Tamoxifen has shown some promising results in the management of gynecomastia.
Here's a medical article published on April 2006 by
Department of Surgery, University Hospital of Wales, UK
gynecomastia affects half of the male population at some stage in their life. Only a small proportion of them would require treatment for cosmetic appearance or to relieve pain and tenderness. Recently, tamoxifen has shown some promising results in the management of gynecomastia. To assess the efficacy of tamoxifen, we carried out a retrospective study of all men treated for gynecomastia with particular emphasis on those treated medically. Men with painful gynecomastia were given 10 mg of tamoxifen for 3 months. Response to treatment was categorised as good, moderate and no response. Thirteen men (median age 36) were placed on tamoxifen. Ten patients responded well to tamoxifen. One patient developed calf tenderness and stopped the medication. No other adverse effects were reported. Two patients could not be followed up. Tamoxifen appears safe and effective in men with painful idiopathic or physiological gynecomastia and should be considered as an initial option before contemplating surgery.
Tamoxifen treatment for pubertal gynecomastia.
Article published on International Journal Adolsec Med Health 2003 Oct-Dec
Section of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, 06100 Ankara-Turkey
We evaluated the efficacy of the tamoxifen treatment in 37 patients with pubertal gynecomastia. All had distinct, easily palpable breast swellings with a diameter of over three cm. Pain, tenderness, and swelling associated with gynecomastia were reported by six patients. Eight of the patients were obese. One patient also suffered from varicocele. Pain and size reduction was seen in all patients with tamoxifen treatment. No long-term side effects of tamoxifen were observed. The dose of tamoxifen was increased in three patients due to poor response. Two of the treatment group had recurrence problem at follow-up. We did not need to refer any patient to surgery. Tamoxifen treatment is relatively non-toxic, may be beneficial and we think it should be considered for pubertal gynecomastia.
Link to original article on pubmed:
Management of physiological gynecomastia with tamoxifen.
Article published on February 2004
Professorial Unit of Surgery, Department of Surgery, Nottingham City Hospital, Nottingham UK
AIMS: We aimed to confirm suggestions that tamoxifen therapy alone may resolve physiological gynecomastia. METHODS: A prospective audit of the outcome of tamoxifen routinely given to men with physiological gynecomastia was carried out at Nottingham. Men referred with gynecomastia had clinical signs recorded, e.g., type (diffuse 'fatty' or retro-areolar 'lump'), size and possible aetiology. They were offered oral tamoxifen 20mg once daily for 6-12 weeks. On follow-up patients were assessed for complete resolution (CR), partial resolution where patient is satisfied with outcome (PR) or no resolution (NR). Success was either CR or PR. RESULTS: Thirty-six men accepted tamoxifen for physiological gynecomastia. Median age was 31 (range 18-64). Tenderness was present in 25 (71%) cases. Sixteen men (45%) had 'fatty' gynecomastia and 20 had 'lump' gynecomastia. Tamoxifen resolved the mass in 30 patients (83.3%; CR=22, PR=8) and tenderness in 21 cases (84%; CR=0, PR=0). Lump gynecomastia was more responsive to tamoxifen than the fatty type (100% vs. 62.5%; P=0.0041). CONCLUSIONS: Oral tamoxifen is an effective treatment for physiological gynecomastia, especially for the lump type.
Testosterone and estradiol levels in male gynecomastia. Clinical and endocrine findings during treatment with tamoxifen.
Article published on November 1984
Deutsche medizinische Wochenschrift
Oestradiol-(E2) levels in serum were significantly higher in a group of 91 males with gynecomastia than in a control group. The levels were highest in patients with testicular tumour, hyperprolactinaemia and idiopathic gynecomastia. In gynecomastia of puberty and primary or secondary hypogonadism, the E2 level was within normal limits, but the testosterone/oestradiol ratio was significantly reduced. Tamoxifen, at a daily dose of 20 mg, was administered over 2-4 months to 16 patients with gynecomastia. Of twelve patients with painful gynecomastia ten became painfree. gynecomastia regressed partially or completely in 14 patients, in only 2 was it unchanged. There was no recurrence of gynecomastia after discontinuing tamoxifen. Side-effects did not occur. It is concluded that tamoxifen is a promising alternative to the surgical treatment of gynecomastia.
Treatment of gynecomastia with tamoxifen: a double-blind crossover study.
Article published on August 1986
Metabolism: clinical and experimental
Benign asymptomatic or painful enlargement of the male breast is a common problem, postulated to be due to an increased estrogen/testosterone ration or due to increased estrogenic or decreased androgenic stimulation via estrogen or androgen receptor interactions. Treatment at present consists of analgesic medication or surgery. However, treatment directed against the preponderance of estrogenic stimulation would seem to represent a more specific form of therapy. In the present double-blind crossover study, one-month courses of a placebo or the antiestrogen tamoxifen (10 mg given orally bid) were compared in random order. Seven of ten patients experienced a decrease in the size of their gynecomastia due to tamoxifen (P less than 0.005). Overall, the decrease for gynecomastia for the whole group was significant (P less than 0.01). There was no beneficial effect of placebo (P greater than 0.1). Additionally, all four patients with painful gynecomastia experienced symptomatic relief. There was no toxicity. The reduction of breast size was partial and may indicate the need for a longer course of therapy. A followup examination was performed in eight out of ten patients nine months to one year after discontinuing placebo and tamoxifen. There were no significant changes from the end of the initial study period except for one tamoxifen responder who developed a recurrence of breast tenderness after six months, and one nonresponder who demonstrated an increase in breast size and a new onset of tenderness after ten months. Therefore, antiestrogenic treatment with tamoxifen may represent a safe and effective mode of treatment for selected cases of cosmetically disturbing or painful gynecomastia.
