Box 6.28Treatment of gynecomastia in men

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
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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