Here's a good read, and one reason I probably won't use orals...
"As mentioned earlier, the use of anabolic/androgenic steroids may have an impact on the level of LDL (low density lipoprotein), HDL (high density lipoprotein) and total cholesterol values. As you probably know, HDL is considered the "good" cholesterol since it can act to remove cholesterol deposits from the arteries. LDL has the opposite effect, aiding in the buildup of cholesterol on the artery walls. The general pattern seen with steroid use is a lowering of HDL concentrations, while total and LDL cholesterol numbers increase. The ratio of HDL to LDL values is usually more important than one's total cholesterol count, as these two substances seem to balance each other in the body. If these changes are exacerbated by the long-term use of steroidal compounds, it can clearly be detrimental to the cardiovascular system. This may be additionally heightened by a rise in blood pressure, which is common with the use of strongly aromatizable compounds.
It is also important to note that due to their structure and form of administration, most 17 alpha alkylated oral steroids have a much stronger negative impact on these levels compared to injectable steroids. Using a milder drug like Winstrol® (stanozolol), in hopes HDL level changes will also be mild, may therefore not turn out to be the best option. One study comparing the effect of a weekly injection of 200mg testosterone enanthate vs. only a 6mg daily oral dose of Winstrol® makes this very clear". After only six weeks, stanozolol was shown to reduce HDL and HDL-2 (good) cholesterol by an average of 33% and 71% respectively. The HDL reduction (HDL-3 subfraction) with the testosterone group was only an average of 9%. LDL (bad) cholesterol also rose 29% with stanozolol, while it actually dropped 16% with the use of testosterone. Those concerned with cholesterol changes during steroid use may likewise wish to avoid oral steroids, and opt for the use of injectable compounds exclusively. We also must note that estrogens generally have a favorable impact on cholesterol profiles. Estrogen replacement therapy in postmenopausal women for example is regularly linked to a rise in HDL cholesterol and a reduction in LDL values. Likewise the aromatization of testosterone to estradiol may be beneficial in preventing a more dramatic change in serum cholesterol due to the presence of the hormone. A recent study investigated just this question by comparing the effects of testosterone alone (280 mg testosterone enanthate weekly), vs. the same dose combined with an aromatase inhibitor (250mg testolactone 4 times daily)42. Methyltestosterone was also tested in third group, at a dose of 20mg daily. The results were quite enlightening. The group using only testosterone enanthate showed no significant decrease in HDL cholesterol values over the course of the 12 week study. After only four weeks the group using testosterone plus an aromatase inhibitor displayed a reduction of 25% on average. The methyltestosterone group noted an HDL reduction of 35% by this point, and also noted an unfavourable rise in LDL cholesterol. This clearly should make us think a little more closely about estrogen maintenance during steroid therapy. Aside from deciding whether or not it is actually necessary in any given circumstance, drug choice may also be an important consideration. For example, the estrogen receptor antagonist Nolvadex® does not seem to exhibit ant estrogenic effects on cholesterol values, and in fact often raises HDL levels. Using this to combat the side effects of estrogen instead of an aromatase inhibitor such as Arimidex® or Cytadren® may therefore be a good idea, particularly for those who are using steroids for longer periods of time. Since heart disease is one of the top killers worldwide, steroid using athletes (particularly older individuals) should not ignore these risks. If nothing else it is a very good idea to have your blood pressure and cholesterol values measured during each heavy cycle, being sure to discontinue the drugs should a problem become evident. It is also advisable to limit the intake of foods high in saturated fats and cholesterol, which should help minimize the impact of steroid treatment. Since blood pressure and cholesterol levels will usually revert back to their pre-treated norms soon after steroids are withdrawn, long-term damage is not a common worry."
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