Contraindications: Methyltestosterone is contraindicated in individuals with existing hepatic disease, cholestatic jaundice, prostate or breast carcinoma, hypercalcaemia, or known hypersensitivity to 17α-alkylated androgens. Oral alkylated androgens place repeated first-pass hepatic load on the liver; pre-existing hepatic compromise amplifies this risk significantly. Pregnancy and breastfeeding are absolute contraindications.
Side_Effects: Oral methyltestosterone is associated with hepatotoxicity, elevated liver enzymes (ALT, AST), cholestasis, and in long-term use, peliosis hepatis. Androgenic effects include acne, accelerated androgenic alopecia, and virilisation in women. Suppression of endogenous LH and FSH production leads to testicular atrophy and reduced sperm output. Cardiovascular risk factors — including adverse shifts in LDL/HDL cholesterol ratio — are reported with oral 17α-alkylated androgens.
Monitoring: Liver function panels (ALT, AST, ALP, bilirubin) should be obtained at baseline and every two weeks during use. Haematocrit and haemoglobin monitoring is recommended given androgen-driven erythropoiesis. Lipid profiles (total cholesterol, LDL, HDL) require assessment at cycle midpoint. Blood pressure monitoring is recommended throughout, as androgen-mediated sodium retention can elevate cardiovascular load.
PCT: Post-cycle therapy using a SERM — typically tamoxifen citrate or clomiphene citrate — should begin within 24–48 hours of the final tablet, consistent with the oral compound's short systemic half-life. Recovery of the hypothalamic-pituitary-gonadal axis requires structured SERM support for a minimum of four weeks. HCG may be added to restore testicular volume in cycles exceeding six weeks.