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Methyltestosterone is a synthetic, orally active androgen and anabolic steroid (AAS). It is a 17α-methylated derivative of testosterone, which enhances its oral bioavailability by reducing first-pass hepatic metabolism. As an agonist of the androgen receptor (AR), it mimics the effects of endogenous testosterone, promoting the development of male secondary sexual characteristics and exerting anabolic effects on muscle and bone. It is primarily indicated for replacement therapy in males with primary or hypogonadotropic hypogonadism and for the stimulation of puberty in males with delayed onset. In females, it is used as a secondary treatment for advancing inoperable metastatic mammary cancer and, at lower doses, in combination with estrogens for menopausal vasomotor symptoms. Due to its 17α-alkylated structure, long-term use is associated with potential hepatotoxicity, including peliosis hepatis and hepatocellular carcinoma.
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