Methenolone acetate (tablets)
Metenolone acetate, Primobolan, Primobolan oral, Primobolan tablets
Forms: Acetate tablets (Primobolan). The enanthate depot injection (Primobolan Depot) has its own card.
Other esters and forms: Methenolone enanthate (injection)
Oral steroidsControlled substanceWADA S1.1 · prohibitedEvidence: approved medicine
The oral form of methenolone, a DHT-derived steroid that does not convert to estrogen and is not 17α-alkylated. Still a prescription tablet in Japan (Primobolan).
Legal status: Controlled anabolic steroid (US Schedule III, UK Class C); the tablets remain a prescription medicine in Japan; status varies by country.
What it gives
What people use it for and what the sources report. Strength is a general category from the literature: mild, clear or strong.
Purpose
Used for slow, lean gains and to keep muscle while dieting; often seen as 'mild'. In Japan the tablets are prescribed for osteoporosis, severe wasting and aplastic anemia; in many other countries methenolone is discontinued.
What people seek and what studies show
In a randomized trial in aplastic anemia, adding oral methenolone to immune therapy raised the response rate to 73% versus 31% without it. Its Japanese label describes more protein synthesis with less breakdown and calcium and phosphorus retention. Sport use has not been studied; its reputation for 'quality gains without water' comes from users.
Effects
Evidence: Approved medicine — studied in people for its medical use
Sought effects by goal (as reported)
Mass
Sought for: muscle growth, strength
Cutting
Sought for: keeping muscle in a deficit, hard, dry look
Recomposition
Sought for: muscle growth, keeping muscle in a deficit
Strength
Sought for: strength, muscle growth
Works against it: tendon / ligament injury risk
Possible side effects
Possible does not mean certain: whether they appear depends on dose, duration, individual response and monitoring. Below — what to watch for and how to notice it early.
15 possible side effects
level · how often it is reportedElevated
Suppression of natural testosterone & fertility
commonSuppresses natural testosterone and sperm production; its label notes reduced sperm with large continuous doses.
How to notice: Lower libido and energy, smaller testicles; after stopping — low natural testosterone on tests, often with tiredness and low mood.
In women: Menstrual changes or missed periods, lower libido and energy; reduced fertility.
Moderate
Worse cholesterol (HDL↓ LDL↑)
commonAs a non-aromatizing androgen it tends to lower HDL; the change is silent and needs a lipid panel.
How to notice: No symptoms — only visible on a lipid panel.
Moderate
Black-market quality risk (fakes, contamination)
commonDiscontinued in many countries; much of what is sold for sport as Primobolan tablets is underground or counterfeit, with uncertain content.
How to notice: Unexpected effects, pain or infection, a stronger or weaker effect than expected.
Moderate
Thick blood (hematocrit) / clot risk
possiblePrescribed for aplastic anemia as it supports red-cell production. Thicker blood plus dehydration (weight cuts, heat) or long trips to events raises clot risk.
How to notice: Often silent; sometimes headaches, flushed face, itch after a hot shower.
Moderate
Androgenic hair loss
possibleA DHT derivative: it can speed up genetic hair loss.
How to notice: More hair in the shower, thinning at the temples or crown.
Moderate
Heart strain / heart-muscle thickening
possibleNot 'athlete's heart': steroid-using lifters pumped weaker than non-using lifters (LVEF 52% vs 63%) and had more coronary plaque.
How to notice: Shortness of breath on effort, endurance falling for no training reason, palpitations.
Moderate
Tendon / ligament injury risk
possibleClass data: steroid-using bodybuilders had about 9 times more tendon ruptures than non-using lifters, upper-body ones only in users; a quarter followed local pain.
How to notice: Pain at tendon attachments under heavy load; in steroid-using bodybuilders about a quarter of ruptures followed such pain.
Moderate
Irritability, aggression, mood swings
possibleClass data: more aggression is among the effects male athletes on steroids most often report; body dissatisfaction can drive use, and dependence can develop.
How to notice: Short temper, irritability, conflicts with others.
Moderate
Liver strain
rareNot 17α-alkylated, yet its label warns of liver dysfunction and jaundice; a fatal case in a frail patient is described. Hard training also raises ALT and AST.
How to notice: Usually silent early; later tiredness, nausea, itch, dark urine.
