Dealing With Gynecomastia - FAQ

[hawkmoon]

we need a thread on how to reverse gyno

anyone used raloxifene before? supposed to help

Only Letro seems to work.

 

[lilarnold]

- actually there are good studies showing reversal of existing gyno using SERMs - raloxifene best, nolvadex 2nd best.

also, Letrozole has anecdotal buzz for reversal, but last I searched (about a year ago), the only non-surgical agents that have studies showing reduction of EXISTING gynecomastia are the SERMs Nolvaldex and raloxifene. Ralox is more effective, but also more expensive and less available.

arimidex, which is an anti-a like Femera - letrozole - did nothing for reduction. great for prevention.

What may end up being shown is that because Femera - letrozole - is so much more effective at destroying or virtually eliminating Estrogen than arimidex , it would be effective at reducing existing gynecomastia even tho the studied anti-aromatse (arimidex) was not.


here's some of the SERM Gyno reversal studies:


1)
Prevention and management of bicalutamide-induced gynecomastia and breast pain: randomized endocrinologic and clinical studies with tamoxifen and anastrozole.
Saltzstein D, Sieber P, Morris T, Gallo J.
Urology San Antonio Research PA, Pasteur Medical Plaza, San Antonio, Texas, USA.

A randomized, double-blind, placebo-controlled multicenter trial involving 107 men receiving bicalutamide ('Casodex') 150 mg/day therapy following radical therapy for prostate cancer assessed tamoxifen ('Nolvadex') 20 mg/day and anastrozole ('Arimidex') 1 mg/day for the prophylaxis and treatment of gynecomastia/breast pain. Tamoxifen, but not anastrozole, significantly reduced the incidence of gynecomastia/breast pain when used prophylactically and therapeutically. Serum testosterone levels increased with tamoxifen relative to placebo but prostate-specific antigen levels declined in all treatment groups. Further studies are needed to define the optimum tamoxifen dose and to assess any impact on cancer control. The use of tamoxifen in this setting remains to be investigated



2)
1: J Pediatr. 2004 Jul;145(1):71-6. Related Articles, Links

Comment in:

* J Pediatr. 2005 Apr;146(4):576; author reply 576-7.
* J Pediatr. 2005 Apr;146(4):576; author reply 576-7.

Beneficial effects of raloxifene and tamoxifen in the treatment of pubertal gynecomastia.
Lawrence SE, Faught KA, Vethamuthu J, Lawson ML.
Department of Pediatrics, University of Ottawa, Ontario, Canada.

[email protected]

OBJECTIVES: To assess the efficacy of the anti-estrogens tamoxifen and raloxifene in the medical management of persistent pubertal gynecomastia.

STUDY DESIGN: Retrospective chart review of 38 consecutive patients with persistent pubertal gynecomastia who presented to a pediatric endocrinology clinic. Patients received reassurance alone or a 3- to 9-month course of an estrogen receptor modifier (tamoxifen or raloxifene).

RESULTS: Mean (SD) age of treated subjects was 14.6 (1.5) years with gynecomastia duration of 28.3 (16.4) months. Mean reduction in breast nodule diameter was 2.1 cm (95% CI 1.7, 2.7, P <.0001) after treatment with tamoxifen and 2.5 cm (95% CI 1.7, 3.3, P <.0001) with raloxifene. Some improvement was seen in 86% of patients receiving tamoxifen and in 91% receiving raloxifene, but a greater proportion had a significant decrease (>50%) with raloxifene (86%) than tamoxifen (41%). No side effects were seen in any patients.

CONCLUSION: Inhibition of estrogen receptor action in the breast appears to be safe and effective in reducing persistent pubertal gynecomastia, with a better response to raloxifene than to tamoxifen. Further study is required to determine that this is truly a treatment effect.

PMID: 15238910 [PubMed - indexed for MEDLINE]

3)
Management of physiological gynaecomastia with tamoxifen.
Khan HN, Rampaul R, Blamey RW.
Professorial Unit of Surgery, Department of Surgery, Nottingham City Hospital, Nottingham NG5 1PB, UK.

