Other possible side effects may include headaches, nausea, vomiting, stomach aches, lack of appetite, insomnia, and diarrhea. The athlete can expect a feeling of "general indisposition" with the in-take of Anadrol which is completely in contrast to Dianabol which conveys a "sense of well-being". The increased aggressiveness is caused by the resulting high level of androgen and occurs mostly when large quantities of testosterone are "shot" simulta-neously with the Anadrol. The body's own production of testoster-one is considerably reduced since Anadrol has an inhibiting effect on the hypothalamus, which in turn completely reduces or stops the release of GnRH (gonadotropin releasing hormone). For this reason the intake of testosterone-stimulating compounds such as HCG and Clomid is absolutely necessary to main-tain the hormone production in the testes.
Staging and treatment are generally handled by an oncologist familiar with gynecologic cancer. Surgery is a mainstay of therapy depending on anatomical staging and is usually reserved for cancers that have not spread beyond the vulva.  Surgery may involve a wide local excision, radical partial vulvectomy , or radical complete vulvectomy with removal of vulvar tissue, inguinal and femoral lymph nodes . In cases of early vulvar cancer, the surgery may be less extensive and consist of wide excision or a simple vulvectomy. Surgery is significantly more extensive when the cancer has spread to nearby organs such as the urethra, vagina, or rectum. Complications of surgery include wound infection, sexual dysfunction, edema and thrombosis , as well as lymphedema secondary to dissected lymph nodes.