There are a variety of side effects that could occur in individuals who receive nandrolone decanoate injections. Some of these reactions include, but are not limited to, the following:
- Enlargement of the prostate in elderly men.
- Reduced sperm count and volume in men.
- Hepatitis and hepatocellular carcinoma may occur at high doses. A rare but life-threatening liver disease known as peliosis hepatis may also occur.
- Females may experience the signs of virilization previously mentioned as well as menstrual abnormalities. These effects are reversible if the medication is discontinued promptly.
- In prepubertal children, nandrolone may cause premature closing of the growth plates, which may result in stunted growth.
- There may be alterations in blood clotting factors in individuals receiving nandrolone decanoate injections, which may impair clotting times. Patients on anticoagulants should be closely monitored for bleeding abnormalities while receiving nandrolone decanoate injections.
- Patients may exhibit psychiatric effects such as depression, insomnia, and mania while on nandrolone injections.
- In the renal system, there may be increased retention of water, potassium, nitrogen, chloride, and calcium. The retention of these electrolytes may result in edema.
- Some patients may experience gastrointestinal disturbances, such as nausea, vomiting, and diarrhea.
- Significant increases in low-density lipoproteins (LDL) with a corresponding decrease in high-density lipoproteins may occur in individuals receiving nandrolone injections.
- Change in sex drive or performance; diarrhea; hair loss; headache; trouble sleeping.
This list may not describe all possible side effects. Call your health care provider immediately if you are experiencing any signs of an allergic reaction: allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue; breast lump; breathing problems; changes in mood, especially anger, depression, or rage; change in voice; dark urine; increase in facial hair; irregular menstrual periods; acne, nausea, vomiting; stomach pain; swelling in ankles or legs; trouble passing urine or change in the amount of urine; yellowing of the eyes or skin. Menstrual irregularity can occur with nandrolone decanoate therapy in females. Disruption of the regular menstrual cycle secondary to nandrolone decanoate-induced suppression of gonadotropin secretion can lead to amenorrhea or oligomenorrhea.
When androgens (such as nandrolone) are given to women, virilization, manifested by acne, hirsutism, clitoromegaly, male pattern baldness, reduced breast size, and deepening of the voice or hoarseness, can occur. If treatment is discontinued when these symptoms first appear, they usually subside. Prolonged treatment can lead to irreversible masculinity, so the benefit of treatment should be measured against the risk.
Androgens can cause teratogenesis. Androgens are classified as pregnancy category X, and are absolutely contraindicated during pregnancy because of probable adverse effects on the fetus. Androgenic anabolic steroids such as nandrolone decanoate are known to cause embryotoxicity, fetotoxicity, and masculinization of female animal offspring. Nandrolone decanoate is contraindicated in women who are or may become pregnant.
Male patients can experience feminization during prolonged therapy with nandrolone decanoate, which is believed to result from inhibition of gonadotropin secretion and conversion of androgens to estrogens. These effects are more pronounced in patients with concurrent hepatic disease and include mastalgia and gynecomastia. Feminizing effects are generally reversible. Inhibition of testicular function, testicular atrophy, impotence (erectile dysfunction), epididymitis, and bladder irritation can also occur.
Priapism and excessive sexual stimulation, more common in geriatric males, are generally the effect of excessive nandrolone decanoate dosage. Oligospermia and decreased ejaculate volume may occur in patients receiving long-term therapy or excessive doses. Alopecia resembling male pattern baldness has also occurred.
Prostate cancer as a secondary malignancy or prostatic hypertrophy can develop during prolonged therapy with nandrolone decanoate and are more likely to occur in elderly males. Signs of acute epididymitis (e.g., fever, chills, pain in the inguinal region) and/or urinary urgency should prompt withdrawal of the drug and reevaluation of dosage.
In prepubescent males: When androgens (such as nandrolone) are used in the treatment of immature males, early virilism can be a disadvantage because it is accompanied by premature epiphyseal closure. Monitoring of skeletal maturation should be undertaken at about 6-month intervals. Once the epiphyses have closed, growth is terminated. Even after discontinuation of treatment, epiphyseal closure can be enhanced for several months. Penile enlargement and an increased frequency of erections can also occur.
In males and females:
Peripheral edema can occur with nandrolone use as the result of increased fluid retention (in association with sodium retention) and is manifested by weight gain. In the treatment of patients with impaired renal function or congestive heart failure, the fluid retention is of greater significance. Other serum electrolytes (i.e., calcium, chloride, phosphate, and potassium) are also retained.
Androgen therapy (such as nandrolone) is related to growth and secretion of the sebaceous glands, which can cause an acneiform rash indistinguishable from acne vulgaris.
Hepatic dysfunction can occur from use of androgenic anabolic steroids (such as nandrolone) and have been shown to be more significant with administration of the oral 17-alpha-alkylandrogens (e.g., methyltestosterone). Cholestatic jaundice with, rarely, hepatic necrosis and death have been reported. Elevated hepatic enzymes are more common than overt jaundice. The drug should be discontinued if cholestatic jaundice or hepatitis occurs. Peliosis hepatis, a condition characterized by splenic tissue being replaced by blood filled cysts, has occurred in patients receiving androgenic anabolic steroids. The cysts are sometimes present with minimal hepatic dysfunction, but may be associated with hepatic failure. They are often not noticeable until life-threatening hepatic failure or intra-abdominal hemorrhage develops. Discontinuation of steroid therapy usually results in complete disappearance of cysts. Hepatoma also occurs rarely and is usually benign and androgen-dependent; life-threatening malignant hepatoma has been reported. Withdrawal of drug often results in regression or cessation of progression of the tumors. However, hepatomas associated with androgens or anabolic steroids are much more vascular than other hepatic tumors and may be undetected until life-threatening intra-abdominal hemorrhage develops. Androgen therapy (such as nandrolone) has induced osteolysis and can exacerbate hypercalcemia. Androgen-induced hypercalcemia occurs especially in immobile patients and those with metastatic carcinoma of the breast.
Observational studies in post-menopausal women, bodybuilders, and weightlifters using anabolic steroids have revealed ‘pro-atherogenic’ changes in lipid profiles, including decreases in HDL concentrations and increases in LDL concentrations. Synthetic androgens may produce a greater lowering of the HDL-C:LDL-C ratio than does testosterone. Oral anabolic steroids (e.g., stanozolol) may produce greater changes than parenteral ones. Although the implications of androgen-induced (such as nandrolone) hypercholesterolemia are unclear, caution should be exercised, particularly in patients predisposed to dyslipidemias or atherosclerosis.
Androgen therapy (such as nandrolone) can produce libido decrease or libido increase. Geriatric males have been found to be more likely to experience excessive sexual stimulation.
Miscellaneous adverse reactions to nandrolone decanoate therapy have included decreased glucose tolerance, diarrhea, edema, excitability, habituation, increased CPK and creatinine, insomnia, mental depression, nausea and vomiting.
Intramuscular administration of anabolic steroids (such as nandrolone) can cause inflammation, urticaria, postinjection induration and furunculosis. Patients should be observed for any signs of an injection site reaction.
Anabolic steroids (such as nandrolone) may cause suppression of clotting factors II, V, VII, and X. Prolonged bleeding time may occur. This list may not include all possible adverse reactions or side effects. Call your health care provider immediately if you are experiencing any signs of an allergic reaction: skin rash, itching or hives, swelling of the face, lips, or tongue, blue tint to skin, chest tightness, pain, difficulty breathing, wheezing, dizziness, red, a swollen painful area/areas on the leg.