Estrogen Receptor alpha

Bone Mineral Density

How much mineral is packed into bone. In men it is maintained mostly by ESTRADIOL rather than testosterone, which is why crushing oestrogen has a skeletal cost that takes years to show up.

HDL Cholesterol

The protective lipid fraction. Oral 17-alpha-alkylated steroids can cut it by half or more within weeks, and it is the fastest-moving marker of cardiovascular cost.

Adipose Tissue

Stores fat and houses most of the body's aromatase, so more fat mass means more conversion of androgen to estrogen.

Breast Tissue

Responds to both estrogen and prolactin. Once glandular tissue forms it does not go away on its own, which is why this one is worth preventing rather than treating.

Liver

Processes every oral steroid on first pass. The 17-alpha-alkyl group that lets an oral survive that trip is also what makes it hard on this organ.

Clot Risk

Blood clotting where it should not. Rises with haematocrit, and this is the reason a red cell count is worth watching rather than admiring.

Gynecomastia

Glandular breast tissue growth in men. Two separate routes reach it, estrogen and prolactin, and treating the wrong one does nothing.

Erectile Function

Depends on nitric oxide signalling, which needs DHT and adequate estradiol. Compounds that suppress natural testosterone without providing strong androgenic signal are the classic cause of failure here.

Insulin Sensitivity

How well tissue responds to insulin. Falling sensitivity means higher fasting insulin for the same blood sugar, and it is one of the quieter costs of long steroid use.

Libido

Sexual desire. Needs androgen, a workable estradiol level and prolactin that is not elevated, so it fails from several directions at once.

Sodium and Water Retention

Holding onto salt and the water that follows it. Shows up as a smoother look, a heavier scale reading and a higher blood pressure.

Fat Mass

Total body fat. It is the endpoint the whole fat-loss class is measured on, and the one place where the incretin drugs have hard trial data rather than mechanism.