Methyltestosterone
Android, Testred, Methitest, Metandren, Virilon, Oreton Methyl, EEMT, Covaryx
Forms: Tablets and capsules, plus buccal and sublingual forms; also combined at low strength with esterified estrogens in menopause products.
Oral steroidsControlled substanceWADA S1.1 · prohibitedEvidence: approved medicine
One of the oldest synthetic androgens: testosterone with a 17α-methyl group. A prescription drug that converts to a potent estrogen and carries the classic 17α-alkylated liver risks.
Legal status: Prescription medicine and a controlled substance in many countries (US Schedule III, Canada Schedule IV); 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
In sport it has been used for quick strength gains and aggressive drive, less so today. Prescribed in the US for low testosterone and delayed puberty in males and for some breast cancers, and at low strength with estrogens for menopausal symptoms.
What people seek and what studies show
Its effects are documented mainly in medical trials. In postmenopausal women, a low-strength combination with estrogen raised lean mass by about 1.2 kg, increased lower-body strength about twice as much as estrogen alone and improved sexual desire scores more than estrogen alone. In men at sport doses it has not been studied in controlled trials; effects there are known from user reports.
Effects
Evidence: Approved medicine — studied in people for its medical use
Sought effects by goal (as reported)
Mass
Sought for: muscle growth, strength
Recomposition
Sought for: muscle growth
Works against it: water retention / bloating
Strength
Sought for: strength, muscle growth
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.
16 possible side effects
level · how often it is reportedElevated
Suppression of natural testosterone & fertility
commonSuppresses natural testosterone and sperm production; low sperm counts are listed on the label.
How to notice: Lower libido and energy, smaller testicles; low natural testosterone on tests after stopping.
In women: Menstrual changes or missed periods, lower libido and energy; reduced fertility.
Elevated
Worse cholesterol (HDL↓ LDL↑)
commonLike other 17α-alkylated oral steroids it lowers HDL more than injectable testosterone; raised cholesterol is listed on the label. Only a lipid panel shows it.
How to notice: No symptoms — only visible on a lipid panel.
Elevated
Liver strain
possibleThe label warns of cholestatic hepatitis, jaundice and peliosis hepatis, which can be fatal; liver cancer is linked to long use. Dark urine or itching is a reason for prompt liver tests.
How to notice: Usually silent early; later tiredness, nausea, itch, dark urine.
Elevated
Kidney strain
rareRare: the cholestatic jaundice its label warns of can spill over to the kidneys (bile cast nephropathy); steroid users have needed dialysis.
How to notice: Usually silent; foamy urine or swelling in later stages.
Moderate
High estrogen (water, gyno risk)
commonAromatized to 17α-methylestradiol, a potent estrogen that resists breakdown; puffiness and nipple tenderness are typical signs.
How to notice: Puffiness, sensitive or itchy nipples, mood swings, water weight.
Moderate
Gynecomastia
commonThe label states that gynecomastia frequently develops; a tender lump under the nipple is the first sign and deserves a doctor's look.
How to notice: A tender lump or swelling under the nipple.
Moderate
Water retention / bloating
possibleEdema with sodium retention is listed on the label.
How to notice: Puffy face and ankles, softer look, quick weight jumps.
Moderate
Higher blood pressure
possibleThe label warns that blood pressure can rise, increasing cardiovascular risk; home readings show the trend.
How to notice: Often silent; sometimes headaches, flushing, nosebleeds — a home monitor shows it.
Moderate
Heart strain / heart-muscle thickening
possibleEdema can tip people with heart, kidney or liver disease into heart failure; heart attack and stroke are among reactions on the label.
How to notice: Shortness of breath on effort, lower endurance, palpitations.
Moderate
Thick blood (hematocrit) / clot risk
possiblePolycythemia is listed on the label, which also warns of venous blood clots; a blood count shows it before symptoms do.
How to notice: Often silent; sometimes headaches, flushed face, itch after a hot shower.
Moderate
Androgenic hair loss
possible5α-reduced to mestanolone (methyl-DHT) in hair follicles, which can speed up genetic hair loss.
How to notice: More hair in the shower, thinning at the temples or crown.
Moderate
Irritability, aggression, mood swings
possibleUsed for aggressive drive; irritability and mood swings can follow, and changes others notice are a warning sign.
How to notice: Short temper, irritability, conflicts with others.
Moderate
Black-market quality risk (fakes, contamination)
possibleBlack-market tablets have uncertain content.
How to notice: Unexpected effects, pain or infection, a stronger or weaker effect than expected.
MenLow
WomenHigh
Virilization in women (often irreversible)
commonIn women it can cause voice deepening, facial hair and clitoral enlargement; the label warns these become irreversible if use continues.
How to notice: Hoarse or deeper voice, new facial or body hair, menstrual changes, clitoral enlargement.
