Genitourinary effects have included oligospermia and decreased ejaculatory volume. Elderly male patients may experience prostatic enlargement resulting in urinary obstruction. Priapism and excessive stimulation may develop. Female patients may experience virilization, including deepening voice, hirsutism, acne, clitomegaly (not reversible), and menstrual abnormalities. Discontinuation of anabolic steroids at signs of mild virilization may prevent irreversible virilization. Alterations in libido may occur (increased/decreased).[Ref]
Hepatic tumors associated with anabolic steroid use are more vascular than other hepatic tumors and may remain silent until the development of life-threatening abdominal hemorrhage. Peliosis hepatitis may present as mild liver dysfunction, but has resulted in liver failure.[Ref] Hepatic side effects have included life-threatening peliosis hepatitis and hepatic abnormalities such as hepatic neoplasms and hepatocellular carcinomas following prolonged therapy with high doses of anabolic steroids. Tumor regression did not occur in all cases following medication withdrawal. Cholestatic hepatitis, jaundice, and abnormal liver function tests can occur at relatively low dosages.