Moderate
Kidney strain
rareNo compound data; long-term heavy AAS use is linked to protein in urine and FSGS in bodybuilders. Big muscle mass raises creatinine; cystatin C depends on it much less.
How to notice: Usually silent; foamy urine or swelling in later stages. Big muscle mass or creatine also raise creatinine.
MenLow
WomenHigh
Virilization in women (often irreversible)
possibleIn women its label lists hoarseness that may become irreversible, hair growth, acne, menstrual changes and clitoral enlargement; menstrual changes often come first.
How to notice: Hoarse or deeper voice, new facial or body hair, menstrual changes, clitoral enlargement.
Low
Too-low estrogen (joints, libido, mood, lipids)
possibleDoes not aromatize; when used on its own, low estrogen may show as joint aches, low libido or low mood.
How to notice: Aching, stiff joints, low libido, flat mood, poor sleep.
Low
Acne, oily skin
possibleAcne is listed on its label for both men and women.
How to notice: Oily skin, spots on back, shoulders and face.
Low
Prostate growth / PSA rise
possibleIts label asks for regular prostate checks in men.
How to notice: More frequent urination or a weak stream, especially at night.
Low
Higher blood pressure
possibleSodium and fluid retention can occur, mainly a concern with heart or kidney disease.
How to notice: Often silent; sometimes headaches, flushing, nosebleeds — a home monitor shows it. Heavy lifts briefly spike it even in healthy lifters.
What the levels mean
Lowbackground — just be aware
Moderatewatch for signs
Elevatedneeds regular control
Highcritical — can be life-threatening or permanent
Level: general category from the literature, not your personal risk
How often
- common
- reported often
- possible
- reported in some people
- rare
- reported occasionally
How to lower the risks
For 13 of 15 possible side effects there are specific ways to lower the chance: everyday measures, supplements and options a doctor may consider. For the rest — general advice. No measure removes a risk completely. Prescription medicines are listed only for a doctor to decide on, after tests — they have side effects of their own.
ElevatedSuppression of natural testosterone & fertility
Check hormones before and after; if they stay low, see an endocrinologist. Hard training on too little food (RED-S) also lowers testosterone.
Measure
Only if a doctor prescribes
How each option helps (8)
- Regular blood tests — LH, FSH and testosterone show how deep suppression is and whether natural production has recovered afterwards.
- Working with a doctor — Assesses how deep suppression is and guides recovery afterwards, including fertility testing.
- Choriogonadotropin alfa (recombinant hCG) — A doctor may consider it off-label to preserve fertility (it keeps the testes working); it does not restart the pituitary. Risks: higher estradiol, gynecomastia. Has side effects of its own.
- Clomiphene — A doctor may consider it after stopping, guided by hormone tests; most men recover on their own within months, and lasting benefit is unproven. Risks: vision changes, mood swings, rare clots. Has side effects of its own.
- hCG (urinary human chorionic gonadotropin) — A doctor may consider it to preserve fertility (in men it keeps the testes working); it does not restart the pituitary, so natural LH still has to recover. Risks: higher estradiol, gynecomastia. Has side effects of its own.
- Tamoxifen — A doctor may consider it after steroids are stopped, guided by hormone tests; it has not been tested for this after steroid use. Risks: blood clots, vision changes. Has side effects of its own. Not offered to women: in the women’s view it adds to a risk this substance already carries.
- Follicle-stimulating hormone (follitropins, menotropins) — A fertility doctor may consider adding it to hCG when semen tests and FSH stay low; it does not restart the pituitary. Risks: gynecomastia, acne. Has side effects of its own.
- Toremifene — A doctor may consider it after steroids are stopped, guided by hormone tests; it raised testosterone in subfertile men but was never tested after steroids. Risks: QT prolongation, clots. Has side effects of its own. Not offered to women: in the women’s view it adds to a risk this substance already carries.
ModerateWorse cholesterol (HDL↓ LDL↑)
Avoid combining several oral steroids; regular cardio, soluble fiber (psyllium), less saturated fat and alcohol; if LDL/ApoB stay high, a doctor may consider a statin. Omega-3 only lowers triglycerides.
Measure
Supplement or OTC product
How each option helps (8)
- Regular blood tests — A lipid panel with ApoB shows how far HDL has dropped and LDL risen — changes you cannot feel.
