Anabolic steroids and women

From AIDS Treatment Update – April 2001

Anabolic Steroids And Women

(Michael Mooney’s comment appears at the end.)

Anabolic steroids are synthetic versions of the male hormone testosterone, that promote the formation of lean body mass, skeletal muscle, and masculine sexual characteristics in the body.

Anabolic steroids have been shown to increase muscle mass, and so may be used to treat AIDS wasting and weight loss. However, most studies have investigated their use in men, and in comparison, the use of anabolic steroids in the treatment of HIV-positive women is much less well understood.

Although testosterone is considered a male hormone, it also occurs naturally in women, but at lower levels. A study investigating the use of testosterone patches in women with AIDS wasting found weight and quality of life improved in some women, and the development of masculine , or virilising , features, such as hair growth, or a coarsening of the voice, was not reported.

At February s 8 th Annual Retroviruses Conference in Chicago, Dr Kath Mulligan reported results from ACTG 329, a clinical trial of an anabolic steroid, nandrolone decanoate, in HIV-positive women diagnosed with wasting.

Nandrolone is approved in the US for treatment of men and women with anaemia associated with chronic kidney disease, where it has been shown to increase lean body mass. It has also been found to increase lean body mass in open-label studies involving HIV-positive men.

38 women were randomized to receive either twelve weeks treatment with placebo or with nandrolone, dosed 100mg once every two weeks by injection into muscle. For the next twelve weeks, everyone in the study received nandrolone, with a follow-up assessment at 36 weeks.

Participants:

• had involuntary weight loss of at least 5% in the past year, or a body
  mass index below 20kg per metre squared
• had been on stable anti-HIV therapy for at least 30 days
• and were consuming more than 80% of their resting energy requirement.

During the blinded phase, there was a significant increase in weight and lean body mass in the women receiving nandrolone compared to placebo. In the open-label phase, women who had previously received placebo, gained weight and lean body mass, and women who had previously received nandrolone sustained their gains. Women had not been offered advice on exercise, and this was not investigated in this study.

Side-effects were rare, but occurred primarily in the nandrolone group (and included hoarseness, hirsutism, and clitoral enlargement). These were not considered severe, and were found to resolve off treatment.

A separate study investigating the use of low dose testosterone in HIV-positive women is ongoing in the US.

Reference: Mulligan. 8th CROI abs 641, 2001.

Michael Mooney’s Comment:

This study showed a potential for side effects at a dose of 100 mg every two weeks for the women in the study. Note that clitoral enlargement does not typically reverse. This is also true to some extent of the other side effects, although some side effects reduce when the person stops using the steroid.

I have seen women use Deca Durabolin (nandrolone decanoate) at doses of 25 mg per week and experience significantly less side effects than they do at higher doses or when higher doses, like 100 mg, are given every two weeks rather than using half the two week dose, but administered weekly. I suggest that women consider asking their doctor to find a dose that is lower than the 100 mg dose used in this study and administer it once per week to reduce the potential for side effects.

Doses as low as 5 mg per week up to 25 mg per week have produced gains in lean body mass with little or no side effects in adult women I have monitored. Each person is unique, so I strongly suggest trying to find your own specific dose, beginning with a low dose like 5 mg and increasing it if it is needed. The lower the dose the less the potential for side effects