Tamoxifen, an estrogen antagonist, is an effective treatment for sensitive and new-onset gynecomastia when taken at doses of 10 to 20 mg twice daily. Up to 80% of patients report partial or total resolution of their condition. Generally, tamoxifen is used for three months before a referral to a surgeon. If medications are the cause of gynecomastia, your doctor may suggest stopping or replacing them.
Although these medications are approved by the Food and Drug Administration, they have not been specifically approved for use in people with gynecomastia. Additionally, the effectiveness of these drugs is not yet clear since they work as nutritional supplements and not as therapeutic agents. It may take some time for results to become fully apparent. People usually get results by the end of the first month or two when they take these medications regularly.
Therefore, other options such as exercise can be tried along with a diet regimen. Adequate exercise and eating the right foods can improve the effects of these medications. There are many options available for treating gynecomastia. While drug-based treatments cannot completely reverse gynecomastia, cosmetic surgery can. Patient counseling pharmacists can help patients in a number of ways.
When advising a male patient on the use of a new medication that may cause gynecomastia, such as amitriptyline, the pharmacist must explain in detail the nature and importance of this problem. It is also very important to remind the patient that the incidence is low for most medications. Unlike medications, there are relatively few contraindications that prevent you from undergoing gynecomastia surgery. Therefore, restricting the use of such medications and chemicals (found in marijuana, alcohol) may reduce the chances of gynecomastia. And the subgroup of patients for whom this medication may be useful is small, since most cases of gynecomastia are not strictly the result of excessive estrogen production. Because of the many causes of gynecomastia, it's essential to have a complete history to determine the best treatment approach.
When performing tests, the doctor can diagnose gynecomastia or any other condition such as breast cancer or adipose tissue in the breast. The diagnosis should include an ultrasound of the breast and blood levels of beta-hCG, LH, follicle-stimulating hormone, estradiol, prolactin, testosterone, thyroid function (thyroid-stimulating hormone and thyroxine) and liver function tests. These signs and symptoms can indicate anything from self-limited gynecomastia to systemic neoplasia. The effectiveness of any pharmacological treatment for gynecomastia is largely poor and unpredictable with side effects that outweigh any potential benefit. The longer a patient has gynecomastia (with the exception of pubertal men), the less likely it is to resolve completely.
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