- Working with a doctor — Interprets lipids and ApoB and decides whether a statin or other therapy is warranted.
- Avoiding alcohol and other liver stressors — Alcohol raises triglycerides; its small HDL bump does not lower heart risk.
- Regular cardio training — Raises HDL a little and lowers triglycerides; it cannot offset a steroid-driven fall in HDL on its own.
- Berberine — Placebo-controlled meta-analysis: LDL about 0.5 and triglycerides about 0.4 mmol/L lower; HDL unchanged. Trials are mostly small; no statin substitute.
- Citrus bergamot — Pooled small trials show lower LDL and triglycerides, but certainty is low to very low; it is no replacement for statins.
- Omega-3 (fish oil, EPA/DHA) — Lowers triglycerides but does not fix the steroid HDL drop, the main lipid harm; omega-3 supplements may even raise LDL (IOC).
- Psyllium husk fiber — Lowers LDL by about 0.2–0.3 mmol/L (roughly 5–10%), also on top of doctor-prescribed statins; no effect on HDL.
ModerateBlack-market quality risk (fakes, contamination)
Products obtained without a prescription are often fake, mislabeled or non-sterile, and there is no way to check at home. For legal supplements, third-party testing (Informed Sport, NSF) lowers, but does not remove, the risk of a positive doping test.
ModerateThick blood (hematocrit) / clot risk
Check the blood count regularly; if hematocrit stays high, a doctor decides — usually stopping or reducing the cause, sometimes therapeutic phlebotomy, never blood-bank donation. Dehydration in long or hot sessions and long flights add to clot risk.
Measure
How each option helps (3)
- Regular blood tests — A blood count shows hematocrit and hemoglobin climbing toward the range where clot and stroke risk rises.
- Therapeutic phlebotomy prescribed by a doctor — Only on a doctor's decision, never at a blood bank. Lowers hematocrit quickly but temporarily; repeated sessions drain iron, and a lower clot risk is unproven.
- Working with a doctor — Manages thick blood by changing what you use or, if justified, by therapeutic phlebotomy; dehydration, long flights and injury immobilization add to clot risk in athletes.
ModerateAndrogenic hair loss
Ketoconazole shampoo, minoxidil, a dermatologist early if you are prone to it.
Supplement or OTC product
How each option helps (1)
- Minoxidil (topical) — Slows thinning and regrows some hair; scalp itching and early temporary shedding are common, unwanted facial hair possible. Gains fade once stopped.
ModerateHeart strain / heart-muscle thickening
Regular cardio, blood pressure control, an echo as a baseline and then yearly, read by a cardiologist who knows athletes’ hearts.
Measure
How each option helps (4)
- Heart screening: ECG and echocardiogram — Echocardiography shows wall thickening and reduced pumping early, while stopping AAS and treating BP can still help.
- Working with a doctor — Orders ECG and echocardiography and treats early heart changes.
- Home blood-pressure monitoring — Keeping BP controlled is one of the main ways to limit heart-wall thickening.
- Regular cardio training — Supports heart and vessel function, but does not reverse steroid-related heart thickening or weakening.
ModerateTendon / ligament injury risk
Progress weights gradually — strength rises faster than tendons adapt; with persistent tendon pain, cut the load and see a sports physician.
ModerateIrritability, aggression, mood swings
Good sleep, fewer stressors, tell someone close what to watch for. About one in three androgen users becomes dependent; if you cannot stop or never feel big enough, talk to a doctor or psychologist.
Measure
How each option helps (2)
- Avoiding alcohol and other liver stressors — Alcohol and other drugs on top of steroids explain much of the link between steroid use and violence.
- Sleep hygiene — Enough sleep lowers irritability and improves impulse control.
ModerateLiver strain
No alcohol or other liver stressors, limit oral steroids and their combinations; check liver enzymes (hard training raises ALT and AST too).
Measure
Supplement or OTC product
How each option helps (5)
- Avoiding alcohol and other liver stressors — Removes a major extra liver stressor during oral steroids and other hepatotoxic drugs.
- Regular blood tests — ALT, AST, GGT and bilirubin show liver strain early. Weightlifting raised AST, ALT and CK for at least a week in men new to it, while GGT stayed normal — it helps tell muscle from liver.
