Significant side effects such as gynecomastia, high blood pressure, acne and male pattern baldness may occur with extended usage. Dianabol has also been found to have severe masculinizing effects in women even when administered at low doses. Additionally, it is metabolized into an isomer of methylestradiol by aromatase. When used without aromatase inhibitors these estrogenic effects will begin to appear in men. Aromatase inhibitors such as aminoglutethimide and anastrozole, can be used to lessen these effects.

In addition to the estrogenic effects, the use of this substance over extended periods of time can result in liver damage.

Dianabol has been popular with bodybuilders, weightlifters and powerlifters because of the very large dosing range of the drug. This allows the drug to be adjusted with the goal of the individual user in mind. Because this steroid causes noticeable results in a short period of time, it is also a popular choice for novice steroid users who can achieve exceptional results over a period of 8-10 weeks with a fairly low dose.

The U.S. Food and Drug Administration has not allowed American companies to manufacture Dianabol since the early 1990s. Numerous drug companies outside of the U.S. continue to make the drug and it is easily available from a variety of sources.