Testosterone is the primary anabolic steroid naturally produced by the human body, making it the most familiar substance to the body and considered the safest among all anabolic steroids.
However, being safe does not mean it is free from side effects.
Fortunately, the side effects of testosterone are mostly well-known and relatively easy to manage.
Another advantage is the absence of unexpected or ‘surprising’ side effects.
Esterified variants like Testosterone Cypionate can also have side effects, but they can be used safely if you are aware of and manage them beforehand.
Estrogenic Side Effects
Testosterone is easily aromatized by the aromatase enzyme, leading to a moderate level of estrogenic activity in the body.
Testosterone Cypionate shares this characteristic, and the incidence and severity of estrogen-related side effects increase with the dosage.
Bodybuilding doses of testosterone (250mg or more per week) cause more aromatization, and to combat this, an Aromatase Inhibitor (AI), such as Aromasin or Arimidex, can be used.
This works by inhibiting the aromatase enzyme, fundamentally blocking the increase in estrogen levels, and is effective in reducing water retention and other estrogenic side effects.
Another option is to use a Selective Estrogen Receptor Modulator (SERM) like Nolvadex.
A SERM blocks the action of estrogen in breast tissue, preventing gynecomastia, but it does not lower total estrogen levels in the body, so it won’t resolve side effects like water retention or increased blood pressure.
Estrogen-related side effects include water retention, bloating, increased blood pressure, potential for fat gain, and gynecomastia.
Androgenic Side Effects
One of the side effects of Testosterone Cypionate is androgen-related side effects.
Testosterone is the body’s primary androgenic hormone, and as the dosage increases, androgenic side effects become more pronounced.
In tissues such as the prostate, scalp, and skin, testosterone is converted into the more potent androgen, Dihydrotestosterone (DHT), by the 5-alpha reductase (5AR) enzyme. Severe androgenic side effects are primarily caused by this DHT.
To inhibit the 5-alpha reductase enzyme, drugs like Proscar or Dutasteride can be used.
This inhibits DHT production, but the androgenic activity of testosterone itself remains, so it cannot eliminate all androgenic side effects.
Another coping strategy is a topical approach to prevent male pattern baldness, with Nizoral 2% shampoo being a prime example.
The ketoconazole in this shampoo, when applied topically to the scalp and skin, acts as an androgen blocker, which can help prevent hair loss and acne.
Androgenic side effects include increased sebum secretion (oily skin), acne breakouts, growth of body and facial hair, and an increased risk of Male Pattern Baldness (MPB).
MPB, in particular, can be more pronounced in individuals with a genetic predisposition.
HPTA and Endogenous Testosterone Production Side Effects
All anabolic steroids, when used in bodybuilding dosage ranges, will suppress the function of the Hypothalamic-Pituitary-Testicular Axis (HPTA) and shut down endogenous testosterone production.
Testosterone Cypionate is no exception; when exogenous testosterone is detected in the bloodstream above a certain level, natural testosterone production is suppressed.
The longer the cycle, the more difficult it becomes to restore endogenous production, which is why shorter cycles of 8-10 weeks are recommended.
After a cycle, a 4-6 week Post Cycle Therapy (PCT) period is necessary, using ancillary drugs like Nolvadex or HCG to help stimulate testosterone production.
Failure to do this can result in permanent damage to the HPTA, potentially requiring lifelong Testosterone Replacement Therapy (TRT).
Hepatotoxic Side Effects
Testosterone Cypionate is not a C17-alpha alkylated anabolic steroid, and therefore, does not exhibit liver toxicity.
In fact, one study where high doses of oral testosterone (400mg daily, totaling 2,800mg per week) were administered for 20 days showed no signs of liver toxicity.
The purpose of this study was to determine if toxicity arose from the way oral administration interacts with the liver, but no changes in the liver were observed.
Therefore, there are no concerns about liver toxicity with Testosterone Cypionate.
Cardiovascular Side Effects
All anabolic steroids, including Testosterone Cypionate, have a negative impact on cholesterol levels.
Oral steroids, in particular, have the worst impact on cholesterol in the body. Anabolic steroid use causes a reduction in HDL (good cholesterol) and an increase in LDL (bad cholesterol).
This increases the risk of arteriosclerosis, and the negative changes become more severe as the dosage increases.
Testosterone has less of an impact on cholesterol than other steroids, but high doses or the use of an aromatase inhibitor can lead to a greater reduction in HDL cholesterol.
According to studies, a 280mg injection of Testosterone Enanthate resulted in a slight decrease in HDL cholesterol, and the reduction became more significant with higher doses.
Estrogen has a positive impact on cholesterol, so it is important to use aromatase inhibitors appropriately.
Excessive use of an aromatase inhibitor can lower estrogen levels too much, so it is advisable to control estrogen with the minimum effective dose.
