Hope I Can Get An Answer To My Worries!

[ant]

Hello!

I'm hoping someone can answer my question as I am very concerned. Due to having Chronic Liver Disease and Ascites in January 2010 I was placed on 100mg once per day of Spironolactone which I was on until around January 2011. These were combined with a 20mg once per day dose of Furosemide. Although getting rid of the ascites it had the side effect of starting to cause gynecomastia. I was very tender and starting to become more 'pronounced', for want of a better word!

This obviously caused me alot of concern as I am only 43 and enojoyed swimming, which I have'nt participated in since. After voicing my concerns to my doctor he took me off the spironolactone and replaced it with 10mg once per day of Amiloride, combined with the 20mg of furosemide. I have been on this now since the end of January 2011 but although the tenderness has gone completely, and I think my breast area has reduced in size a lttle, it is still pronounced. Does anyone know how long it takes to completely go away or will it now stay there? I am also trying to use my common sense and am I right in thinking that trying to stick to a good healthy diet will help in the reduction of breast tissue? Due to the Liver Disease I had I obviously do not drink alcohol at all, but I do tend to eat pretty much what I want!

I hope that someone will take the time to send me a quick reply!

Ant

[Dr. Elliot Jacobs]

Chronic liver disease alone is a known cause of gynecomastia.  Perhaps the spironolactone did contribute to your problem.

Once gyne is established, it rarely disappears on its own -- surgery is usually required. 

In your case, once your condition has stabilized, you should consult with a surgeon to discuss possible surgery for your gyne.  Just be aware, however, that your underlying chronic liver condition may not make you a suitable candidate for elective surgery.

Dr Jacobs

[ant]

Dear Dr Jacobs

Just a quick reply back to say thank you for taking the time out to send me a reply. At least I now know what possible options there will be for the future, that I can explore!

Thanks you once again!

Ant

[DrPensler]

Liver disease can contribute to gynecomastia. Problematic ascites would indicate advanced disease. I would focus on your liver I presume you are seeing a hepatologist,if not I would seek one out. In my experience drug induced gynecomastia rarely completely resolves.
Best of Luck
Jay Pensler,MD

[ant]

Hello and thank you also for you reply-I do see a hepatologist yes and also I have a consultant. My liver thankfully is very much improved now as this time last year they were telling me I needed a liver transplant, due to binge-drinking on and off for several years. Even though I no longer drank it seemed the only option. I no longer need a transplant at this moment in time, although they obviously cannot rule it out completely later on in life, so I have been very lucky, due to my total change in lifestyle.

I have been very upset though by the appearance of this as I enjoyed swimming, and is now making me very self concious with regard to taking my top off. I think I will go back to my doctor and ask him to refer me to a surgeon to see if there is anything that can be done, whilst taking into account my medical history in relation to my liver problems-you can only ask can't you!

Thank you once again!

Ant