@sarahmarramaldi's TRT and anavar claims need a fact-check

What did @sarahmarramaldi actually say?

Sarah made a case that women relying on oral androgens like Anavar, Winstrol, or Primobolan while skipping testosterone replacement are quietly wrecking their hormones. She says she takes "three milligrams of test prop every five days" subcutaneously at a very low concentration, keeps cycles of Anavar to "maybe six to eight weeks" and no more than two per year, and traces her own low testosterone to being put on birth control at age eight for ovarian cysts. Her central argument: oils alone are not a safe substitute for actual hormone management.

She also frames oral anabolic steroids as tools that can build muscle in the right context, not inherently evil, but dangerous when used without understanding baseline hormone levels. That framing is more nuanced than most TikTok content on this topic, even if some of the specifics deserve scrutiny.

Does the science back this up?

Partially, yes. The claim that oral 17-alpha alkylated androgens like Anavar (oxandrolone) are harder on the endocrine system than low-dose injectable testosterone has real support, though the research in women is thinner than advocates suggest.

Oxandrolone suppresses the hypothalamic-pituitary-gonadal axis in women, as demonstrated in Lovejoy et al. (1996, Journal of Clinical Endocrinology and Metabolism), which found significant reductions in endogenous sex hormone production even at therapeutic doses. The suppression is real. Meanwhile, low-dose testosterone therapy in women, when properly monitored, has a growing evidence base. Davis et al. (2019, Lancet Diabetes and Endocrinology) reviewed testosterone use in women and found reasonable safety profiles at physiologic doses with appropriate monitoring.

The idea that sub-q injection of testosterone propionate maintains more stable levels than oral androgens is plausible pharmacologically. Testosterone propionate has a short half-life, roughly two days, so frequent small dosing can approximate steadier serum levels. That logic holds.

What did they get wrong (or right)?

The virilization list she gives, "deepening of the voice, bone structure changes, hair loss, hair growth," is accurate. These are well-documented androgenic side effects in women exceeding physiologic testosterone ranges. Clitoromegaly, which she did not mention, is also common and often irreversible. Credit where it is due: she acknowledged these risks plainly rather than glossing over them.

Where she gets shaky is the implied equivalency between her personal protocol and what is broadly safe or effective. Saying "I take three milligrams of test prop every five days" without medical context is not a recommendation anyone should follow. Testosterone propionate is not an FDA-approved formulation for women, and compounded versions vary in concentration and quality. Presenting a personal dose as a kind of benchmark, even casually, does real harm to viewers who might replicate it without labs or clinical oversight.

Her claim that birth control at age eight "completely castrated" her for years is dramatic and not well supported by endocrinology literature. Combined oral contraceptives do suppress ovarian testosterone production and raise sex hormone binding globulin, which lowers free testosterone. Mendoza et al. (2014, Contraception) confirmed this effect. But calling it castration overstates the mechanism and risks stigmatizing contraception for young women who need it medically.

What should you actually know?

Women do produce testosterone, and low levels are associated with reduced libido, fatigue, and impaired body composition. But female testosterone physiology is genuinely understudied compared to male TRT, and normal reference ranges for women remain contested. The Endocrine Society has not issued formal guidelines supporting testosterone therapy for women outside of hypoactive sexual desire disorder.

Oral anabolic steroids like oxandrolone are not the same as testosterone replacement. They are not interchangeable, they carry distinct hepatic and lipid risks, and using them without baseline hormone testing is genuinely reckless. Sarah is right about that. However, the solution is not just to add injectable testosterone without clinical evaluation. It is to get comprehensive labs, work with a provider who understands female endocrinology, and avoid self-directed stacking of multiple androgenic compounds entirely.

Any woman considering androgens for performance or hormone optimization should know that virilizing side effects, particularly voice deepening and clitoral changes, can be permanent even after stopping. That risk does not go away just because someone frames their protocol as "optimization."