Low
Acne, oily skin
commonConverted in skin to a stronger androgen by 5α-reductase: oily skin and acne are common.
How to notice: Oily skin, spots on back, shoulders and face.
Low
Prostate growth / PSA rise
possibleConverted to a DHT-like androgen in the prostate; it can enlarge the gland and raise PSA.
How to notice: More frequent urination or a weak stream, especially at night.
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 15 of 16 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.
Measure
Only if a doctor prescribes
How each option helps (7)
- 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.
- Clomiphene — A doctor may consider it after stopping, guided by hormone tests; recovery after long use can still take months. Risks: vision changes, mood swings, rare clots. Has side effects of its own.
- Human chorionic gonadotropin (hCG) — 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.
ElevatedWorse 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
Only if a doctor prescribes
How each option helps (12)
- 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) — Clearly lowers triglycerides but does not fix the steroid HDL drop, the main lipid harm; DHA-containing oils may even raise LDL slightly.
- 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.
- Atorvastatin — A doctor may consider it when LDL or ApoB stay high; it strongly lowers them but barely lifts steroid-lowered HDL. Risks: muscle aches, drug interactions, rarely muscle or liver injury. Has side effects of its own.
- Rosuvastatin — A doctor may consider it when LDL or ApoB stay high; it strongly lowers them but barely lifts steroid-lowered HDL. Risks: muscle aches, rarely muscle or liver injury, slightly higher diabetes risk. Has side effects of its own.
- Ezetimibe — A doctor may consider it when LDL stays high on a statin or a statin isn't tolerated; it lowers LDL moderately but does not raise HDL. Risks: rare liver-enzyme rises. Has side effects of its own.
- Pravastatin / pitavastatin (low-interaction statins) — A doctor may consider them when LDL is high and other statins aren't tolerated; they lower LDL moderately and barely lift HDL. Risks: muscle aches, slightly higher diabetes risk. Has side effects of its own.
ElevatedLiver strain
No alcohol, no other liver stressors, limit oral steroids and their combinations, check liver enzymes.
Measure
Supplement or OTC product
Only if a doctor prescribes
How each option helps (6)
- 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 before symptoms; heavy lifting alone raises AST/ALT for days, and GGT 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 and helped in early acute liver failure of other causes, but untested in steroid users.
- 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.
- Ursodeoxycholic acid (UDCA) — A doctor may consider it to improve bile flow; in steroid cholestasis benefit is unproven and severe cases often did not respond. Stopping the oral steroid comes first. Has side effects of its own.
ElevatedKidney strain
Drink enough water, control blood pressure, avoid regular painkillers (NSAIDs).
Measure
Only if a doctor prescribes
How each option helps (6)
- 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 reads high in muscular people and with creatine; cystatin C and a urine test give a truer picture of the kidneys.
- Working with a doctor — Investigates protein in the urine or falling kidney function and can start treatment that slows kidney damage.
- ACE inhibitors (ramipril, perindopril, lisinopril) — May reduce protein leakage into urine and slow kidney disease. But with dehydration, diuretics or NSAIDs (ibuprofen etc.) they can trigger acute kidney injury. Has side effects of its own.
- Losartan / valsartan (angiotensin receptor blockers) — May reduce protein leakage into urine. But with dehydration, water cuts, diuretics or NSAIDs (ibuprofen etc.) they can trigger acute kidney injury. Has side effects of its own.
- Telmisartan — May reduce protein leakage into urine. But with dehydration, diuretics or NSAIDs (ibuprofen etc.) it can trigger acute kidney injury. Has side effects of its own.
ModerateHigh estrogen (water, gyno risk)
Check estradiol by blood test before acting on symptoms; keep salt and body fat in check.
Measure
How each option helps (2)
- Regular blood tests — A sensitive estradiol test shows whether water retention or nipple tenderness really comes from high estrogen.
- Working with a doctor — Prescription estrogen control is safer when adjusted by lab results than by guesswork.
ModerateGynecomastia
React early: see a doctor at the first lump, check estradiol and prolactin.
Measure
How each option helps (1)
- Working with a doctor — Early assessment of breast-tissue growth allows treatment before the change becomes permanent.
ModerateWater retention / bloating
Steady salt and water intake, cardio, check estradiol.
Measure
How each option helps (1)
- Working with a doctor — Tells harmless water retention from swelling due to heart, kidney or liver trouble; steroid labels warn that edema can come with heart failure.
ModerateHigher blood pressure
Less salt, regular cardio, good sleep; home readings; a doctor if it stays high.
Measure
Supplement or OTC product
How each option helps (8)
- Home blood-pressure monitoring — Seated, rested readings on several days show your true BP; persistently high values are a signal to see a doctor.
- Regular cardio training — Regular aerobic training lowers resting BP by a few mmHg, more in people with high 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 trials: about 2 mmHg lower systolic pressure on average.
