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.
* 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