Because the ultimate goal of a steroid cycle is to increase strength and muscle size, the associated spike in estrogen which accompanies steroids such as Testosterone is considered undesirable. In order to disassociate the two effects, two classes of drug are used. Medications such as Nolvadex or Clomid target the estrogen receptors. They make it more difficult for the estrogen to exert it’s influence within the body thus allowing the testosterone to act more freely. The second class is aromatase inhibitors such as Femara. They target the aromatase enzyme itself in order to prevent the production of estrogen in the first place. Sometimes, it’s not always clear which option you should go with or even what the differences are between the two. Lets clear that up a little.
Anticoagulants: Patients on anticoagulants such as warfarin should be carefully monitored during anabolic steroid therapy as anabolic steroids may increase sensitivity to oral anticoagulants which may require a concomitant reduction in anticoagulant dosage to achieve a desirable prothrombin time (PT). Anticoagulant patients should be monitored regularly during anabolic steroid therapy, particularly during initiation and termination of therapy. Warfarin patients should have INR and PT monitored throughout androgen therapy and warfarin dosages titrated to achieve the desired INR and PT. Such patients should be monitored for occult bleeding.