Introduction and Aims: There has been a recent change among female's body ideal, from a slim body to one that is strong and muscular. This transition may be linked to increased participation of women in strength sports (e.g., powerlifting, bodybuilding). Together, these trends may have propagated to a higher prevalence of performance and image enhancing drug (PIED) use among women. The aim of this study was to explore the unique practices of females who use PIEDs through triangulation of multiple stakeholder perspectives.

Method: A series of online interviews ranging from 15 to 90 min were conducted on Zoom. Twenty female and 12 male participants consented to be interviewed, with 14 female participants reporting PIED use. Data were imported into the NVivo (Version 12) platform and analysed using thematic analysis.

Results: Our preliminary data demonstrate significant differences in the way PIEDs are used among women when compared to men. The analysis generated an overarching theme – ‘For Females, It's going to come with other Sh** as well!’. The accompanying higher order themes of ‘compound selection: orals over injectables’, ‘unique experience of changes’, and ‘the tabooness’ articulate the driving forces between practices and accompanied challenges in this group of PIED users.

Discussions and Conclusions: Female's choices in PIED selection are predominantly around oral compounds (e.g., Oxandralone) as well as other substances (e.g., clenbuterol). The use of injectable compounds (e.g., testosterone) represents a radical change in the profile of the typical user and comes with drastic physical challenges.

Disclosure of Interest Statement: None to declare.