Insight
Women using performance-enhancing drugs face major gaps in healthcare support

Women using PIEDs reported difficulty accessing reliable information, testing and clinical expertise, according to a qualitative study.
Researchers interviewed nine women who used performance- and image-enhancing drugs, primarily to enhance body composition, physical appearance or sporting performance.
Participants reported problems accessing comprehensive blood and hormone testing and finding clinicians familiar with health concerns linked to women’s use of these drugs.
This has been a male-dominated area of research for a long time, so there are significant gaps in understanding women’s health care needs.
The research, led by University of Queensland School of Psychology PhD candidate Hannah Schuurs, explored how the women managed their health while using PIEDs, which include substances such as steroids and peptides.
Schuurs said: “We interviewed nine women who use PIEDs about how they managed their health throughout their PIED use.
“They reported difficulty accessing reliable information and a lack of clinical expertise and formal health care support.
“The study participants were all active in self-monitoring, tracking changes in their bodies, and actively sought formal health care support.
“But they found it hard to access comprehensive blood and hormone testing, or clinicians who were familiar with the unique health concerns associated with women’s PIED use.”
The study found participants spent considerable time educating themselves about the drugs and their potential risks.
“They often found themselves educating healthcare professionals rather than receiving guidance tailored to their circumstances.
Schuurs said: “The participants had spent considerable time educating themselves about PIEDs and their risks and found they were often educating their health care providers, rather than receiving guidance tailored to their circumstances.”
“Structural and systemic barriers shifted a disproportionate level of responsibility for harm reduction and care coordination onto the women themselves.”
Participants were also aware of sex-specific risks, including hormonal disruption and virilisation. Virilisation is when masculine physical traits develop due to high levels of androgens.
However, the women did not necessarily expect healthcare professionals to have all the answers.
Schuurs said: “Participants were often understanding of gaps in clinical knowledge, provided they were met with openness and a willingness to work collaboratively.
“They emphasised that respectful, nonjudgmental health care relationships were just as important as technical expertise.”
The findings also challenged stereotypes that people using PIEDs are uneducated or indifferent to their health.
Participants reported actively managing their health while navigating stigma, uncertainty and gaps in healthcare.
Schuurs said: “The participants actively managed their health and navigated stigma, uncertainty and gaps within health care.”
“We need health care responses that are collaborative rather than judgmental, as those narratives can oversimplify people’s experiences and make it harder for them to seek support.”
She said the research showed PIED use could form part of wider goals relating to health, wellbeing, performance and self-management.
Schuurs said: “Better understanding women’s experiences is critical if we want health care systems to respond effectively and ensure women can access the support they need.”
“There is a real opportunity to improve education, clinical guidance and support for health care professionals in this space that values and draws from the lived experience of women themselves.”
Insight
Women urged to be wary of menopause misinformation on social media

Women are being urged to seek evidence-based advice and avoid menopause misinformation shared on social media.
A seminar co-hosted by the World Health Organization (WHO) mainly examined what is known about the cognitive effects of menopause and current research in the field worldwide.
Dr Nicole Jaff, a South African academic and certified menopause practitioner, said research into menopause and its effects was now at a peak.
She said: “There’s a lot of information out there.
“But I would say please look for the evidence-based information, not for the influencers and the misinformation, but those who are giving guidelines, who are giving information.”
Jaff highlighted research into cognitive changes during menopause and how some women experience brain fog, a term for difficulties with memory, concentration and clear thinking.
She said: “I’m very excited about the non-hormonal treatments that are now available, especially for women who could never take hormone therapy because of breast cancers and various cancers, who can now take it.
“I’m extremely excited about people who are standing up for evidence-based medicine, for science, who are actually fighting back against a lot of the social media and influencers who are not giving evidence-based information and making life very difficult for women because they think they should be forever young or buying this or buying that.”
Jaff advised women and healthcare workers to read new guidelines recently issued by the International Menopause Society. They are available free to download from its website.
The seminar also heard from Professor Aimee Spector, professor of clinical psychology of ageing at University College London.
She raised similar concerns about misinformation, particularly claims linking hormone replacement therapy, known as HRT, to dementia. Some claims suggest HRT reduces dementia risk, while others suggest it increases the risk.
Spector said: “I think there’s also lots of misinformation.
“And I think that there’s huge variations in how even professionals and doctors interpret this information.”
She was part of an international research team commissioned by the WHO last year to assess published studies on the issue.
The institutions involved also included the Global Brain Health Institute at Trinity College Dublin.
Spector said: “The first thing to say is that the quality of evidence was very low.
“Nine out of the 10 studies we looked at were observational, which means that you’re observing patterns over time. But you don’t necessarily know whether that’s due to the hormone therapy or not.
“Our overall recommendation was that there’s insufficient evidence for menopause hormone therapy in terms of either increasing or reducing the risk of dementia. In other words, we don’t know either way.”
Spector said women should therefore decide whether to use HRT to treat menopause symptoms rather than based on concerns about dementia.
She said: “It’s recommended for menopause symptoms, but it’s not recommended to reduce dementia. And I think a lot of people are saying that.”
The Menopause on the Brain webinar was part of an ongoing series hosted by the WHO and other global health agencies.
Insight
Endometriosis musical set for Edinburgh Fringe stage

An endometriosis musical by two US writers will debut at the Edinburgh Festival Fringe in August.
“Endometriosis: The Musical” follows Jane, a woman trying to discover why she is living with chronic pain.
Maria Bartholdi and Kristin Stowell first developed the production for the 2022 Minnesota Fringe Festival.
The full show premiered at Theater in the Round in Minneapolis in 2025.
Stowell said the play drew on personal experience, although neither writer realised it at the time.
“So it’s like my goal to let women see themselves in this who are dealing with this and have a question they can bring back to their doctor,” she said.
“Like, could it be endometriosis?”
Bartholdi said she did not realise she might have the condition herself until after the play premiered.
“This show helped diagnose me, which I think is just one of the miraculous things that we hope this the show does for other people as well,” Bartholdi said.
Dr Wendy VanBuren, a radiologist at Mayo Clinic in Rochester, said she was a fan of the musical and its role in raising awareness of a common but underdiagnosed disease.
“Cells that are similar to but not identical to the cells that comprise the lining of the uterus, the inside of the uterus, are located outside the uterus,” said VanBuren.
“When they’re outside the uterus, there isn’t the right environment to deal with that. So basically, what you get is bleeding, and then you get inflammation.”
Roughly one in seven women live with the disease, and receiving a diagnosis can take nearly a decade.
Insight
Johnson & Johnson offers to pay US$5.5bn to settle talc cancer lawsuits

Johnson & Johnson has offered an estimated US$5.5bn settlement covering about 76,000 claims that its talc products caused ovarian cancer.
The proposed agreement could end a contentious legal dispute over the company’s baby powder and other talc-based products that has lasted around a decade.
Johnson & Johnson said the settlement covers claims consolidated in a federal court in New Jersey and related cases in state court.
The claims represent nearly all the remaining talc cases against the US multinational, according to the company.
Johnson & Johnson has previously settled most claims alleging that its talc contained asbestos and caused mesothelioma.
Mesothelioma is a rare cancer affecting the lining of organs, most commonly the lungs, and is usually linked to asbestos exposure.
Law firms representing claimants confirmed the proposed deal, describing it as a good resolution after around 10 years of litigation.
The agreement must be accepted by 95 per cent of ovarian cancer claimants in state or federal court before it becomes final.
Erik Haas, vice-president of litigation at Johnson & Johnson, said the claims were “meritless” and that the company was willing to settle to bring the litigation to a close.
“While we are confident the company would have ultimately prevailed with further litigation, as it has in the vast majority of cases tried to date, this resolution allows the company to put this matter behind it and remain focused on its mission to develop medicines and devices that save lives,” Haas said.
The company expects to pay US$3bn in 2027, with further payments due in 2028.
The deal could be worth more, depending on how many people take part in the settlement.
Chris Seeger, a lawyer representing around 2,500 clients with talc claims who helped negotiate the agreement, said Johnson & Johnson could ultimately pay US$7bn or more.
The settlement assigns specific values to qualifying ovarian cancer claims but does not cap the company’s total payout.
“We got a fair settlement, and our clients are going to be happy with it,” Seeger said.
Johnson & Johnson reached the agreement after a series of court victories, including wins in individual trials and successful efforts to disqualify claimants’ lawyers from the litigation.
The company also secured court rulings against experts used by claimants to support their cases.
A federal judge last week questioned whether individual claimants could prove that talc had specifically caused their ovarian cancer.
Johnson & Johnson has consistently denied that its talc products caused cancer, maintaining that the products were safe and did not contain asbestos.
The company stopped selling talc-based baby powder in the US in 2020 and switched to a cornstarch-based product.
Litigation resumed in March 2025 after being paused for more than three years while Johnson & Johnson pursued a bankruptcy strategy known as the “Texas two step”.
The company filed three bankruptcies through a shell-company subsidiary in an attempt to settle the cases. Each bankruptcy was dismissed.
Before the bankruptcy attempts, Johnson & Johnson had a mixed record in talc trials.
These included a multibillion-dollar verdict for 22 women who said baby powder caused their ovarian cancer, alongside trials won by Johnson & Johnson and other verdicts later reduced on appeal.
Unlike the proposed bankruptcy settlements, the latest agreement applies only to existing claims and does not cover future lawsuits.
Seeger said excluding future claims made more money available for current claimants than the bankruptcy proposal and would allow all claims to be paid within 18 months rather than over more than a decade.
News2 weeks agoUK femtech investment surges 194% in a decade, research finds
Entrepreneur2 weeks agoTidalSense raises £14m to expand five-minute COPD test across NHS
Entrepreneur2 weeks agoCross-Border Impact Ventures raises US$58m for women and children’s health
Entrepreneur7 days agoApplications close August 18 for Women’s Health Innovation Summit 2026 Innovation Showcase
News2 weeks agoCultural stigma is a barrier to menopause help, black women say
Menopause7 days agoThird of women unaware of perimenopause mental health impact
Motherhood2 weeks agoOne in eight mothers diagnosed with gestational diabetes, research finds
Hormonal health2 weeks agoMenstrual data is missing a critical layer: The mind












