Box 6.28Treatment of gynecomastia in men

Medical
DrugUseAdvantagesDisadvantages/side effects
Tamoxifen †Antiestrogen *Orally active. Effective# (~80%)Loss of libido, erectile dysfunction
Clomiphene †AntiestrogenOrally active. Effective (~40%)Hepatitis, psychiatric changes
Testolactone †Aromatase inhibitorOrally active. Effective (~70%)Few side effects in reported studies
Danazol †Antiandrogen *Orally active. Effective (~30%)Hepatic dysfunction, gastrointestinal upset, CNS effects
Surgical
ProcedureUseAdvantagesDisadvantages/side effects
Breast removalReduce gynecomastia‘Definitive’. Also reduces risk of breast cancerComplications include scarring (100%) and infection (~<5%)
*

Not strictly true as these agents have both agonist and antagonist actions depending on tissue.

#

Effectiveness and in particular relative effectiveness is difficult to judge since comparative trial data is only now becoming available and the condition has a natural tendency to remit. The values given are very approximate.

Not a licensed indication.

From: Chapter 6, The gonad

Cover of Endocrinology
Endocrinology: An Integrated Approach.
Nussey S, Whitehead S.
Copyright © 2001, BIOS Scientific Publishers Limited.

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