The side-effects of short-term use of the drug itself include nausea, bloating, acne, and masculinising effects such as deepening of the voice, growth of facial hair and clitoral hypertrophy . In addition, oxymetholone is readily aromatized by aromatase to form a progestagen, and unless selective estrogen receptor modulators such as tamoxifen or clomifene are taken in conjunction with the drug, there is a significant risk of the appearance of estrogenic effects such as gynaecomastia over time. Because of its 17α-alkylated structure, oxymetholone is highly hepatotoxic. Long term use of the drug can cause a variety of serious ailments, including hepatitis, liver cancer, and cirrhosis. It’s dangerous to take oxymetholone in high dosages for periods of time exceeding four weeks, and is commonly used by bodybuilders during the start of a steroid cycle to help gain mass and increase serum levels of androgens quickly.