Careful steroid selection and reasonable dosing are usually regarded as the most basic and reliable methods for preventing its onset. Many steroid users also frequently take some form of estrogen maintenance medication, which may effectively counter the effects of elevated estrogenicity. Common options include aromatase inhibitors such as anastrozole. The use of a PCT program at the conclusion of steroid administration (which usually includes several weeks of anti-estrogen use) is also commonly advised, as gynecomastia is sometimes reported in the post-cycle hormone imbalance phase when steroids are not actually being taken.
Stanozolol appears to offer less hepatic stress than an equivalent dose of Dianabol (methandrostenolone). Studies giving 12mg of stanozolol per day for 27 weeks failed to demonstrate clinically-significant changes in markers of liver function, including serum aspartate amino-transferase, alanine amino-transferase, gamma-glutamyltransferase, bilirubin, and alkaline phosphatase. 621 Relative hepatotoxicity increases as the dosage escalates, so hepatic dysfunction should still be a concern. In rare instances, high doses (alone or in combination with other steroids) have been implicated in cases of serious life-threatening hepatotoxicity in bodybuilders. Injectable stanozolol has also been implicated in severe hepatotoxicity in an otherwise healthy bodybuilder, 622 and should not be used as an alternative medication when liver toxicity precludes oral stanozolol use.