The common side effects of oxymetholone include depression , lethargy , headache , swelling , rapid weight gain , priapism , changes in skin color, urination problems, nausea , vomiting , stomach pain (if taken on an empty stomach), loss of appetite , jaundice , breast swelling in men, feeling restless or excited, insomnia , and diarrhea .  In women, side effects also include acne , changes in menstrual periods , voice deepening , hair growth on the chin or chest , pattern hair loss , enlarged clitoris , and changes in sex drive .   Because of its 17α-alkylated structure, oxymetholone is hepatotoxic .  Long term use of the drug can cause a variety of serious ailments, including hepatitis , liver cancer , and cirrhosis ; therefore periodic liver function tests are recommended for those taking oxymetholone. 
After the Kefauver Harris Amendment was passed in 1962, the . FDA began the DESI review process to ensure the safety and efficacy of drugs approved under the more lenient pre-1962 standards, including Dianabol.  In 1965, the FDA pressured CIBA to further document its legitimate medical uses, and re-approved the drug for treating post-menopausal osteoporosis and pituitary-deficient dwarfism .  After CIBA's patent exclusivity period lapsed, other manufacturers began to market generic metandienone in the .
Some bodybuilders and athletes use trenbolone esters for their muscle-building and otherwise performance-enhancing effects.  Such use is illegal in the United States and many other countries. The DEA classifies trenbolone and its esters as Schedule III controlled substances under the Controlled Substances Act .  Trenbolone is classified as a Schedule 4 drug in Canada  and a class C drug with no penalty for personal use or possession in the United Kingdom .  Use or possession of steroids without a prescription is a crime in Australia .  The infamous "duchess" cocktail allegedly administered to Russian athletes at the Sochi Winter Olympics consisted of oxandrolone , a metenolone ester, and a trenbolone ester.