Gynecomastia Medication

  • Author: George Ansstas, MD; Chief Editor: George T Griffing, MD   more...
 
Updated: Apr 16, 2012
 

Medication Summary

Clomiphene,[19] an antiestrogen, can be administered on a trial basis at a dose of 50-100 mg per day for up to 6 months. Approximately 50% of patients achieve partial reduction in breast size, and approximately 20% of patients note complete resolution. Adverse effects, while rare, include visual problems, rash, and nausea.

Tamoxifen, an estrogen antagonist, is effective for recent-onset and tender gynecomastia when used in doses of 10-20 mg twice daily.[20] Up to 80% of patients report partial to complete resolution. Tamoxifen is typically used for 3 months before referral to a surgeon. Nausea and epigastric discomfort are the main adverse effects.[21]

Other, less frequently used drugs include danazol.[22] Danazol, a synthetic derivative of testosterone, inhibits pituitary secretion of LH and follicle-stimulating hormone (FSH), which decreases estrogen synthesis from the testicles. The dose used for gynecomastia is 200mg twice daily. Complete resolution of breast enlargement has been reported in 23% of cases. Adverse effects include weight gain, acne, muscle cramps, fluid retention, nausea, and abnormal liver function test results.

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Androgens

Class Summary

Androgens suppress pituitary release of gonadotropic hormones.

These agents are used to inhibit the effects of estrogen.[1, 19, 20, 21, 22, 31]

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Testosterone (Androderm, AndroGel, Axiron, Testim)

 

Testosterone is the predominant male sex hormone used for replacement therapy in male hypogonadism.

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Danazol

 

Danazol is a synthetic steroid analog with strong antigonadotropic activity (it inhibits LH and FSH) and weak androgenic action.

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Selective Estrogen Receptor Modulators

Class Summary

Selective estrogen receptor modulators inhibit estrogen effects.

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Clomiphene (Clomid, Serophene)

 

Clomiphene stimulates the release of pituitary gonadotropins.

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Tamoxifen

 

Tamoxifen competitively binds to the estrogen receptor, producing a nuclear complex that decreases deoxyribonucleic acid (DNA) synthesis and inhibits estrogen effects.

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Contributor Information and Disclosures
Author

George Ansstas, MD  Instructor, Department of Internal Medicine, Washington University School of Medicine

George Ansstas, MD is a member of the following medical societies: American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Michael Ansstas, MD  Resident Physician, Department of Internal Medicine, St Louis University Hospital

Disclosure: Nothing to disclose.

George T Griffing, MD  Professor of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physician Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical Research, Endocrine Society, International Society for Clinical Densitometry, and Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD  Professor of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physician Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical Research, Endocrine Society, International Society for Clinical Densitometry, and Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Additional Contributors

Mark R Allee, MD Associate Professor, Department of Medicine, University of Oklahoma College of Medicine

Mark R Allee, MD is a member of the following medical societies: American College of Physicians

Disclosure: Nothing to disclose.

Mary Zoe Baker, MD Professor, Department of Medicine, Section of Endocrinology, Metabolism and Hypertension, University of Oklahoma College of Medicine; Medical Director, Medicine Specialty Clinic, General Medicine Clinic and Medicine Residents' Clinic, University of Oklahoma Physicians

Mary Zoe Baker, MD is a member of the following medical societies: American Association of Clinical Endocrinologists, American Chemical Society, and American College of Physicians-American Society of Internal Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Reference Salary Employment

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