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.
The fact is that anabolic steroids do present various health risks – they are not without their faults and potential risks, as with anything. However, the context under which they are utilized presents a vast difference in how much of a risk is being taken. Responsible and judicious anabolic steroid use among healthy adult males is a significantly different situation in comparison to anabolic steroid use among children, teenagers, and females. Within the context of healthy adult male anabolic steroid use, the associated and proposed risks plummet by a massive degree, and from what we already know from studies referenced above, the average anabolic steroid user is in fact not teenagers and nor are they athletes, but are healthy adult males in the median age range of 25 – 35 years of age. Other more recent studies have also supported this fact among steroids statistics, where a 2006 study that surveyed 500 anabolic steroid users found that almost 80% of these users were not competitive athletes or bodybuilders but instead average adult physically active males  . Furthermore, the majority of anabolic steroid users are short-term users that do not engage in lifetime use (either in cycles or constant use), and that the rate of actual lifetime use among anabolic steroid users was found to be % for males, and % for females5. What this means is that only % and % of all male and female anabolic steroid users respectively will engage in lifetime use (mostly via subsequent cycles), while the rest will only utilize anabolic steroids once or a handful of times during their life.