Lean Body Mass in Osteoporotic Postmenopausal Women Treated with Nandrolone Decanoate: A Systematic Search Review

Aims: Along with the bone loss due to aging and postmenopausal osteoporosis (PMO) is the muscle mass loss, with an increasing occurrence of poorer body composition and osteosarcopenia. The current pharmacological recommendation guidelines for PMO treatment does not include any drugs that promote muscle hypertrophy. Nandrolone Decanoate (ND) is an anabolic steroid that has proven to increase bone and muscle mass in several pathologic conditions. Thus, we aimed to search for studing with body composition measurements, especially lean body mass, in postmenopausal women undergoing pharmacological treatment with ND for PMO.

Study Design: Review with systematic search strategy.

Methodology: We used free and structured MeSh terms combined in a PICO strategy, searching for studies in PubMed, CENTRAL, LILACS, Scielo, Open Grey, and TRIP database.

Results: Three studies were found and included for analysis, two of which were randomized controlled and one observational. All studies observed positive increments in muscle mass concomitant with an increase in bone mass, and a reduction in body fat mass, due to the treatment of PMO with ND. Side effects were predominantly androgenic (voice deepening, increased hirsutism), considered mild, well tolerated, and without serious adverse events.

Conclusion: ND was an effective drug for increasing lean body mass, reduce body fat, concomitantly improving several bone health parameters (bone mineral content and density) and outcomes (fractures), showing adequate clinical safety, therefore becoming a potential adjuvant to be considered in the medical therapeutic armamentarium for optimized PMO treatment.