Due to its chemical structure nandrolone is weakly exposed to aromatase (only 20% of the aromatizing activity of testosterone). However, not estrogenic effects are its main concern: nandrolone has a potent progestogenic activity (20% of progesterone). While binding to progestogenic pituitary receptors nandrolone causes increased production of prolactin, which in effect is very similar to estrogen: its effect presents in reducing testosterone production, increasing fat mass and in gynecomastia. To prevent these side effects prolactin inhibitors (cabergoline) shall always be at hand when on nandrolones cycle.
Heavy consumption of the essential amino acid lysine (as indicated in the treatment of cold sores) has allegedly shown false positives in some and was cited by American shotputter C. J. Hunter as the reason for his positive test, though in 2004 he admitted to a federal grand jury that he had injected nandrolone.  A possible cause of incorrect urine test results is the presence of metabolites from other AAS, though modern urinalysis can usually determine the exact steroid used by analyzing the ratio of the two remaining nandrolone metabolites. As a result of the numerous overturned verdicts, the testing procedure was reviewed by UK Sport . On October 5, 2007, three-time Olympic gold medalist for track and field Marion Jones admitted to use of the drug, and was sentenced to six months in jail for lying to a federal grand jury in 2000. 
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