- Ademetionine (SAMe) — Used for intrahepatic cholestasis in some countries, but trials are small and of low quality; untested in steroid users. Stopping the oral steroid matters most.
- N-acetylcysteine (NAC) — Restores glutathione; proven in paracetamol poisoning but untested in steroid-related liver injury.
- TUDCA (tauroursodeoxycholic acid) — Improves bile flow in cholestatic disease; in steroid cholestasis only case reports, with failures in severe cases. Stopping the oral steroid matters most.
ModerateKidney strain
Drink enough, more in heat; control blood pressure; avoid regular painkillers (NSAIDs) and any during long or hot events; no weight cutting by dehydration.
Measure
How each option helps (3)
- Fluid & electrolyte management — Good hydration eases kidney stress from heavy training and heat; dehydration plus NSAIDs is a classic cause of acute kidney injury.
- Regular blood tests — Creatinine runs high with big muscle mass, creatine and hard training, and standard eGFR formulas mislead in athletes; compare with your own baseline and add cystatin C and urinalysis.
- Working with a doctor — Investigates protein in the urine or falling kidney function and can start treatment that slows kidney damage.
MenLow
WomenHigh
Stop at the first voice change and see a doctor — early stopping matters.
Measure
How each option helps (1)
- Working with a doctor — Steroid labels say to stop at the first mild signs (hoarse voice, facial hair, clitoral growth) to prevent permanent change; checks catch them early but do not make use safe.
Low-level side effects
Low estrogen
Avoid controlling estrogen blindly; adjust only by blood tests with a doctor.
Measure
How each option helps (1)
- Regular blood tests — Testing ends guesswork use of aromatase inhibitors — prescription drugs that can push estrogen too low and harm joints, libido, mood and lipids.
Acne
Gentle skin care, cleansing after training, a dermatologist if it spreads.
Supplement or OTC product
How each option helps (3)
- Adapalene — Reduces spots in many users. Redness, scaling, dryness and stinging are common early and usually ease; acne may look worse at first. Rarely, allergic swelling.
- Benzoyl peroxide — A first-line acne option. Dryness, redness and peeling are common at first; it bleaches hair, towels and training clothes; rarely, serious allergy. Severe steroid acne needs a dermatologist.
- Zinc — Trials show a modest drop in inflamed spots, weaker than antibiotics; steroid acne is driven by androgens.
Prostate
PSA as a baseline, especially after 40; a urologist if urination changes.
Measure
How each option helps (1)
- Regular blood tests — PSA tracks prostate changes on androgens — most relevant after 40 or with urinary symptoms.
Blood pressure
Less salt, regular cardio, good sleep, home readings; if it stays high — a doctor, and a talk about maximal lifts.
Measure
Supplement or OTC product
How each option helps (19)
- Home blood-pressure monitoring — Persistently high resting readings mean seeing a doctor. For athletes, guidance prefers ARBs or ACE inhibitors, which don't limit exercise capacity; diuretics are banned in sport.
- Regular cardio training — In a meta-analysis of trials, endurance training lowered resting BP by about 8/5 mmHg in people with high BP and only slightly in those with normal BP.
- Working with a doctor — Diagnoses persistent hypertension and prescribes treatment when needed.
- Avoiding alcohol and other liver stressors — Regular drinking raises blood pressure; cutting it out lowers it.
- Coenzyme Q10 — Inconsistent: some analyses show a small systolic drop in cardiometabolic disease, but a Cochrane review found no clinically meaningful effect.
- Magnesium — Meta-analysis of 34 trials in adults, not athletes: about 2 mmHg lower systolic pressure on average.
- Magnesium aspartate — On average magnesium lowers blood pressure only slightly — not a substitute for a doctor's assessment of high pressure found at a sports check.
- Magnesium chloride — On average magnesium lowers blood pressure only slightly — not a substitute for a doctor's assessment of high pressure found at a sports check.
- Magnesium citrate — On average magnesium lowers blood pressure only slightly — not a substitute for a doctor's assessment of high pressure found at a sports check.
- Magnesium gluconate — On average magnesium lowers blood pressure only slightly — not a substitute for a doctor's assessment of high pressure found at a sports check.
- Magnesium glycinate (bisglycinate) — On average magnesium lowers blood pressure only slightly — not a substitute for a doctor's assessment of high pressure found at a sports check.
