A growing number of American girls are using anabolic steroids in the attempt to win coveted college scholarships and go on to well-paid careers in sports.
A study in the American Medical Association journal found that use of steroids by teenage girls has doubled since 1991 - while remaining unchanged among adolescent boys.
This increase is in spite of possibly permanent side-effects such as baldness, facial hair, a deeper voice and enlarged clitoris. There is also a risk of heart and liver disease, and the long-term effect on a woman's reproductive system is unknown.
"The increased competitive athletic opportunities and increased rewards for teenage girls and young women, while basically a very good thing, have a down side," said Charles Yesalis, a professor of exercise and sport science at Pennsylvania State University and a co-author of the study.
"There are more people willing to cheat to gain an advantage as the competitive fray becomes more intense."
Dr Yesalis and his colleagues estimated that 2.4 per cent of 14 to 18-year-old girls - or 175,000 - used anabolic steroids, a synthetic form of the male hormone testosterone that can build muscle and make the user leaner. That compares to 4.9 per cent of boys in the same age group, or 375,000.
Experts blame the phenomenon, in part, on competition for athletic scholarships that can ease the high cost of going to college and are increasingly available to women under federal gender equity requirements.
Other factors are the rise in well-paid sports careers open to women and the lean, hard-body image popular among actresses and models.
"I'm concerned that the usage is not strictly by athletes trying to increase their athletic prowess, but also by the minor athlete or the non-athletic girl who wants to look more muscular and have less fat," said Diana Everett, executive director of the National Association for Girls and Women in Sport, which speaks for teachers and coaches.
"These are the girls who don't want to work hard to get there," said Dr Everett. "They're the ones who also will take diet pills or whatever the fad is that comes along, whereas athletes know that they get where they want to go by hard work."
The use or sale of steroids without a prescription has been illegal in the United States since 1988. However, an underground trade in them has continued at commercial gyms and health clubs now increasingly patronised by women.
"The wrong messages are too often being sent that it's OK to cheat to gain a sports advantage, that using chemicals to alter your body to play sports or to look good is OK," Dr Yesalis said.
"Our society continues to greatly reward winning at any cost."