Gynecomastia medical therapy: Difference between revisions
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*If the gynecomastia is believed to be due to a use of a medication, withdrawal of that medication should lead to improvement over a period of a few months. | *If the gynecomastia is believed to be due to a use of a medication, withdrawal of that medication should lead to improvement over a period of a few months. | ||
=== Pharmacologic therapy === | === Pharmacologic therapy === | ||
Pharmacologic medical therapies for gynecomastia include:<ref name="pmid17543732">{{cite journal| author=Narula HS, Carlson HE| title=Gynecomastia. | journal=Endocrinol Metab Clin North Am | year= 2007 | volume= 36 | issue= 2 | pages= 497-519 | pmid=17543732 | doi=10.1016/j.ecl.2007.03.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17543732 }} </ref><ref name="pmid17881754">{{cite journal| author=Braunstein GD| title=Clinical practice. Gynecomastia. | journal=N Engl J Med | year= 2007 | volume= 357 | issue= 12 | pages= 1229-37 | pmid=17881754 | doi=10.1056/NEJMcp070677 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17881754 }} </ref><ref name="pmid2137877">{{cite journal |vauthors=Biro FM, Lucky AW, Huster GA, Morrison JA |title=Hormonal studies and physical maturation in adolescent gynecomastia |journal=J. Pediatr. |volume=116 |issue=3 |pages=450–5 |year=1990 |pmid=2137877 |doi= |url=}}</ref> | Pharmacologic medical therapies for gynecomastia include:<ref name="pmid17543732">{{cite journal| author=Narula HS, Carlson HE| title=Gynecomastia. | journal=Endocrinol Metab Clin North Am | year= 2007 | volume= 36 | issue= 2 | pages= 497-519 | pmid=17543732 | doi=10.1016/j.ecl.2007.03.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17543732 }} </ref><ref name="pmid17881754">{{cite journal| author=Braunstein GD| title=Clinical practice. Gynecomastia. | journal=N Engl J Med | year= 2007 | volume= 357 | issue= 12 | pages= 1229-37 | pmid=17881754 | doi=10.1056/NEJMcp070677 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17881754 }} </ref><ref name="pmid2137877">{{cite journal |vauthors=Biro FM, Lucky AW, Huster GA, Morrison JA |title=Hormonal studies and physical maturation in adolescent gynecomastia |journal=J. Pediatr. |volume=116 |issue=3 |pages=450–5 |year=1990 |pmid=2137877 |doi= |url=}}</ref><ref name="pmid6772358">{{cite journal |vauthors=Friedman NM, Plymate SR |title=Leydig cell dysfunction and gynaecomastia in adult males treated with alkylating agents |journal=Clin. Endocrinol. (Oxf) |volume=12 |issue=6 |pages=553–6 |year=1980 |pmid=6772358 |doi= |url=}}</ref> | ||
==== Androgens ==== | |||
*Testosterone replacement can improve gynecomastia in hypogonadism of short duration, but it can worsen gynecomastia in eugonadal men due to aromatization to estradiol. | *Testosterone replacement can improve gynecomastia in hypogonadism of short duration, but it can worsen gynecomastia in eugonadal men due to aromatization to estradiol. | ||
==== Aromatase inhibitors ==== | ==== Aromatase inhibitors ==== | ||
| Line 20: | Line 20: | ||
==== Selective estrogen receptor modulators (SERMs) ==== | ==== Selective estrogen receptor modulators (SERMs) ==== | ||
*Selective estrogen receptor modulators (tamoxifen, raloxifene) have been used with varying degree of success with tamoxifen better than raloxifene. | *Selective estrogen receptor modulators (tamoxifen, raloxifene) have been used with varying degree of success with tamoxifen better than raloxifene. | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 20:01, 15 August 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Medical Therapy
- Asymptomatic gynecomastia usually does not require treatment; reassurance is all that is required.
- Treatment of symptomatic gynecomastia (discomfort, tenderness, psychological stresses) is guided by the patient's goal.
- In gynecomastia with the identifiable underlying cause, treatment of that underlying cause can address the symptoms.
- If the gynecomastia is believed to be due to a use of a medication, withdrawal of that medication should lead to improvement over a period of a few months.
Pharmacologic therapy
Pharmacologic medical therapies for gynecomastia include:[1][2][3][4]
Androgens
- Testosterone replacement can improve gynecomastia in hypogonadism of short duration, but it can worsen gynecomastia in eugonadal men due to aromatization to estradiol.
Aromatase inhibitors
- Aromatase inhibitor (anastrozole) is useful in aromatase excess syndrome cause of gynecomastia.
Selective estrogen receptor modulators (SERMs)
- Selective estrogen receptor modulators (tamoxifen, raloxifene) have been used with varying degree of success with tamoxifen better than raloxifene.
References
- ↑ Narula HS, Carlson HE (2007). "Gynecomastia". Endocrinol Metab Clin North Am. 36 (2): 497–519. doi:10.1016/j.ecl.2007.03.013. PMID 17543732.
- ↑ Braunstein GD (2007). "Clinical practice. Gynecomastia". N Engl J Med. 357 (12): 1229–37. doi:10.1056/NEJMcp070677. PMID 17881754.
- ↑ Biro FM, Lucky AW, Huster GA, Morrison JA (1990). "Hormonal studies and physical maturation in adolescent gynecomastia". J. Pediatr. 116 (3): 450–5. PMID 2137877.
- ↑ Friedman NM, Plymate SR (1980). "Leydig cell dysfunction and gynaecomastia in adult males treated with alkylating agents". Clin. Endocrinol. (Oxf). 12 (6): 553–6. PMID 6772358.