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I pulled this from a research article on non-surgical treatment of gyno...
Investigators have reported a 64 percent response rate (reduction in gyno) with 100 mg/day of clomiphene citrate, a weak estrogen and moderate antiestrogen (26). Lower doses of clomiphene have shown varied results, indicating that higher doses may need to be administered, if clomiphene is to be attempted. Tamoxifen, also an antiestrogen, has been studied in 2 randomized, double-blind studies in which a statistically significant regression in breast size was achieved, although complete regression was not documented (1). One study compared tamoxifen with danazol in the treatment of gynecomastia. Although patients taking tamoxifen had a greater response with complete resolution in 78 percent of patients treated with tamoxifen, as compared to only a 40 percent response in the danazol-treated group, the relapse rate was higher for the tamoxifen group (46). Although complete breast regression may not be achieved and a chance of recurrence exists with therapy, tamoxifen, due to relatively lower side effect profile, may be a more reasonable choice when compared to the other therapies. If used, tamoxifen should be given at a dose of 10 mg twice a day for at least 3 months (30). An aromatase inhibitor, testolactone, has also been studied in an uncontrolled trial with promising effects (51). Further studies must be performed on this drug before any recommendations can be established on its usefulness in the treatment of gynecomastia. Newer aromatase inhibitors such as anastrozole and letrozole may have therapeutic potential but no study has been published to confirm its efficacy in treatment of gynecomastia. (32)
1. Alagaratnam TT: Idiopathic gynecomastia treated with tamoxifen; a preliminary report. Clin Ther 9:483-7, 1987
26. Leroith D, Sobel R, Glick SM: The effect of clomiphene citrate on pubertal gynaecomastia. Acta Endocrinol (copenh). 95:177-80, 1980
46. Ting AC, Chow LW, Leung YF: Comparison of tamoxifen with danazol in the management of idiopathic gynecomastia. Am Surg 66(1):38-40, 2000.
30. Mathur R, Braunstein: Gynecomastia: Pathomechanisms and Treatment Strategies. Hormone Research 48:95-102, 1997
51. Zachmann M, Eiholzer U, Muritano M, et al: Treatment of pubertal gynaecomastia with testolactone. Acta Endocrinol supple (copenh) 279:218-26, 1986
32. Miller WR, Jackson J: The therapeutic potential of aromatase inhibitors. Expert Opin Investig Drugs 12(3):337-51, Mar, 2000
Investigators have reported a 64 percent response rate (reduction in gyno) with 100 mg/day of clomiphene citrate, a weak estrogen and moderate antiestrogen (26). Lower doses of clomiphene have shown varied results, indicating that higher doses may need to be administered, if clomiphene is to be attempted. Tamoxifen, also an antiestrogen, has been studied in 2 randomized, double-blind studies in which a statistically significant regression in breast size was achieved, although complete regression was not documented (1). One study compared tamoxifen with danazol in the treatment of gynecomastia. Although patients taking tamoxifen had a greater response with complete resolution in 78 percent of patients treated with tamoxifen, as compared to only a 40 percent response in the danazol-treated group, the relapse rate was higher for the tamoxifen group (46). Although complete breast regression may not be achieved and a chance of recurrence exists with therapy, tamoxifen, due to relatively lower side effect profile, may be a more reasonable choice when compared to the other therapies. If used, tamoxifen should be given at a dose of 10 mg twice a day for at least 3 months (30). An aromatase inhibitor, testolactone, has also been studied in an uncontrolled trial with promising effects (51). Further studies must be performed on this drug before any recommendations can be established on its usefulness in the treatment of gynecomastia. Newer aromatase inhibitors such as anastrozole and letrozole may have therapeutic potential but no study has been published to confirm its efficacy in treatment of gynecomastia. (32)
1. Alagaratnam TT: Idiopathic gynecomastia treated with tamoxifen; a preliminary report. Clin Ther 9:483-7, 1987
26. Leroith D, Sobel R, Glick SM: The effect of clomiphene citrate on pubertal gynaecomastia. Acta Endocrinol (copenh). 95:177-80, 1980
46. Ting AC, Chow LW, Leung YF: Comparison of tamoxifen with danazol in the management of idiopathic gynecomastia. Am Surg 66(1):38-40, 2000.
30. Mathur R, Braunstein: Gynecomastia: Pathomechanisms and Treatment Strategies. Hormone Research 48:95-102, 1997
51. Zachmann M, Eiholzer U, Muritano M, et al: Treatment of pubertal gynaecomastia with testolactone. Acta Endocrinol supple (copenh) 279:218-26, 1986
32. Miller WR, Jackson J: The therapeutic potential of aromatase inhibitors. Expert Opin Investig Drugs 12(3):337-51, Mar, 2000