In the 1960s East German politicians zeroed in on athletic performance as one of the fastest and cheapest means for their country to obtain international prestige. Huge efforts were made to improve athletic success, from selection of talented children for special sports schools to the systematic use of drugs.

Synthetic derivatives of the male hormone testosterone were the most frequently used. Girls as young as 12 were recruited and, as part of their training, dosed with steroids and male hormones without their knowledge. The drug caused its most marked effects in females, who have less natural testosterone. In the swimming events of the Montreal 1976 Olympics – in which East Germany won 11 out of 13 events – the husky voices and broad shoulders of its female swimmers were widely remarked upon. Not until the introduction of random out-of-competition drug testing was such egregious drug use brought under control.