- Magnesium lactate — On average magnesium lowers blood pressure only slightly — not a substitute for a doctor's assessment of high pressure found at a sports check.
- Magnesium malate — On average magnesium lowers blood pressure only slightly — not a substitute for a doctor's assessment of high pressure found at a sports check.
- Magnesium orotate — On average magnesium lowers blood pressure only slightly — not a substitute for a doctor's assessment of high pressure found at a sports check.
- Magnesium oxide — On average magnesium lowers blood pressure only slightly — not a substitute for a doctor's assessment of high pressure found at a sports check.
- Magnesium taurate — Meta-analysis of trials: about 2 mmHg lower systolic pressure on average — too small to replace a doctor's assessment of high pressure found at a sports check.
- Omega-3 (fish oil, EPA/DHA) — Small drop of a few mmHg, mainly in people with untreated high blood pressure.
- Potassium — Meta-analysis of trials: about 3.5 mmHg lower systolic pressure on average, seen only in people with hypertension.
- Taurine — Meta-analysis of 20 small trials: about 4 mmHg lower systolic pressure on average.
Check-ups and blood tests
Which tests and check-ups to do and when. This is a guide — agree the exact schedule with a sports physician.
Baseline tests
your own starting values — every later result is compared with them
Lipid panel (HDL, LDL, triglycerides, ApoB)In athletes, a high LDL can also be a sign of too little food for the training (RED-S) — tell the doctor about dieting.low estrogen, cholesterol
Liver panel (ALT, AST, GGT, bilirubin)Unaccustomed heavy weight training raised ALT and AST (from muscle) for at least a week, while GGT and bilirubin stayed normal — test after a break from hard training.liver
Complete blood count (hematocrit, hemoglobin)Endurance training dilutes the blood (“sports anemia”), dehydration concentrates it — test hydrated and rested, against your own baseline.hematocrit
Kidney panel (creatinine, eGFR, cystatin C)Creatinine reads higher with big muscle mass or creatine; cystatin C barely depends on muscle and helps judge the kidneys in athletes.kidneys
Testosterone (total, free), LH, FSH, SHBGTestosterone also falls with hard training on too little food (RED-S) — test in the morning, rested, and tell the doctor about dieting.natural testosterone
Estradiol (sensitive assay)low estrogen
PSA
Home blood-pressure logMeasure seated and rested, not within 30 minutes after training, caffeine or smoking — they change the reading.heart, kidneys
ECGTraining changes the ECG in ways that are normal for athletes; ask for a reading by the international athlete criteria, which separate these from disease.heart
Echocardiogram (heart ultrasound)Weight training alone does not weaken the heart’s pumping or relaxation; in a lifter that is not “athlete’s heart” — in steroid users it was linked to the drugs.heart
UrinalysisHard exercise can briefly put protein and blood into the urine, usually gone within a few days — test after rest and repeat before drawing conclusions.kidneys
While taking
about 4–6 weeks in, then every 6–8 weeks — agree the exact schedule with your doctor
Lipid panel (HDL, LDL, triglycerides, ApoB)In athletes, a high LDL can also be a sign of too little food for the training (RED-S) — tell the doctor about dieting.low estrogen, cholesterol
Liver panel (ALT, AST, GGT, bilirubin)Unaccustomed heavy weight training raised ALT and AST (from muscle) for at least a week, while GGT and bilirubin stayed normal — test after a break from hard training.liver
Complete blood count (hematocrit, hemoglobin)Endurance training dilutes the blood (“sports anemia”), dehydration concentrates it — test hydrated and rested, against your own baseline.hematocrit
Kidney panel (creatinine, eGFR, cystatin C)Creatinine reads higher with big muscle mass or creatine; cystatin C barely depends on muscle and helps judge the kidneys in athletes.kidneys
Estradiol (sensitive assay)low estrogen
Home blood-pressure logMeasure seated and rested, not within 30 minutes after training, caffeine or smoking — they change the reading.heart, kidneys
UrinalysisHard exercise can briefly put protein and blood into the urine, usually gone within a few days — test after rest and repeat before drawing conclusions.kidneys
After stopping
4–8 weeks after stopping (later after long-acting injections), then until values return to baseline
Lipid panel (HDL, LDL, triglycerides, ApoB)In athletes, a high LDL can also be a sign of too little food for the training (RED-S) — tell the doctor about dieting.low estrogen, cholesterol
