Testosterone vs Primobolan: What to Choose and for Whom

In informal sources primobolan is often recommended as a "first" or "safest" steroid, and testosterone as a mandatory "base." The editorial team checked these notions from the standpoint of medicine and found out for whom and under what circumstances each substance might make sense, and for whom both are unambiguously inappropriate.

History: how the role of the two substances changed

Testosterone was synthesized in 1935 and has not disappeared from medical practice since. Only the forms changed: from early injections to modern gels and long-acting esters. Today testosterone therapy has detailed clinical guidelines and large safety studies.

Methenolone appeared in the early 1960s and was used in situations where physicians sought an anabolic effect: in anemia due to bone marrow insufficiency, in wasting after severe illnesses, in osteoporosis. At that time the choice of agents for these conditions was limited.

Later, more effective methods appeared: erythropoiesis stimulators, bone marrow transplantation, bisphosphonates, modern nutritional support. The role of anabolic steroids in medicine declined, and methenolone disappeared from pharmacies in most countries.

This history explains the current asymmetry: testosterone is a current medicinal product, methenolone is a substance that medicine has effectively left in the past.

Who receives testosterone by indication today

The main group of patients is men with confirmed hypogonadism. This can be a congenital condition (for example, Klinefelter syndrome), a consequence of trauma or surgery on the testes, pituitary tumors, chemotherapy, or severe systemic diseases.

In older men with declining testosterone, decisions are made individually. The Endocrine Society guideline does not recommend routinely prescribing testosterone to all elderly men with a low hormone level, but advises discussing the risks and expected benefits.

The TRAVERSE study (2023) showed that in middle-aged and older men with hypogonadism and high cardiovascular risk, testosterone replacement therapy did not increase the incidence of major cardiovascular events compared with placebo. However, atrial fibrillation, acute kidney injury, and pulmonary embolism were observed more often in the testosterone group.

These data concern precisely replacement, physiological levels of testosterone. They do not transfer to the supraphysiological amounts used in sport, and still less do they concern methenolone.

For methenolone there are no modern patient groups: it is not recommended in any current international guideline.

The myth of the "steroid for beginners"

The notion of primobolan as a drug for a "first experience" is based on three arguments: the absence of aromatization, the existence of a tablet form non-toxic to the liver, and a moderate strength of effect. Let us consider each.

Another aspect of the myth is the idea that a "mild" start reduces the risk of dependence. Studies show that a proportion of anabolic steroid users develop a dependence associated with the desire to maintain the achieved physique and to avoid symptoms after withdrawal. The starting drug does not substantially affect this mechanism.

Finally, a "first experience" usually occurs at a young age, when the hormonal system is still forming or has only just formed. It is precisely in this group that the risk of prolonged suppression of one's own hormonal axis and of psychological dependence is especially significant.

Thus, from a medical standpoint there is no "steroid for beginners." There is only a different risk profile, and in this sense primobolan is no exception.

Special groups: women, youth, people with liver diseases

Women.Methenolone is often called a "female" anabolic. However, it is a full-fledged androgen receptor agonist, so it can cause deepening of the voice, hirsutism, acne, clitoral enlargement, and cycle disturbances. Medicine prescribes testosterone to women only for a narrow indication and at concentrations physiological for women.

Adolescents and young people.Androgens can prematurely close the growth plates, and suppression of the hormonal axis before the completion of puberty threatens lasting disturbances. For this group, any non-medical use of androgens is unacceptable.

People with liver diseases.Even the relatively less toxic oral form of methenolone passes through the liver and affects the synthesis of lipoproteins. In the presence of liver diseases, any oral androgens are especially undesirable.

People with cardiovascular risks.Regardless of the substance chosen, supraphysiological levels of androgens are associated with unfavorable changes in lipids and heart structure. The presence of hypertension, dyslipidemia, or a family history of early myocardial infarction is a weighty reason to refrain from non-medical use.

What is worth doing instead of choosing a drug

If a person feels symptoms they associate with low testosterone — fatigue, reduced libido, poor recovery — the first step is examination, not choosing a drug. Such symptoms are non-specific and can have many causes.

• Take a morning test of total testosterone, and if necessary repeat it and supplement it with LH, FSH, SHBG, and prolactin.
• Assess sleep, stress level, nutrition, body weight, and training load — they substantially affect hormonal status.
• Check a complete blood count, lipids, glucose, and thyroid function.
• Discuss the results with an endocrinologist or andrologist.

If, however, the goal is athletic progress, then progressive load, adequate protein intake, a sleep regimen, and training periodization deliver a measurable result without hormonal risks. For athletes undergoing doping control, this is moreover the only permissible path: both testosterone and methenolone are included in section S1 of the WADA Prohibited List.

For people who already use androgens, the editorial team advises not concealing this from the physician. Knowledge of the use makes it possible to interpret tests correctly and detect complications in time.

Editorial conclusions

Only testosterone has medical indications today — for men with confirmed hypogonadism, under a physician's supervision. Medicine has left methenolone in the past.

Primobolan's reputation as a "steroid for beginners" does not withstand scrutiny: it suppresses the hormonal axis, affects lipids, and causes virilization in women.

For adolescents, women, people with liver diseases, and cardiovascular risks, non-medical use of either substance is especially dangerous.

We also recommend reviewing our materials on the symptoms of low testosterone and their causes, on dependence on anabolic steroids, and on natural ways to support hormonal health.

References

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7. World Anti-Doping Agency. The Prohibited List. International Standard. Montreal: WADA; 2025.