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The main side effect associated with primobolan is testosterone suppression, which is likely to be mild to moderate. A very small study of men with early-onset OA (age 35–60 y) found that testosterone replacement therapy and/or antiandrogens significantly reversed the development of OA (P=0.001) . Additionally, a single-blind comparison of 3 testosterone-replacement therapies found one to decrease the likelihood of OA and the other two did not do so, meaning one may be more effective than the other. Studies of men with fibromyalgia using steroids have resulted in a large number of reported cases of OA [10–14] with men treated with testosterone, both alone and in combination with antiandrogens, having significantly greater rates of OA compared to untreated men who received placebo [2,4,14,15]. A meta-analysis of 22 studies with 1654 participants demonstrated that testosterone replacement (4 mg/d for 5 mo and 8.5 mg/d for 10 mo) was effective in the control of fibromyalgia (n=1247) and OA (n=1168) while antiandrogens (n=1330), a combined therapy (5 mg/d for 5 mo and 8.5 mg/d for 10 mo), did not . One randomized controlled trial reported the efficacy of a testosterone/epitestosterone regimen in treating men with chronic pain from nonunion, with a high percentage of men reporting improvement and a relatively low number of participants experiencing adverse events . While the overall incidence of the primary endpoint of pain was reduced by 43% for those taking the combined therapy than placebo, in men on testosterone, 42% of patients reported a decrease in pain compared to 8% of men on placebo. With regards to arthritis, a double-blind, randomized, placebo-controlled crossover trial of 945 men with osteoarthritis found that 5 mg/d of testosterone was more effective than placebo for decreasing pain of osteoarthritis and reduced the amount of time reported to return to work (3 years) from 4 years . With regard to hip replacement, a two-group study of 3,971 men with hip osteoarthritis showed that 1.5 mg/d of transdermal testosterone given for 6 weeks twice a week significantly reduced pain and time spent in bed compared to placebo for men with hip osteoarthritis and nonunion . These results suggest that the use of testosterone has beneficial actions against osteoarthritis. One double Similar articles: