Toxicity in Either

Androgen administration to male or female adults, especially at high dosages, results in erythrocytosis and polycythemia, fluid retention, and it may produce or exacerbate edema. This can be serious when associated with congestive heart failure, cirrhosis of the liver, or nephrotic syndrome. Since androgens stimulate the activity of sebaceous glands, oily skin and acne are found in some individuals who are receiving androgen therapy. A change in cholesterol levels can result from androgen therapy, such as decreased levels of high-density lipoprotein cholesterol and increased levels of low-density lipoprotein cholesterol. This change in the distribution of cholesterol may contribute to increased risk of atherosclerosis and coronary artery disease, especially in athletes who are exposed for long periods to high levels of anabolic steroids.

Oral androgen preparations that have the 17-methyl substitution on the steroid molecule are associated with the development of liver disorders, including hyper-bilirubinemia, and elevated liver function tests. As many as 80% of individuals who take these compounds have been shown to develop liver problems. Although these changes are usually reversed if steroid treatment is discontinued, use of the oral preparations is also associated with the development of benign liver tumors and a rare liver disorder involving the development of blood-filled sacs (peliosis hepatis). Finally, worsening of sleep apnea and precipitation of superior sagittal sinus thrombosis—seizures, facial palsy, hemiplegia, stupor, and coma—have been associated with androgen therapy.

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