It should be noted that in theory if one was to consistently suppress your natural estrogen levels for a long period of time, this would negatively impact your health, including your cholesterol. Due to the ability of Letrozole- to inhibit estrogen so much, this should definitely be a concern to most users. However the research that has focused on the relationship between use of letrozole and cholesterol levels is rather inconsistent in it's findings. Many studies have concluded that the compound is detrimental to both a user's HDL and LDL cholesterol levels, while other research has found no link. Obviously individuals are best served to monitor their cholesterol while using any compound via blood tests however barring that, letrozole should simply not be run for extended periods of time if at all possible. Doing so could cause serious medical complications.
Along with the issues related to blood lipids is the fact that many users complain that their libido is dramatically reduced when using the compound. This is related to the fact that estrogen is partly responsible for the regulation of an individual's sex drive. Since Letrozole- is so potent it can often drive estrogen levels too low and this inhibits a user's libido. To avoid this users can lower dosages, but some anecdotally report that even extremely low doses of the drug can cause problems. If this is the case a less potent compound such as exemestane or anastrozole may be a more appropriate option.
Antiandrogens like spironolactone are male-specific teratogens which can feminize male fetuses due to their antiandrogen effects (see below ).    For this reason, it is recommended that antiandrogens only be used to treat women who are of reproductive age in conjunction with adequate contraception.    Oral contraceptives, which contain an estrogen and a progestin , are typically used for this purpose.  Moreover, oral contraceptives themselves are functional antiandrogens and are independently effective in the treatment of androgen-dependent skin and hair conditions, and hence can significantly augment the effectiveness of antiandrogens in the treatment of such conditions.  
Of course, we said there were two testosterone related Winstrol side-effects , the first being testosterone suppression and the second being testicular atrophy. As testosterone is manufactured in the testicles, when production is suppressed the testicles simply atrophy. They do not shrink and disappear; in-fact, in some cases the difference may not be all that noticeable. When we’re speaking of testicular atrophy we’re simply referring to the testicles losing some of their fullness. Once the use of all anabolic steroids has been discontinued and all the hormones are out of your system natural testosterone production will begin again, and your testicles will return to their normal size.