Liver panel (ALT, AST, GGT, bilirubin)Unaccustomed heavy weight training raised ALT and AST (from muscle) for at least a week, while GGT and bilirubin stayed normal — test after a break from hard training.liver
Complete blood count (hematocrit, hemoglobin)Endurance training dilutes the blood (“sports anemia”), dehydration concentrates it — test hydrated and rested, against your own baseline.hematocrit
Kidney panel (creatinine, eGFR, cystatin C)Creatinine reads higher with big muscle mass or creatine; cystatin C barely depends on muscle and helps judge the kidneys in athletes.kidneys
Testosterone (total, free), LH, FSH, SHBGTestosterone also falls with hard training on too little food (RED-S) — test in the morning, rested, and tell the doctor about dieting.natural testosterone
Semen analysisnot earlier than 3 months after stopping, then every 3 months until normalnatural testosterone
Every year
with regular or repeated use
ECGTraining changes the ECG in ways that are normal for athletes; ask for a reading by the international athlete criteria, which separate these from disease.heart
Echocardiogram (heart ultrasound)Weight training alone does not weaken the heart’s pumping or relaxation; in a lifter that is not “athlete’s heart” — in steroid users it was linked to the drugs.heart
Which doctors can help
Cardiologistcholesterol, hematocrit, heart
Endocrinologistnatural testosterone, low estrogen
Gastroenterologist / hepatologistliver
Nephrologistkidneys
Psychotherapist / psychiatristmood
Sports physiciantendons
Dermatologisthair loss
Gynecologistvirilization, natural testosterone (women)
At home
- Home blood pressure: 2–3 times a week in the morning, keep a log
Get medical help at once if
- Swelling, pain or redness in one leg (especially after a long flight) — urgent care; sudden breathlessness, chest pain, one-sided weakness or numbness, trouble speaking or seeing — call your local emergency number.
- Chest pain or pressure, fainting or near-fainting on exertion, breathlessness on light effort, swollen ankles — stop training and seek urgent care; collapse — call your local emergency number.
- Yellow skin or eyes, dark urine, pale stools, intense itching, pain under the right ribs — see a doctor now; sudden severe abdominal pain with dizziness or fainting — call your local emergency number.
- Much less urine than usual, cola-colored urine (especially with severe muscle pain after hard training), new swelling, flank pain — see a doctor now.
- Losing control of anger, thoughts of harming yourself or others — stop and get help today.
- A snap and sudden sharp pain in a tendon, inability to load the limb — stop training and get it examined.
- Deepening voice, new facial hair, clitoral enlargement — stop and see a doctor: changes can become permanent. (women)
In an emergency, call your local emergency number.
For women
Popular among women as 'mild', but its label warns that hoarseness may become irreversible and lists hair growth and clitoral enlargement. Menstrual changes often come first — an early sign of androgen excess. Androgens virilize a female fetus, so they are ruled out in pregnancy.
Myth & fact
Myth
“Primobolan doesn't touch the liver.”
Fact
It is not 17α-alkylated and is gentler than most oral steroids, yet its Japanese label warns of liver dysfunction and jaundice and asks for periodic liver tests.
Combinations
No specific combination notes for this substance yet. The stack check still adds up side effects that several substances share.
Sources
Primobolan tablets (metenolone acetate) — Japanese prescribing information, Bayer, rev. Aug 2020 (KEGG MEDICUS) (opens in a new tab)Kaltwasser JP et al., Eur J Haematol 1988: oral methenolone added to antithymocyte globulin raised response in aplastic anemia (randomized) (opens in a new tab)Tsukamoto N et al., Ann Hematol 1993: fatal liver failure in a frail patient with aplastic anemia after metenolone acetate (opens in a new tab)Kanayama G et al., Am J Sports Med 2015: tendon ruptures in steroid-using vs non-using bodybuilders (HR ≈ 9; upper-body ruptures only in users) (opens in a new tab)Baggish AL et al., Circulation 2017: steroid-using weightlifters vs non-using lifters — weaker heart pumping and more coronary plaque (opens in a new tab)
Check how Methenolone acetate (tablets) combines with your stack
Possible side effects by body system, combinations, how to lower the risks and which tests to do — free.
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