AIMS: We aimed to confirm suggestions that tamoxifen therapy alone may resolve physiological gynaecomastia. METHODS: A prospective audit of the outcome of tamoxifen routinely given to men with physiological gynaecomastia was carried out at Nottingham. Men referred with gynaecomastia 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 gynaecomastia. Median age was 31 (range 18-64). Tenderness was present in 25 (71%) cases. Sixteen men (45%) had 'fatty' gynaecomastia and 20 had 'lump' gynaecomastia. Tamoxifen resolved the mass in 30 patients (83.3%; CR=22, PR=8) and tenderness in 21 cases (84%; CR=0, PR=0). Lump gynaecomastia 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 gynaecomastia, especially for the lump type.

--

4) writeup:

Treatment of gynaecomastia with raloxifene.
Ariel S¨¢nchez (24 September 2003)
Centro de Endocrinolog¨ªa, San Lorenzo 876, (2000) Rosario, SF, Argentina



............We decided to evaluate the effect of raloxifene in a series of patients with gynaecomastia. Twelve patients aged 18-84 years were treated. Breast enlargement was unilateral in 5 cases; its duration ranged from a few weeks (7 cases) to several years (5 cases). Four patients were hypogonadal by clinical criteria, and had low serum testosterone. In two patients there was a possible drug effect (prasterone in one, ranitidine in the other). The size of breast tissue ranged between 1.5 and 6.0 cm. All patients had normal testes by palpation, and normal serum levels of estradiol, lh - leutenizing hormone - , FSH - follicle stimulating hormone - , prolactin, and alpha-HCG - human chorionic gonadotropin - . Liver function tests and serum creatinine also were normal. The dose of raloxifene was 60 mg every other day in 4 elderly patients (age 70 years or more), and 60 mg daily in the remaining; the medication was given for 2-12 months. Hypogonadal patients received, in addition, i.m. injections of testosterone enanthate, 100 mg twice a month.
Raloxifene was well tolerated; only one young patient reported a slight decrease in sexual potency. No subject complained of hot flushes; there were no episodes of thrombophlebitis during follow-up. The analgesic effect of treatment was fast (2-4 weeks) and sustained among 9 patients with pain and tenderness. The size of the gynaecomastia was evaluated monthly by means of a caliper (all patients), and ultrasonography (7 patients).

All patients responded: there was an average reduction in size of 61% (range: 34-100%); in 2 patients gynaecomastia disappeared. Six of 8 eugonadal patients (75%) had a reduction in the size of breast tissue of at least 50% (average, 73%). Among hypogonadal patients (all of them followed with ultrasonography) gynaecomastia disappeared in one, and size reduction in the remaining subjects ranged between 46 and 67% (this is particularly noteworthy, since testosterone replacement not infrequently causes or aggravates gynaecomastia due to local aromatization to oestrogens by mammary tissue). Maximal effect was observed during the first 2 months of treatment.

This open, observational study suggests that raloxifene may be a safe, well tolerated and effective therapeutic alternative for drug-induced or idiopathic gynaecomastia in men of all ages.

 

[lilarnold]

the ralox 60mg dose for reversal is from at least one study ( **broken link removed** ) and anecdotal info


- the nolva shorter-term 60mg for reversal is more bro-ology, based on many posts on many boards over many years by experienced vets --- the reversal studies are more conservative in the 30mg range over a longer period of time (example, Prevention and management of bicalutamide-induced gynecomastia and breast pain: randomized endocrinologic and clinical studies with tamoxifen and anastrozole.
Saltzstein D, Sieber P, Morris T, Gallo J.
Urology San Antonio Research PA, Pasteur Medical Plaza, San Antonio, Texas, USA. )
Mavafanculo is offline Report Post Reply With Quote

 

[lilarnold]

some studies on safety and increased effectiveness of higher doses in stubborn cases:

-
1)
Idiopathic gynecomastia treated with tamoxifen: a preliminary report.Alagaratnam TT.
Department of Surgery, Queen Mary Hospital, University of Hong Kong.