Here's a medical article published on April 2006 by
Department of Surgery, University Hospital of Wales, UK
gynecomastia affects half of the male population at some stage in their life. Only a small proportion of them would require treatment for cosmetic appearance or to relieve pain and tenderness. Recently, tamoxifen has shown some promising results in the management of gynecomastia. To assess the efficacy of tamoxifen, we carried out a retrospective study of all men treated for gynecomastia with particular emphasis on those treated medically. Men with painful gynecomastia were given 10 mg of tamoxifen for 3 months. Response to treatment was categorised as good, moderate and no response. Thirteen men (median age 36) were placed on tamoxifen. Ten patients responded well to tamoxifen. One patient developed calf tenderness and stopped the medication. No other adverse effects were reported. Two patients could not be followed up. Tamoxifen appears safe and effective in men with painful idiopathic or physiological gynecomastia and should be considered as an initial option before contemplating surgery.
Tamoxifen treatment for pubertal gynecomastia.
Article published on International Journal Adolsec Med Health 2003 Oct-Dec
Section of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, 06100 Ankara-Turkey
We evaluated the efficacy of the tamoxifen treatment in 37 patients with pubertal gynecomastia. All had distinct, easily palpable breast swellings with a diameter of over three cm. Pain, tenderness, and swelling associated with gynecomastia were reported by six patients. Eight of the patients were obese. One patient also suffered from varicocele. Pain and size reduction was seen in all patients with tamoxifen treatment. No long-term side effects of tamoxifen were observed. The dose of tamoxifen was increased in three patients due to poor response. Two of the treatment group had recurrence problem at follow-up. We did not need to refer any patient to surgery. Tamoxifen treatment is relatively non-toxic, may be beneficial and we think it should be considered for pubertal gynecomastia.
Link to original article on pubmed:
Management of physiological gynecomastia with tamoxifen.
Article published on February 2004
Professorial Unit of Surgery, Department of Surgery, Nottingham City Hospital, Nottingham UK
AIMS: We aimed to confirm suggestions that tamoxifen therapy alone may resolve physiological gynecomastia. METHODS: A prospective audit of the outcome of tamoxifen routinely given to men with physiological gynecomastia was carried out at Nottingham. Men referred with gynecomastia had clinical signs recorded, e.g., type (diffuse 'fatty' or retro-areolar 'lump'), size and possible aetiology. They were offered oral tamoxifen 20mg once daily for 6-12 weeks. On follow-up patients were assessed for complete resolution (CR), partial resolution where patient is satisfied with outcome (PR) or no resolution (NR). Success was either CR or PR. RESULTS: Thirty-six men accepted tamoxifen for physiological gynecomastia. Median age was 31 (range 18-64). Tenderness was present in 25 (71%) cases. Sixteen men (45%) had 'fatty' gynecomastia and 20 had 'lump' gynecomastia. Tamoxifen resolved the mass in 30 patients (83.3%; CR=22, PR=8) and tenderness in 21 cases (84%; CR=0, PR=0). Lump gynecomastia was more responsive to tamoxifen than the fatty type (100% vs. 62.5%; P=0.0041). CONCLUSIONS: Oral tamoxifen is an effective treatment for physiological gynecomastia, especially for the lump type.
Testosterone and estradiol levels in male gynecomastia. Clinical and endocrine findings during treatment with tamoxifen.
Article published on November 1984
Deutsche medizinische Wochenschrift
Oestradiol-(E2) levels in serum were significantly higher in a group of 91 males with gynecomastia than in a control group. The levels were highest in patients with testicular tumour, hyperprolactinaemia and idiopathic gynecomastia. In gynecomastia of puberty and primary or secondary hypogonadism, the E2 level was within normal limits, but the testosterone/oestradiol ratio was significantly reduced. Tamoxifen, at a daily dose of 20 mg, was administered over 2-4 months to 16 patients with gynecomastia. Of twelve patients with painful gynecomastia ten became painfree. gynecomastia regressed partially or completely in 14 patients, in only 2 was it unchanged. There was no recurrence of gynecomastia after discontinuing tamoxifen. Side-effects did not occur. It is concluded that tamoxifen is a promising alternative to the surgical treatment of gynecomastia.
Treatment of gynecomastia with tamoxifen: a double-blind crossover study.
Article published on August 1986
Metabolism: clinical and experimental
Benign asymptomatic or painful enlargement of the male breast is a common problem, postulated to be due to an increased estrogen/testosterone ration or due to increased estrogenic or decreased androgenic stimulation via estrogen or androgen receptor interactions. Treatment at present consists of analgesic medication or surgery. However, treatment directed against the preponderance of estrogenic stimulation would seem to represent a more specific form of therapy. In the present double-blind crossover study, one-month courses of a placebo or the antiestrogen tamoxifen (10 mg given orally bid) were compared in random order. Seven of ten patients experienced a decrease in the size of their gynecomastia due to tamoxifen (P less than 0.005). Overall, the decrease for gynecomastia for the whole group was significant (P less than 0.01). There was no beneficial effect of placebo (P greater than 0.1). Additionally, all four patients with painful gynecomastia experienced symptomatic relief. There was no toxicity. The reduction of breast size was partial and may indicate the need for a longer course of therapy. A followup examination was performed in eight out of ten patients nine months to one year after discontinuing placebo and tamoxifen. There were no significant changes from the end of the initial study period except for one tamoxifen responder who developed a recurrence of breast tenderness after six months, and one nonresponder who demonstrated an increase in breast size and a new onset of tenderness after ten months. Therefore, antiestrogenic treatment with tamoxifen may represent a safe and effective mode of treatment for selected cases of cosmetically disturbing or painful gynecomastia.
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