Anabolic steroids in postmenopausal osteoporosis.

The anabolic steroids were first developed in the 1950's to provide the anabolic advantages of androgens with less androgenic action. They are widely used in the treatment of osteoporosis, although their effectiveness has only recently been demonstrated with the advent of bone densitometry. It is now established that their administration leads to a significant increase in bone mass in osteoporotic men and women associated with an apparent conversion of fat into muscle tissue. The bone gain is of the order of 3% per annum but the maximal effect is obtained in the first few months. The bone gain is probably due to stimulation of bone formation and is associated with elevation of serum albumin and fat-free skinfold thickness. The most serious side-effect with parenteral use is lowering of voice pitch but there is some evidence that oral anabolic steroids may adversely affect liver function. The optimum dose and duration of therapy has not yet been established.