARMs as a Steroid Alternative
Selective androgen receptor modulators, commonly called SARMs, have become popular among women who want some of the muscle-building benefits of steroids with fewer androgenic side effects. Ostarine (MK-2866) is the most widely discussed. It works by stimulating androgen receptors primarily in muscle tissue rather than throughout the entire body, which in theory limits side effects like hair growth and voice changes.
Ostarine is particularly appealing during a cutting phase because it helps maintain muscle mass and strength while a competitor is in a significant caloric deficit. Users have also reported enhanced fat loss while on cycle. However, SARMs are not FDA-approved for human use, are banned by the World Anti-Doping Agency, and the long-term safety data in women is essentially nonexistent. Products sold online frequently contain unlisted ingredients or inaccurate dosing.
Growth Hormone for Body Composition
Human growth hormone (HGH) is another tool used by female competitors in non-tested divisions, valued because it simultaneously builds lean tissue and strips fat without the masculinizing effects of steroids. A meta-analysis of placebo-controlled trials found that growth hormone treatment increased lean body mass by an average of 2.6 kg while reducing fat mass by about 2.2 kg, with higher doses producing more pronounced body composition changes.
Women in bodybuilding typically use lower doses than men, prioritizing the fat-loss and skin-quality benefits over raw size gains. Growth hormone is expensive, requires injection, and carries its own side effects including joint pain, water retention, and potential insulin resistance with prolonged use. Some competitors use peptides that stimulate the body’s own growth hormone release as a less expensive alternative, though these are also unregulated.
Clenbuterol and Thyroid Hormones for Fat Loss
Contest prep demands extremely low body fat levels, and many female competitors turn to non-steroidal fat-burning agents to get there. Clenbuterol is one of the most widely used. It stimulates the central nervous system similarly to epinephrine, ramping up metabolism and accelerating fat burning. Originally developed as an asthma medication at doses of 20 to 40 micrograms daily, bodybuilders typically use it in cycles of two weeks on and two weeks off to manage tolerance. The World Anti-Doping Agency bans it at all times, both in and out of competition.
Side effects include jitteriness, elevated heart rate, muscle cramps, and insomnia. At higher doses, clenbuterol can cause dangerous heart rhythm disturbances.
Thyroid hormones, particularly T3, are another common fat-loss tool. The thyroid controls metabolic rate, and supplementing with synthetic T3 pushes the body to burn more calories at rest. The risk is that exogenous thyroid hormone suppresses your body’s own production, meaning competitors can experience rebound weight gain and sluggish metabolism after stopping. Recovery of normal thyroid function can take weeks to months.
Diuretics During Peak Week
In the final days before stepping on stage, some competitors use diuretics to shed subcutaneous water and create the “dry,” defined look judges reward. This practice carries serious medical risks. Bodybuilders have used prescription diuretics like spironolactone (a potassium-sparing diuretic) and furosemide (a loop diuretic) to increase urine output and flush sodium from the body.
The dangers are well documented. In one reported case, a bodybuilder taking 100 mg of spironolactone daily while drinking 12 liters of water arrived at the emergency room with dangerous potassium levels, low sodium, water intoxication, and muscle breakdown. In another, a competitor who took furosemide before a show lost 5 to 6 kg of body weight overnight and was hospitalized with heart palpitations and an inability to move his limbs. Prescription diuretics are banned by the World Anti-Doping Agency both for their health risks and their ability to mask other performance-enhancing drugs.
Natural competitors often rely on herbal diuretics like dandelion root or strategic water and sodium manipulation instead, though even these approaches carry risks when taken to extremes.
Effects on Menstrual Health
Whether a female bodybuilder uses performance-enhancing drugs or not, the extreme demands of contest prep frequently disrupt the menstrual cycle. In one study of female bodybuilders, 85.7% had regular periods before starting competition preparation, but 57.1% experienced amenorrhea (complete loss of their period) for at least one cycle during prep. Every competitor in the study acknowledged some form of low energy availability through caloric restriction, excessive cardiovascular training (often 30 to 90 minutes daily), or use of cutting substances.
The mechanism is straightforward: when the body senses it doesn’t have enough energy to support basic functions, it shuts down reproduction first. The severe caloric deficit, high training volume, and psychological stress of prep all contribute. Adding steroids, thyroid hormones, or fat burners on top of that caloric deficit compounds the hormonal disruption. For most competitors, menstrual function returns in the months after competition when body fat and caloric intake normalize, but prolonged or repeated cycles of extreme dieting can delay recovery.
The Spectrum From Natural to Enhanced
Not every female bodybuilder uses drugs. The competitive landscape spans a wide spectrum. Athletes in tested federations rely on legal supplements, strategic nutrition, and training periodization. Their supplement stacks center on protein powder, creatine, caffeine-based pre-workouts, and basic micronutrient support. At the other end, competitors in non-tested divisions may layer multiple compounds: a mild anabolic steroid for muscle retention, growth hormone for body composition, clenbuterol or T3 for accelerated fat loss, and a diuretic for the final stage-ready look.
The choices a competitor makes depend on the division she competes in (bikini competitors rarely use the same stack as physique or bodybuilding athletes), whether her federation drug tests, her risk tolerance, and how far she wants to push her physique. Each additional substance adds both potential benefit and potential cost, and many of the more serious side effects in women are irreversible once they develop.