Oxandrolone
Oxandrolone, oral 17-alpha-alkylated anabolic androgen
Written by Aaron CuhaReviewed Sep 2026
Also known as: Oxandrin, Anavar, Var
The anabolic steroid with the best medical trial record, and it comes from an unexpected place: two years of randomised use in severely burned children, with bone density and growth as endpoints.
Overview
Oxandrolone has a reputation as the mild one, and underneath that reputation sits a genuinely serious body of randomised evidence that has nothing to do with bodybuilding.
Severe burns produce a catabolic state that lasts years, destroying muscle and bone in children who then fail to grow properly. Oxandrolone was studied in that setting for up to two years, with whole-body and lumbar spine bone mineral content and density, height velocity and fracture risk as endpoints. It improved all of them, and two years of treatment outperformed twelve months. Fewer treated children met the criteria for paediatric osteoporosis.
That is a stronger clinical record than most things on this site, and it comes with an important qualifier: it is in a catabolic disease state in children, which is a long way from a healthy adult taking it to add muscle.
It is also an oral 17-alpha-alkylated compound, which is the structural feature that carries liver and lipid risk.
Mechanism of action
A synthetic derivative of dihydrotestosterone with an oxygen substituted into the A ring and a 17-alpha methyl group. The 17-alpha alkylation is what allows it to survive first-pass metabolism and be taken orally, and it is also the feature responsible for the liver strain shared across oral alkylated androgens. It binds the androgen receptor, increasing muscle protein synthesis and nitrogen retention, and it is not aromatised to oestradiol, which is the basis for its reputation as producing less fluid retention and gynaecomastia than testosterone. Not aromatising is not purely an advantage: oestradiol has roles in bone, mood and libido in men, so a non-aromatising androgen removes those contributions.
Human evidence
An unusually strong randomised record in a severe catabolic disease state, with multi-year follow-up and hard skeletal endpoints. Nothing comparable exists for its use in healthy adults.
- Randomised administration for up to 24 months in severely burned children, with five-year outcome follow-up.
- Whole-body and lumbar spine bone mineral content and density improved significantly, as did height velocity.
- Fewer treated children met the diagnostic criteria for paediatric osteoporosis, which is a fracture-risk endpoint rather than a biomarker.
- Two years of treatment was significantly more effective than twelve months, which is a dose-duration relationship rather than a single result.
- No adverse effects were attributed to long-term administration in that cohort, which is a meaningful safety observation in children studied for years.
- It held an FDA approval for weight gain in catabolic states, so the medical indication is not a grey-market reinterpretation.
What this does not tell you: Everything here is in a severe catabolic disease state, mostly in children, where the body is actively destroying its own tissue. A healthy adult is a different physiology and has not been studied this way. The favourable safety observation belongs to that specific supervised context and does not transfer to unsupervised use at higher doses. It remains an oral 17-alpha-alkylated compound, which carries liver and lipid risk that a burns cohort followed by a hospital is well placed to catch and an individual is not.
Reading the research record
Oxandrolone is the clearest example on this site of a compound whose medical evidence and street reputation have almost nothing to do with each other.
The reputation is that it is the mild steroid, the one women can take, the one with few side effects. The evidence is a two-year randomised programme in severely burned children measuring bone mineral content and height velocity, which is a serious clinical trial with serious endpoints and nothing to do with mildness.
The useful transfer between them is narrower than either camp assumes. What the burns work establishes is that this drug reliably shifts a catabolic body toward building tissue, including bone, over long periods under supervision. What it does not establish is anything about a healthy person, at higher doses, without monitoring, using material of unverified composition, which is the actual use case for nearly everyone reading this.
The harms of this class are well characterised and are not exotic. Suppression of the body's own testosterone production through negative feedback, with reduced sperm production that is usually but not always reversible. Adverse lipid changes, typically a fall in HDL cholesterol and a rise in LDL, which is more pronounced with oral 17-alpha-alkylated compounds. Liver strain, again concentrated in the oral alkylated compounds, which is the specific reason those exist as a separate risk category. Raised haematocrit. In women, virilising effects including voice deepening and hair growth that are partly irreversible, which is why dosing in women is a different problem rather than a smaller version of the same one. Cardiac effects at supraphysiological doses are documented and are not the same question as replacement-dose testosterone, which has its own large safety trial.
The evidence, charted
Fig. 1 · evidence composition
1of 1 citation (100%) is in people
Every citation cited here is Human work; no other study type is cited on this page. This count is of our own citation list and understates any literature larger than the sources we cite.
Fig. 2 · evidence over time
Every citation here was published in 2016.
Too few distinct publication years on this page to plot as a timeline. The newest citation on file is from 2016, more than five years ago; the published record may have gone quiet.
Fig. 3 · legal status at a glance
US
Approved
UK
Approved
AU
Approved
CA
Approved
Approved in all four jurisdictions shown. A jurisdiction's classification is a regulatory fact, not a verdict on the science; see Legal status below for the full text and any notes.
Key studies & citations
- Human2016
Five-year outcomes after long-term oxandrolone administration in severely burned children: a randomized clinical trial
Randomised, up to 24 months of oxandrolone in severely burned children with five-year follow-up. Significant improvement in whole-body bone mineral content, lumbar spine bone mineral content and density, and height velocity, with treated children showing significantly greater height velocity throughout the first two years post-burn. Fewer treated children had bone density z-scores below minus 2.0, indicating reduced future fracture risk. Two years of treatment produced significantly greater gains than twelve months. No adverse effects were attributed to long-term administration in this cohort.
Shock
Frequently asked questions
Is oxandrolone actually mild?
It does not aromatise to oestradiol, so it produces less fluid retention and breast tissue than testosterone, which is where the reputation comes from. It is still an oral 17-alpha-alkylated androgen, which is the structure that carries liver strain and adverse lipid changes, and it still suppresses your own testosterone production. Mild compared with some androgens is not the same as benign.
Why is a burns trial relevant to me?
It is the reason anyone can say this drug does something real, and it is also the limit of what can be claimed. A two-year randomised trial with bone density and growth endpoints is far better evidence than most things in this class have. It was conducted in children whose bodies were destroying their own tissue, under hospital supervision, which is not a healthy adult buying it online.
Is it safe for women?
It is the androgen most often given to women, and virilising effects including voice change and hair growth are dose-dependent and partly irreversible. That irreversibility is the thing to understand before starting rather than after. It is a medical decision with monitoring, not a smaller version of a man's decision.
Can I still get it?
The brand was discontinued in the United States, so what is sold under the name Anavar is compounded or grey-market material whose contents nobody has verified. It remains a Schedule III controlled substance, so possession without a prescription is a criminal matter rather than a regulatory one.