Less so than orals. When pills are swallowed, they enter the digestive system and enters the hepatic portal system & into the liver where it is metabolized. This process (called First Pass Metabolism) makes the liver work and can worsen liver disease. The
17 alpha-alkylated steroids are the most "hepatotoxic".
Alternative routes like IM injection avoid the first-pass effect because they allow drugs to be absorbed directly into the systemic circulation. Thus, they are less harmful. However, some 17 alpha-alkylated steroids can be injected IM (w.inny) and may cause problems at high doses or for prolonged periods.