- Omega-3 (fish oil, EPA/DHA) — Small drop of a few mmHg, mainly in people with untreated high blood pressure.
- Taurine — Meta-analysis of 20 small trials: about 4 mmHg lower systolic pressure on average.
ModerateHeart strain / heart-muscle thickening
Regular cardio, blood pressure control, an echo as a baseline and then yearly.
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.
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. Avoid dehydration: it thickens the blood further.
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.
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.
ModerateIrritability, aggression, mood swings
Good sleep, fewer stressors, tell someone close to you what to watch for.
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.
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, look for third-party testing (Informed Sport, NSF).
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
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 and fabric; rarely, serious allergic reactions. 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.
Check-ups and blood tests
Which tests and check-ups to do and when. This is a guide — agree the exact schedule with your doctor.
Baseline tests
your own starting values — every later result is compared with them
Lipid panel (HDL, LDL, triglycerides, ApoB)cholesterol
Liver panel (ALT, AST, GGT, bilirubin)liver
Complete blood count (hematocrit, hemoglobin)hematocrit
Kidney panel (creatinine, eGFR, cystatin C)kidneys, blood pressure
Electrolytes (potassium, sodium, magnesium)water retention
Testosterone (total, free), LH, FSH, SHBGnatural testosterone
Estradiol (sensitive assay)high estrogen, gynecomastia
Prolactingynecomastia
PSA
Home blood-pressure logkidneys, blood pressure, heart, water retention
ECGheart
Echocardiogram (heart ultrasound)heart
Urinalysiskidneys
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)cholesterol
Liver panel (ALT, AST, GGT, bilirubin)liver
Complete blood count (hematocrit, hemoglobin)hematocrit
Kidney panel (creatinine, eGFR, cystatin C)kidneys, blood pressure
Electrolytes (potassium, sodium, magnesium)water retention
Estradiol (sensitive assay)high estrogen, gynecomastia
Prolactingynecomastia
Home blood-pressure logkidneys, blood pressure, heart, water retention
Urinalysiskidneys
After stopping
4–8 weeks after stopping (later after long-acting injections), then until values return to baseline
Lipid panel (HDL, LDL, triglycerides, ApoB)cholesterol
Liver panel (ALT, AST, GGT, bilirubin)liver
Complete blood count (hematocrit, hemoglobin)hematocrit
Kidney panel (creatinine, eGFR, cystatin C)kidneys, blood pressure
Testosterone (total, free), LH, FSH, SHBGnatural testosterone
Semen analysisnot earlier than 3 months after stopping, then every 3 months until normalnatural testosterone
Every year
with regular or repeated use
ECGheart
Echocardiogram (heart ultrasound)heart
Which doctors can help
Sports physiciancoordinates everything
Cardiologistcholesterol, blood pressure, hematocrit, heart
Endocrinologistnatural testosterone, high estrogen, gynecomastia
Gastroenterologist / hepatologistliver
Nephrologistkidneys
Psychotherapist / psychiatristmood
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
- 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 emergency services.
- Much less urine than usual, cola-colored urine, new swelling, flank pain — see a doctor now.
- A painful lump under the nipple or nipple discharge — see a doctor early, while it can still regress; a hard, painless or fixed lump, skin dimpling or bloody discharge — see a doctor promptly.
- Sudden severe headache, vision changes, numbness or weakness on one side, trouble speaking — call emergency services.
- Swelling, pain or redness in one leg; sudden shortness of breath or chest pain; sudden one-sided weakness or numbness, trouble speaking or seeing — seek urgent care.
- Chest pain or pressure, breathlessness on light effort, swollen ankles, fainting — seek urgent care.
- Rapid weight gain with breathlessness, or swelling of one leg — see a doctor promptly.
- Losing control of anger, thoughts of harming yourself or others — stop and get help today.
- 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
Some women are prescribed low-strength methyltestosterone with estrogens, yet even then acne and hair growth occur; at sport levels virilization is common and may be permanent. The liver risk applies to women too.
Myth & fact
Myth
“It's a prescription drug, so it's safe for the liver.”
Fact
Its own label warns of cholestatic hepatitis, peliosis hepatis and liver cancer with long use; approval means the risks are known and monitored, not absent.
Combinations
No specific combination notes for this substance yet. The stack check still adds up side effects that several substances share.
Sources
DailyMed: Methyltestosterone capsules label (Amneal) (opens in a new tab)Dobs AS et al. Differential effects of oral estrogen versus oral estrogen-androgen replacement therapy on body composition in postmenopausal women. J Clin Endocrinol Metab 2002 (opens in a new tab)Lobo RA et al. Comparative effects of oral esterified estrogens with and without methyltestosterone on endocrine profiles and dimensions of sexual function in postmenopausal women with hypoactive sexual desire. Fertil Steril 2003 (opens in a new tab)
Check how Methyltestosterone 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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