Sixty-one Chinese men with idiopathic gynecomastia were treated with 40 mg of tamoxifen daily for one of four months (median, two months). Eighty percent had complete regression of their breast swelling. No long-term side effects of tamoxifen were observed over a median follow-up period of 36 months.
PMID: 3664552 [PubMed - indexed for MEDLINE]

2)
Tamoxifen treatment for pubertal gynecomastia.Derman O, Kanbur NO, Kutluk T.
Section of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, 06100 Ankara-Turkey. [email protected]

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.

PMID: 14719418 [PubMed - indexed for MEDLINE]

3)
Tamoxifen for flutamide/finasteride-induced gynecomastia.Staiman VR, Lowe FC.
Department of Urology, St. Luke's-Roosevelt Hospital Center, New York, NY 10019, USA.

OBJECTIVES: Current therapies for advanced prostate carcinoma lead to a marked decrease in serum testosterone levels, which renders patients impotent. In preliminary studies, combination therapy with flutamide and finasteride has been used as an alternative therapy for the treatment of prostate carcinoma because potency can be preserved. Both of these agents can cause gynecomastia and breast/nipple tenderness. METHODS: Six men being treated for advanced prostate carcinoma with flutamide/finasteride combination therapy developed painful gynecomastia, which was treated with tamoxifen 10 to 30 mg/day for 1 month. Clinical follow-up included breast measurements and determination of prostate-specific antigen (PSA), testosterone, and estradiol levels. RESULTS: While on this combination therapy for prostate carcinoma, 4 of 6 patients experienced a decrease in PSA level to less than 0.5 ng/mL. All patients remained potent. Serum testosterone increased in each patient who had a baseline level drawn. Estradiol levels were noted to be elevated in 4 of 6 patients at the time of evaluation for gynecomastia. After treatment with tamoxifen, circulating estradiol levels increased in 3 patients from 1.3 to 2.2 times the baseline level. Five patients experienced complete resolution of breast and nipple pain on tamoxifen 10 mg/day within the first month. The other patient had to be treated with 30 mg/day for 1 additional month, which subsequently resulted in pain resolution. CONCLUSIONS: These preliminary results suggest that low-dose tamoxifen is useful in treating painful gynecomastia for those patients on flutamide/finasteride combination therapy for advanced prostate carcinoma. [my note: ie drug induced gyno ]

PMID: 9426725 [PubMed - indexed for MEDLINE]

 

[hawkmoon]

Only Letro seems to work.

Well after several months of trying I have to retract this statement.
Nolvadex did a far better job on my gyno than letro, _FAR_ better.

Some of this may be due to the use of a "research chem" version of letro vs a UGL generic of Nolvadex, but the results are undeniable.

 

[HeavyHands]

There are some really great posts here about tamoxifen effecting gyno.. Being somebody who has what I believe to be pubertal gyno, this is really great to hear and gives me hope that I can do something about it.

Thanks for all the info guys.

 

[rheaseo25]

Fast Facts about Gynecomastia

The following are basic details about this condition:

• **broken link removed** is derived from the greek word “gyne” which means woman and “mastos” which means “breast”, hence the term “woman-like breast”.

• Gynecomastia can develop from the age of 13 up to 30 years old.

• Up to 90% of male population can have undiagnosed gynecomastia.

• This abnormal enlargement of the male breast may develop on either or both side of a male chest.

• The most common cause of gynecomastia is idiopathic or unknown.

• Obesity is considered one of most common factor linked to male breast enlargement.

• Gynecomastia can be a sign of a more serious underlying disease.

• Long term use of antipsychotic drugs produces gynecomastia as a side effect.

• People who are taking steroidal drugs such as those medicinal treatments for asthma, can
develop breast enlargement as a long term side effect.

• Taking pills to treat gynecomastia can help in the reduction of the breast’s fatty tissue.

• Some chest exercises are also helpful to firm the chest and correct floppy breast.

• Ideal diet for people with gynecomastia are low-fat, low-caloric, and high protein.

• Intake of deep-fried and foods sautéed in oil can aggravate breast enlargement as it adds fatty tissue deposit.

• Using compression gynecomastia vest is helpful to hide the floppy breast. This is like a firming bra for a man that is made with breathable fabric.

