Anavar (oxandrolone) is often described as a “mild” anabolic steroid, which has made it one of the compounds most commonly associated with use by women. But the question of Anavar and female fertility has a clear basic answer: like other anabolic-androgenic steroids (AAS), oxandrolone can disrupt the hormonal signals that control ovulation and the menstrual cycle, and some of its effects on the female body may be permanent.
This article explains how AAS affect the female reproductive system, what research has found, how these effects differ from other causes of menstrual disruption, and what is known about recovery. It also notes an important change in oxandrolone’s regulatory status.
How do anabolic steroids affect the female reproductive system?
Ovulation depends on a carefully timed sequence of hormonal signals. The hypothalamus and pituitary gland release luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which stimulate the ovaries to mature an egg and produce estrogen and progesterone.
Androgens, including oxandrolone and other AAS, can interfere with this system in several ways.
Suppression of the hormonal signals
High levels of androgens can suppress the release of LH and FSH, in much the same way that AAS suppress testosterone production in men. Without normal LH and FSH signals, the ovaries may not mature or release an egg, a state called anovulation.
Disruption of the menstrual cycle
Because ovulation drives the menstrual cycle, suppressed ovulation commonly shows up as irregular periods or the absence of periods (amenorrhea).
A comparison with naturally high androgen levels
The effects of excess androgens on female fertility are well documented in polycystic ovary syndrome (PCOS), a common condition in which elevated androgen levels contribute to irregular ovulation and are a leading cause of infertility. This does not mean AAS use causes PCOS, but it illustrates how strongly androgen levels can influence ovulation.
What does research show?
Research on women who use AAS is limited. Most studies of AAS users involve men, and women who use AAS are a small and hard-to-reach group. The available evidence comes mainly from interview studies, surveys, and clinical reports rather than controlled trials.
In an interview study of 16 Norwegian women with current or previous AAS use, participants described a range of masculinizing effects, including a deepened voice and clitoral enlargement, as well as changes in menstruation, including periods stopping during use (Havnes et al., 2021). The researchers concluded that women who use AAS are at risk of irreversible masculinizing effects that can affect self-esteem, social life, and sexual function both during and after use.
Reviews of AAS effects in women have consistently reported menstrual irregularities and amenorrhea among the most common reproductive effects (Pope et al., 2014). However, there are no reliable estimates of how often AAS use leads to lasting fertility problems in women.
Is Anavar safer for fertility than other steroids?
Oxandrolone is often described as milder than other anabolic steroids because it is considered less androgenic. However, “milder” is a relative description, not an absence of effect. Oxandrolone is still an androgen, it still acts on androgen receptors, and it can still suppress the hormonal signals that drive ovulation.
The extent of the effect is likely to depend on the dose, the duration of use, the use of other compounds, and individual factors. There is no established level of non-medical use known to be free of reproductive effects.
Products sold outside the regulated pharmaceutical supply add further uncertainty. Research has found that a substantial proportion of black-market anabolic steroids are counterfeit or contain different amounts of the active ingredient than labeled, so a product sold as oxandrolone may not contain what its label states (Magnolini et al., 2022).
Are the effects reversible?
Some effects may be reversible, and others may not.
Menstrual disruption caused by hormonal suppression may resolve after AAS use stops, as natural hormone signaling recovers. In the Norwegian interview study, participants described their periods returning after they stopped (Havnes et al., 2021). However, recovery has not been systematically studied in women, and the time it takes is likely to vary.
Several masculinizing effects can be permanent. Deepening of the voice, in particular, may not reverse after use stops. Clitoral enlargement and increased body and facial hair may also persist.
Other causes of menstrual disruption in active women
Not every change in the menstrual cycle in an athletic woman is caused by AAS. Intense training combined with insufficient energy intake can also suppress ovulation and stop periods. This condition, known as low energy availability, is common in sports that emphasize leanness, including physique competitions.
This matters because women using AAS during a cutting phase may be exposed to both factors at once. It also means that a missed period should be evaluated by a healthcare professional rather than assumed to have a single cause.
What about pregnancy?
Anabolic steroids can masculinize a developing female fetus. Oxandrolone’s prescribing information listed pregnancy as a contraindication for this reason. Anyone who is pregnant, trying to conceive, or could become pregnant should not use AAS, and anyone who becomes pregnant after AAS use should tell their doctor.
Anavar’s regulatory status
Oxandrolone was approved in the United States in 1964 for medical uses such as promoting weight gain after surgery or illness. In June 2023, the US Food and Drug Administration (FDA) withdrew approval of all oxandrolone tablets, and later determined that the drug had been withdrawn from sale for reasons of safety or effectiveness (FDA, 2023). It is no longer an approved medicine in the United States.
Our guide to the types of steroids covers the medical and regulatory status of other commonly discussed compounds, and our guide to the key facts about steroids explains how anabolic steroids affect the body more broadly.
When to seek medical advice
A healthcare professional can help evaluate missed or irregular periods, difficulty conceiving, or masculinizing changes, whatever their cause. Being open about past or current AAS use helps a doctor interpret hormone tests correctly and choose appropriate investigations.
Women who are planning a pregnancy after AAS use may benefit from discussing this with a doctor or fertility specialist before trying to conceive.
The bottom line
The question of Anavar and female fertility has a clear basic answer: oxandrolone, like other anabolic steroids, can suppress the hormonal signals that drive ovulation, commonly causing irregular or absent periods. Describing it as “mild” does not mean it is free of reproductive effects.
Menstrual disruption may resolve after use stops, but recovery has not been well studied in women, and some masculinizing effects, such as voice deepening, may be permanent. For comparison, our article on steroids and male fertility explains how AAS affect fertility in men. Anyone concerned about their fertility after AAS use should speak with a qualified healthcare professional.
References
Food and Drug Administration. Determination that Oxandrin (oxandrolone) tablets, 2.5 milligrams and 10 milligrams, were withdrawn from sale for reasons of safety or effectiveness. Federal Register. 2023;88 FR 62799.
Havnes IA, Jørstad ML, Innerdal I, Bjørnebekk A. Anabolic-androgenic steroid use among women: a qualitative study on experiences of masculinizing, gonadal and sexual effects. International Journal of Drug Policy. 2021;95:102876.
Magnolini R, Falcato L, Cremonesi A, et al. Fake anabolic androgenic steroids on the black market: a systematic review and meta-analysis on qualitative and quantitative analytical results found within the literature. BMC Public Health. 2022;22(1):1371.
Pope HG Jr, Wood RI, Rogol A, Nyberg F, Bowers L, Bhasin S. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocrine Reviews. 2014;35(3):341–375.
