Women’s “performance and image-enhancing drug consumption” is a growing phenomenon yet remains an under-studied area of research. This essay reviews the existing literature on women’s consumption and draws on Fraser’s concept of ontopolitically-oriented research to develop an agenda for future research. Ontopolitically-oriented research applies insights from Science and Technology Studies (STS) to consider the ontological politics of research practices, that is, the realities they enact and foreclose. We argue that the current focus in the existing literature on a limited set of methods and issues risks obscuring the diverse meanings and practices of women’s substance consumption for fitness and strength-training, and genders agency in ways that further entrench assumptions of women’s vulnerability and passivity. We consider issues pertaining to the nomenclature of performance and image-enhancing drugs, the gendering of agency in formulations of “health” risks and initiation experiences, and the need to understand women’s consumption practices in relation to broader cultural changes in health optimization and digital fitness cultures. We argue that ontopolitically-oriented research into women’s substance consumption for fitness and strength-training requires greater methodological diversity and attention to the politics of data generation. It should aim to constitute women’s experiences through terms, connections and coalitions that expand our understandings of women’s agency, and the gendered and social contexts of enhancement practices.