• Aerobic exercises that focus on the chest and thorax are ideal exercises that promote firming of the abnormally enlarged male breast.

• Liposuction is considered last resort in correcting gynecomastia. This is done by a cosmetic surgeon by removing the excessive fatty tissues of the breast and tightening the chest skin to make it look firmer.

Having woman-like breasts are advantageous only to gays, in such case they wouldn’t need to undergo cosmetic surgery for breast enhancement. But for real guys, gynecomastia is such an embarrassment. It can even affect your social life and may pull down your self-esteem. Having a firm chest produces a more manly appeal that certainly attracts the opposite sex.

If you are suffering from this condition, it is advised that you look for a reliable cosmetic physician that will help you fully understand gynecomastia. Often times, cosmetic surgery is not advised when breast enlargement can still be corrected with some chest exercises. Remember, appeal is not that difficult to attain. You only have to discover your choices and be acquainted with safe and effective ways to obtain it.

read more details here: **broken link removed**

 

[dxteran]

letro seems to be the bst

 

[maldorf]

This thread got my interest.

Nolvadex sounds promising. I would like to hear more from our members that had sucess with this reversing lump gyno. Here is one exerpt of what I found:

"If you suffer from man boobs, you are probably wondering if any drugs exist that can help you treat the condition. This is of course, if you would rather not have surgery. Fortunately for you, medical research shows that there are drugs that can be used for male breast reduction. It doesn’t matter if the male has pubertal gynecomastia or developed extra male breast tissue as an adult.

So what drugs can possibly be used for the treatment of gynecomastia?

There are many, but in this article, we will focus on tamoxifen.

Tamoxifen is a medicine that was originally developed for the treatment of breast cancer. The effect of the medication is that it prevents the binding between estrogen and its receptor. Therefore, this prevents the breast cancer cells from growing.

For gynecomastia, tamoxifen has been used in several applications. One of the popular brand names that tamoxifen is sold under is Nolvadex. It has been used to treat gynecomastia in men who developed gynecomastia as a result of undergoing prostate cancer treatment. In one study, ten patients were monitored for a certain time period while they took tamoxifen. Most of the patients had smaller breasts at the end. Bodybuilders also use the drug to prevent gynecomastia that is caused as a result of steroid use. Now listen to this! Tamoxifen is also used to prevent chest fat in sex offenders who are undergoing chemical castration. Now, do we really care if sex offenders have gynecomastia? I ‘ll let you think about that one.

Tamoxifen could potentially be an excellent alternative to gynecomastia surgical treatment. You should only take it if you are in good health. Consult your physician more more information."

So docs are using it.

 

[raw33man]

there was a research done on 20 males with bitch tits...

they ran Nolvadex 10 - 20mg for up to a year, 18 of them lost their bitch tits in this research

look for it on google scholars

 

[test4meplz]

Had mine removed and love it. if you really have it nothing is going to rid you of it but removal sorry. it will shrink down but eventually come right back.

 

[test4meplz]

if you want to minimize it nolvadex works well but not as well as letro however nobody wants to run letro for a long time as wiping out all your estrogen is very bad for gains as estrogen has its benefits. if you have a bad flare up a nice run of letro followed by nolva has worked best for me and friends of mine.

 

[EVERLAST]

deca

read a thread on here stating tht Prami was effective when the deca has cused the gyno whereas other treatment (estrogen reducing) agents
were ineffective. Supposed to be quick too.


E

 

[Calves of Steel]

Great read. I've been struggling with pubertal gyno for a while. I have prescription tamoxifen but i go on and it shrinks, go off and it comes back.

