5 Dianabol Side Effects (And How to Combat them)

Dr George TouliatosDisclaimer: The following article is for educational purposes only and does not promote the use of illegal steroids. If you have any questions or concerns, Dr. Touliatos is currently available for consultation.

Dianabol (Methandrostenolone) is one of the most potent anabolic steroids on the market, appropriately nicknamed the ‘granddaddy of anabolic steroids‘.

Arnold Schwarzenegger and classic bodybuilders from the 1970s were prime examples of just how potent Dianabol is in regards to adding size and strength.

Dianabol’s benefits certainly aren’t in doubt, with it remaining just as popular 50 years later. Its benefits are well known in the fitness and bodybuilding community; however, its side effects are often downplayed, with beginners commonly taking Dianabol during a first cycle.

Below are the most common Dianabol side effects users experience, so you can understand the risks and whether it is worth enduring them in order to reap the benefits.

Dianabol Side Effects

Cholesterol and Blood Pressure

We have found Dianabol to have a marked negative effect on blood pressure and cholesterol due to increased plaque buildup. Users can expect a hefty rise in LDL cholesterol levels, with an equally devastating drop in HDL (1). Consequently, this will spike a user’s blood pressure, notably increasing the risk of myocardial infarction (heart attack).

Dianabol is one of the more damaging anabolic steroids from a cardiovascular perspective, due to it being an oral steroid and thus passing through the liver.

Consequently, it stimulates hepatic lipase, an enzyme that exacerbates the lowering of HDL (good cholesterol).

Furthermore, Dianabol causes significant water retention due to the aromatase enzyme being present. This, in turn, increases blood viscosity, impeding blood flow to and from the heart.

To reduce cardiovascular strain on Dianabol, we have found supplementation with fish oil (4 g/day) to be beneficial. This helps to stabilize blood pressure, particularly in hypertensive individuals (2).

We have also seen regular cardio/aerobic exercise reduce elevations in blood pressure on Dianabol (3), due to an increase in nitric oxide (N.O.) production released from endothelium cells.

N.O. essentially relaxes the blood vessels, improving blood flow throughout the body.

Regular cardiovascular activity can be particularly beneficial for bodybuilders, as weightlifting has the opposite effect on blood vessels (being constrictive).

Note: Anyone who has high blood pressure or has heart disease in their family should avoid Dianabol. 


dianabol gyno

Mild case of gynecomastia (on the left)

Dianabol is estrogenic due to the aromatase enzyme being present; thus, it has the potential to cause gynecomastia (4).

Gynecomastia is when breast tissue accumulates in males due to excessive estrogen levels. In mild cases, this may merely result in swollen nipples, and in extreme cases, the chest region can resemble female breasts.

In our experience, swollen nipples are often reversible and thus disappear post-cycle once hormones regulate back to normal (and estrogen levels drop).

However, breast tissue expansion in moderate or aggressive cases may only be corrected with surgery.

To prevent gynecomastia, an aromatase inhibitor (AI) or selective estrogen receptor modulator (SERM) may be taken. An aromatase inhibitor blocks the conversion of testosterone into estrogen; however, this can also exacerbate cholesterol levels, as estrogen increases good (HDL) cholesterol. Thus, blood pressure may worsen using an AI (5).

Alternatively, a SERM can prevent gynecomastia by blocking estrogen-like effects at a receptor level, thus not affecting the conversion of testosterone into estrogen (and keeping healthier cholesterol ratios).

Two popular SERMs we utilize are Nolvadex and Clomid. These may be taken if nipples begin to swell, effectively preventing aggressive breast tissue formation.

Note: Combining Dianabol with other estrogenic compounds, such as Testosterone or Anadrol will also increase the risk of gynecomastia.

Water Retention

Water retention is the byproduct of estrogen levels rising, causing users to gain 10 lbs or more in fluid.

This causes a smooth, soft, and less defined look to the muscles, hence why Dianabol is referred to as an off-season bulking steroid. It can also cause a person’s midsection to increase due to bloating, which may also be visible in the face.

Water retention in itself is not an issue for most users, considering it is temporary and beneficial for muscular strength due to extra intracellular fluid.

If a person wants to reduce water retention on Dianabol, a diuretic may be used, such as furosemide (6). We find this improves overall body composition, albeit at the expense of less full muscles and a small decrease in strength. Such a diuretic also improves blood pressure, in our experience, due to the blood becoming less viscous and thus easier to circulate.

Generally, if a person wants to avoid water retention while building muscle, they may be better suited to cycling Trenbolone, Superdrol or Winstrol, rather than trying to treat water-related Dianabol side effects.

Liver Toxicity

As with other oral steroids, Dianabol is c-17 alpha-alkylated and thus hepatotoxic. In our LFTs, we see Dianabol causing AST/ALT liver enzymes to shoot up, marking significant liver stress until cycle cessation.

To many bodybuilders, such hepatotoxicity is not alarming, as the liver is a very resilient organ, often recovering after extensive abuse.

However, cholestasis is still possible, and thus it is wise to take precautions, such as eliminating alcohol consumption and refraining from taking hepatotoxic medications (such as certain anti-depressants).

Bodybuilders at our clinic have had success taking liver support supplements, particularly TUDCA (tauroursodeoxycholic acid). This bile acid has been shown to drastically reduce AST/ALT scores (7), reducing inflammation and the risk of steroid-induced cholestasis.

Note: If someone has an unhealthy liver, taking Dianabol may be dangerous. Also, stacking Dianabol with other hepatotoxic steroids, such as Winstrol or Anadrol, should be avoided. 

Testosterone Suppression

All anabolic steroids are forms of exogenous testosterone, which cause a shutdown of endogenous testosterone due to damage to the HPTA.

During a cycle, this is not initially problematic; however, once a cycle ceases, users can often experience side effects of low testosterone.

Typical signs of low testosterone we see are:

  • Fatigue
  • Tiredness
  • Testicular atrophy
  • Decreased well-being
  • Diminished libido and sexual function

Users can experience the above for several weeks or months, depending on the severity of damage to the HPTA axis. Thus, bodybuilders will commonly utilize a post cycle therapy (PCT) to shorten this recovery period and recover endogenous testosterone to normal levels.

Common and effective PCT medications taken by bodybuilders are Nolvadex, hCG, and Clomid.

A Dianabol-only cycle may only require one of these; however, Dianabol stacked with other potent steroids may need two or all three.

Dianabol-only cycle PCT:

  • Nolvadex: 2 x 20mg for 45 days

More powerful PCT for Dianabol stacks:

  • hCG: 2000 IU administered every other day for 20 days
  • Nolvadex: 2 x 20mg for 45 days
  • Clomid: 2 x 50mg for 30 days

The PCT trio (above) was a protocol used by Dr. Michael Scally, an expert in hormone replacement therapy. He used hCG, Nolvadex, and Clomid in these dosages to successfully treat 19 men, with 100% endogenous testosterone recovery within 45 days. We have also utilized this methodology with great success.


We have found Dianabol to be one of the better steroids for avoiding androgenic side effects, such as acne vulgaris or male pattern baldness.

However, Dianabol certainly presents risks to users, particularly from cardiovascular and hepatic perspectives.

Therefore, it is essential that if someone is going to use Dianabol, they take all the necessary precautions (as mentioned in this article) to limit damage during a cycle.

If anyone is experiencing excessively high blood pressure or other troublesome symptoms on Dianabol, call an ambulance immediately and discontinue use.

Co Authors :