Questions about Gynecomastia/Propecia...

[bv3131]

Hey guys, I'm 22 years old and have had large puffy nipples since I was about 16.  I don't know if it was actual gynecomastia, as I never felt and lumps behind my nipples, just the puffyness.  Anyway, about 5 months ago, I started taking Propecia for hair loss and about 4 months in, I started to have some nipple/chest soreness.  So I went off it and restarted it at half the dosage, felt the soreness again, stopped and restarted at a quarter of the dosage, and felt the soreness once again.  During all of this, I started feeling around my nipple area for lumps and it seems that on the left side of my left nipple there is a small lump.  I'm curious if this is gynecomastia because it is actually not directly under the middle of the nipple, it's on the side of it.  So my first question is, where do these lumps grow?  Are they easily identifiable?
Anyway, I decided last month that I was going to finally have surgery to correct my puffy nipples/gynecomastia.  I've heard that once the surgeon cuts out the glandular tissue, it makes regrowth almost impossible; is this true?  Does this also mean that the fact that I had pre-existing gynecomastia when I started Propecia made it more likely to experience the breast tenderness/enlargement side effect of the drug?  Also, does that mean if I restart Propecia after the surgery, that it will make gynecomastia growth less likely since the glandular tissue has been excised?  I really hope somebody here can answer these questions for me.  Thanks a lot!

[Paa_Paw]

Obviously there are a large number of men who take Propecia with no ill effect. For a few though, the drug causes real problems.

When Gynecomastia is brought on as a side effect to a drug, it is commonly thought that the condition may self resolve if the drug is withdrawn early enough. It may be wise to stop the drug and see what happens over the next few months.

It is true that while Gynecomastia usually does not return, there are exceptions. The glandular tissue cannot be 100% removed without leaving a deformity and the remaining tissue can again start to grow if it is stimulated. Since your experience suggests that you are sensitive, it may be well to avoid such medications in the future whether or not you have surgery.

[Dr. Elliot Jacobs]

I echo Paa_paw's reply.

Merck, which manufactures Propecia, states in its side effects that there can be "swelling of the breasts."  I do not believe this is swelling -- it is real tissue.  But not all men on Propecia develop this problem.

If a man has gyne and then starts Propecia and experiences no additional growth of his gyne, then it is probably safe to have gyne surgery -- that has been my experience in a number of cases.

But if a guy has gyne and has gotten worse on Propecia, then my suggestion is to choose which is more important -- a flat chest or more hair.

Just for the record, there are no studies on the effects of Propecia on established or recently operated upon gyne.

Propecia is a good drug -- it works.  But for some, there are side effects.

Dr Jacobs

[bv3131]

What about this drug Arimidex?  I have been thinking about stopping Propecia for the next couple weeks until my surgery in order for the gynecomastia to "stabilize,"  then perhaps a couple weeks after the surgery going back on it and taking Arimidex to keep the androgen in check.  Is this an option?  Does anybody have any other suggestions on this?  Thanks again guys!

[Paa_Paw]

The drug Arimidex was developed for use only by post menopausal women and it requires a prescription. Under the direction and close follow up of an Endocrinologist Off label use may have limited value for a few people.

Most of us, I think, would stand to benefit from taking less medications instead of more.