 

[cockdiesel]

ya def need 2 get this done myself seems like everyone says its worth it

 

[PitbullTank]

i didnt have any thing close to "man boobs" but after a year and when i started a heavy test/tren/anadrol cycle, i eventually developed a lump under my left nip(idk why but like 95% of the time i hear about gyno its on the left side, kinda wierd huh?)....it wasnt retarted or huge looking...but enough so that the nipple would be clearly visible in a wifebeater...and looked puffy and full compared to the right one that was flat, and DEF noticiable upon any touch and had extreme pain if squeezed....i wasnt on the forums or anything at the time, and i heard of exemestane from a local competitor...tried that for about 2 months at 25mg ed...it def stopped the progression, took the puffiness down a little, but the lump was still def there...i then started to look into and found that letro was stronger....so i went on letro for a month and a half...letro was a little harsh and i completely lost my libido and started not being able to finish workouts bc my joints were hurtin, esp knees during squats...it reduced the puffiness and lump a lil more, but still could feel the bump...

i finally got on the forums and read and read and read...i eventually turned to SWIFTO for individualised advice... him and mad matt told me to go at it w the nolva, and even start with a double dose ~40mg ed.... I did this for about 2-3 weeks at 40mg...then dropped it to 30mg for a week or 2, then to 20mg for a week or 2....and now i stay on maintence dose of 10mg tamox while running on cycle...the lump was reduced by about 50% from what even the letro did in the 1st 3 weeks....and then id say it reduced it another 30-40% the weeks following that....id still say there is a baked bean size small nudule in there, but it isnt noticiable to me, my girl, or anyone else...only if i take my fingers and physically try to grab it do i know its even still there...

now heres something interesting...the bump altho GREATLYYYY reduced is still slightly present like i said...i recentley ran out of my tamox mid cycle(thanks a fckn lot purity)....and what do you kno? within about 5-7 days i started to see the puffiness coming to the left nip...i immediatley called my friedn and asked him if i could borrow some of his tamox that he had and he said no prob...within 3 days of use, it was reduced back to notta...

i think once you have an actual lump, the only way to truely get rid of it completley is surgery...however, tamox worked wonders for me, and i would DEF recommend people try that nolva protocal b4 going to surgery or anything like that to see if it could change things for ya....

i hear all to often letro for gyno...letro is great AI, but once lump is present, i personally noticed no huge changes in reduction...usually what people say is -"letro reduced my gyno"...the thing is, most of these people werent running an AI like they should have been from the start so they fucked their estrogen levels all up in their cycle and boosted them skiy high so the sides went crazy...then they take AI like letro(like they should have from the beginning) and bc it drops their estro in low ranges and the estrogen SIDES start to reduce, they believe that helped their gyno...

 

[Utah]

I have to totally agree with Pit, and he is a great asset to this board by the way.

I never had any problems back in the day with 10mg nolva, but as the AIs started gaining popularity, I thought those were better.

Aquired gyno both sides, but extremely bad on 1 side(right side, sorry Pit, lol).

Adex and letro did squat for me.

Long story, short, Im 2.5 months post surgery and on for 3 weeks again, and I definitely NEED nolva to keep it at bay.

 

[bernimx]

and now i stay on maintence dose of 10mg tamox while running on cycle...

Hey Pitbull, do you still run 10mg tamox ED on your cycles?

Do you think that someone's who's prone to gyno could get away with using 10mg tamox ED on cycle as a preventative measure instead of an AI, or should both be used in your opinion?

 

[PitbullTank]

Hey Pitbull, do you still run 10mg tamox ED on your cycles?

Do you think that someone's who's prone to gyno could get away with using 10mg tamox ED on cycle as a preventative measure instead of an AI, or should both be used in your opinion?

yes

id always run the AI while on, then if gyno symptons started id add the tamox..i would keep the tamox def on hand tho...u "should" use the least of any chemical/compound you need in order to reach your goal...none of this shit is really good for ya man lol....for me, i found that at this mg/week level that im taking ,that MY body needs 12.5 mg exem and 10mg tamox ed or sides will start....when the tamox came out for a week, even tho i bumped the exem up to 25mg, i saw what happened real quick... YOUR body may be able to be ok with just a 25mg ED dose of exem...or maybe only 5mg ed maintence tamox or maybe you have to run 20...all i can positively say is that the doses i stated work for me.......dont take my words in stone, im def no fckn Dr and i just try to share what has helped me personally lol

 

[kscowboy]

Why do people run ememestane or adex when trying to prevent gyno when they could just run some nolva? What is the downside of running nova instead of exemestane or adex? Personally i have used exemestane for the last 3 or 4 years but question why i have never just ran nolva instead?