Tamoxifen – Nolvadex
Nolvadex is a non steroidal drug that had excellent anti estrogen properties. By binding to the estrogen receptors, it blocks the effects of estrogen. It has been indicated for the treatment of certain types of breast cancer in women and men. It is also used to prevent breast cancer in women who have had ductal carcinoma in situ (abnormal cells in the ducts of the breast) and are at a high risk of developing breast cancer. Nolvadex is also being studied in the treatment of other types of breast cancer. It is also called tamoxifen or tamoxifen citrate.
Nolvadex is used in the treatment of metastatic breast cancer in women and men. It is also used to treat premenopausal women with metastatic breast cancer. Instead of surgery (removal of the ovaries) or radiation, Nolvadex is preferred. Patients who have estrogen receptor positive tumors benefit the most from Nolvadex therapy. Nolvadex is also indicated as adjuvant treatment of breast cancer in women following surgery.
Nolvadex is available as a 10/20 mg pill. It is also available as a 10 mg solution. The recommended dose of Nolvadex is 20 mg daily. It is taken by mouth and easily absorbed. The pill can be taken with or without food.
The dose of Nolvadex in individuals with breast cancer is between 20-40 mg/daily. Doses higher than 20 mg per day should be divided in to 1-3 doses. The majority of bodybuilders start off with 20 mg /day and some go up to 30 mg/day. The drug is not recommended for therapy for more than 5 years
Nolvadex as such has no direct anabolic or androgenic effects. All its effects are secondary to the blockage of estrogen receptors. Nolvadex is known to block estrogen receptors in the body. When it blocks the estrogen receptors on the hypothalamus, the brain senses that the body is lacking in this sex hormone. This results in a surge of the Gonadotropins (LH and FSH) which increases the synthesis of the sex hormones. The drug has been shown to increase the synthesis of testosterone.
The surge in testosterone then accounts for the anabolic and androgenic effects of Nolvadex.
Most bodybuilders take Nolvadex after coming off an anabolic steroid. Since most anabolic steroids suppress the testosterone production, Nolvadex can be added during the washout cycle. While some bodybuilders prefer Nolvadex, others prefer Arimidex. The effects of both drugs are similar. Since Nolvadex also blocks the estrogen activity, most bodybuilders add it to their regimen to prevent the gynecomastia and water retention.
There is minimal weight gain with Nolvadex alone. In order to maintain the weight increase induced by other anabolic steroids, Nolvadex is preferred. Used during the washout cycle, the drug can maintain the weight gain and also allows the testes to recover.
Nolvadex is routinely prescribed for women with metastatic breast cancer. All women who take this drug whether it is legally prescribed or for the purpose of bodybuilding should be followed by a physician. The side effects of concern in women include the following:
- vaginal bleeding
- new breast lumps
- lower abdominal fullness
- pain in the pelvic area
- leg swelling
- sudden or gradual shortness of breath
- changes in vision
- irregular menstrual cycles
It is imperative that all women who do take nolvadex have their breasts examined regularly by health care professionals. While the chances of any complications are rare, it is better to be safe than sorry. A female bodybuilder should remember that the birth control pill will not work in the presence of Nolvadex.
Overall side effects
Nolvadex is a very safe drug; thousands of women have been treated with it and less than 1-3% develop any significant side effects. Very few women have had to discontinue the drug because of the side effects. The most common side effects in both men and women include:
- hot flashes
- swelling in the legs
- loss of taste to food
- itching in the genitals
- tired, dizziness
- hair loss
- vaginal dryness
- nausea, vomiting
- bone pain
- abdominal cramps
- loss of appetite
The majority of these side effects resolve when the drug is stopped.
Nolvadex can cause hypercalcemia in patents with breast cancer within a few weeks after starting the drug. There have also been reports of uterine cancer induced with Nolvadex.
Nolvadex also can cause blood clots which can embolize to the lung. Other rare complications have included liver cancer and changes in vision.
Nolvadex is a very safe drug and no cases of over dose have been reported. If many pills are taken, the effects do not appear for at least 4-6 days. One may develop a tremor, unsteady gait, dizziness or an irregular heart rate. In all cases, the treatment is supportive. No permanent toxicity is seen.
The drug is actively screened for by many sports organizations. While some women may have a prescription for taking the drug, any male who is found to have this drug in the urine is automatically barred from further sports competition. Nolvadex and its metabolites can be detected in the urine for at least 3-4 weeks after the last dose.
Nolvadex is widely available. The drug is not cheap and the cost is variable. On average each pill sells for about $1.50-$2.0. There are generic forms of Nolvadex made in Asia which are cheaper but the quality and purity of these pills is questionable. So far there appear to be no fake Nolvadex products on the market.