Side-effects from the use of steroids are extremely common and can be quite significant. Most side-effects are reversible once the athlete stops usage although serious long-term side-effects and even death have occurred as a direct result of steroid use.
• Decreased sperm production and sex drive
• Increased aggression, irritability and mood swings
• Liver disorders
• Baldness (alopecia)
• Hypertension (high blood pressure)
• Raised cholesterol
• Gynecomastia (development of over-sized mammary glands in males)
• Menstrual irregularities (in women)
• Hirsuitism (excessive hair growth occurring in females which follows the pattern of male hair growth, . facial)
• Deepening of the voice
• Reduced immunity
• Possible development of tumors (wilm’s tumor, prostate carcinoma and leukemia have been reported, although a connection is not proven)
It should be noted that in theory if one was to consistently suppress your natural estrogen levels for a long period of time, this would negatively impact your health, including your cholesterol. Due to the ability of Letrozole- to inhibit estrogen so much, this should definitely be a concern to most users. However the research that has focused on the relationship between use of letrozole and cholesterol levels is rather inconsistent in it's findings. Many studies have concluded that the compound is detrimental to both a user's HDL and LDL cholesterol levels, while other research has found no link. Obviously individuals are best served to monitor their cholesterol while using any compound via blood tests however barring that, letrozole should simply not be run for extended periods of time if at all possible. Doing so could cause serious medical complications.
Along with the issues related to blood lipids is the fact that many users complain that their libido is dramatically reduced when using the compound. This is related to the fact that estrogen is partly responsible for the regulation of an individual's sex drive. Since Letrozole- is so potent it can often drive estrogen levels too low and this inhibits a user's libido. To avoid this users can lower dosages, but some anecdotally report that even extremely low doses of the drug can cause problems. If this is the case a less potent compound such as exemestane or anastrozole may be a more appropriate option.
One last point: Because steroids have all these side effects, a lot of abusers will then take other drugs to offset the effect—steroid abuse causes you to grow man-boobs, so people take another drug to mitigate those side effects. Guys who take steroids often also take augmenting drugs to decrease estrogen production or to improve athletic performance even further, like human growth hormone, insulin-like growth factor 1, insulin, erythropoietin, stimulants, diuretics, levothyroxine, and/or gamma-hydroxybutyrate, according to the study in FP Essentials . That means on top of all these side effects of steroids, most abusers are also looking at a whole separate list of effects from their peripheral drug habits.