1. 1. Some are inevitable but manageable; some are avoidable; some are inevitable, period.
    2. Among the avoidable are extremely intense forms of virilization (if this is not the goal, as in sex transitioning), usually related to poor understanding of the dose-response relation. In the sub-culture of the strength sports there is a wrong assumption according to which “the more, the better”. It is just wrong – not only for women. The effective doses of any testosterone analogue are usually much smaller than the ones used by unassisted (by a doctor) athletes.
    3. Hair and skin: yup, any testosterone analogue will affect those. Are there ways to prevent it, besides using the right dose or not using the drugs at all? At some degree, yes. Some DHT inhibiting drugs my help. Again: dose! The smallest possible effective dose should be used.
    4. Skin. Don’t make a bad situation worse. Shaving will thicken facial (or any) hair. Then the woman freaks out and puts on a ton of concealer and foundation that will only increase damage to the skin. Facial and chest hair are usually completely unwanted and unacceptable for most women. The most effective and healthiest ways to handle them are also the most expensive (laser) or painful (hair plucking). Sorry, that’s life.
    5. Hair. Again, don’t make a bad situation worse. Wild hair styles, dyeing, etc., won’t solve the problem. Your hair is undergoing shedding (hair loss) and miniaturization (hair thinning, part of the androgenic alopecia process). The only way to prevent the progress of androgenic alopecia is to use local and systemic DHT blocking substances. Also, if your hair is much more frail, do you really think it is a good idea to use damaging chemical treatment and straightening? No, it’s not. Your hair is thinner, dryer, frail. Do that and you speed up hair loss.
    6. All the alternatives involve time consuming and sometimes expensive procedures. They can become less expensive if you know what you are doing, so educating yourself about what is going on with the side effects at the biological level is also saving money. But expect to spend time taking care of the issue.
    7. Voice changes: again, it is a question of dose and sensitivity. Some women use “just a little” and have no other side effect besides a radical voice change. Too bad because it is mostly irreversible. DHT blocking agents may (or may not) help. Estrogen treatment as well (in the absence of testosterone analogues, which creates a cruel dilemma for menopausal women: relative voice recovery and loss of libido or nice sex life and bad voice?).
    8. Clitoris enlargement. It will happen. Sometimes just a little, some times significantly. Another item to think about when deciding whether to use those substances or not. If you don’t care or even like it, it’s not a major concern.
    9. Testosterone analogues will affect the reproductive cycle. The extent that it will depends on the dose and period they are used.
    10. Different women react differently to different testoterone analogues. We all do, though. It’s just silly to pretend you don’t use them, didn’t use them or don’t suffer any side effects because you use “female friendly” drugs. SARMs (“Selective Androgen Receptor Modulators”) are not testosterone analogues and if you don’t want any virilizing side effects, maybe that’s something to consider.
    11. Toxicity. Some people go for oxandrolone (anavar) because it is more “female friendly”. The same reasoning is used for choosing stanazolol (winstrol). Both are highly liver-toxic. The drug of choice for female testosterone replacement (in menopause, for example) is also quite toxic: methyltestosterone. Many endocrinologists prefer testosterone esters traditionally used for males, adjusted for dose. There was even a product for hormone replacement manufactured by Organon, that no longer exists, that was exactly a much less concentrated version of Sustanon. I wrote to Shering asking why it was discontinued, while doing research with an endocrinologist, but not even they could provide an explanation. Unfortunately, while the medical community doesn’t evolve to a more scientific approach to testosterone replacement for women, there is no good alternative.
    12. Older women most often than not NEED testosterone, not only for menopause-related sexual dysfunction (loss of libido), but for bone and muscle loss and general health. Unfortunately (again…), although there is consensus concerning this, the medical community is unequally educated in the matter. There is virtually no research money for side effect management and prevention in spite of the fact that the population is getting older, people want to keep having a healthy life (and sexual life!), and testosterone replacement is here to stay.