Author Topic: So Is There Any Kind Of Medication Available?  (Read 8105 times)

Offline rockin813

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According to Uptodate- Endicrinology section many treatments are in fact effective for treating Gynecomastia:



There are three types of medical therapy: androgens, antiestrogens and aromatase inhibitors. Unfortunately, most of the studies of medical therapy for gynecomastia had small sample sizes, were unblinded, or were uncontrolled.

Androgens — A number of different androgen preparations have been evaluated in the treatment of gynecomastia, although none are FDA-approved for this purpose. Testosterone, when given as a long-acting ester parenterally, has not been more effective than placebo and may exacerbate the gynecomastia because the exogenous testosterone is aromatized to estradiol [8], and the usual doses are probably somewhat more than physiologic. However, testosterone replacement therapy has been shown to reduce the prevalence of gynecomastia in patients with cirrhosis [10]. The effect of transdermally administered testosterone on gynecomastia has not been reported. The nonaromatizable androgen, dihydrotestosterone, has been used percutaneously. One report noted a reduction in breast volume in 75 percent of the patients and complete resolution in approximately 25 percent [11]; there were no side effects and the decrease in breast tenderness occurred within one to two weeks. Injections of dihydrotestosterone also demonstrated improvement in gynecomastia in a small number of subjects [12]. Danazol, an androgenic progestin, has been evaluated in a single placebo-controlled study [13]. 23 percent of the patients receiving danazol had complete resolution in contrast to only 12 percent of those receiving placebo [13]. Danazol appeared to be safe and well-tolerated, but it is known to be associated with edema, weight gain, acne, nausea, and muscle cramps when used for other conditions.

Antiestrogens — Both clomiphene and tamoxifen have been evaluated in the treatment of gynecomastia. Response rates of 36 to 95 percent have been reported with clomiphene. However, two major studies of pubertal gynecomastia found a much lower incidence of benefit: fewer than one-half of patients had more than a 20 percent decrease in breast volume or were satisfied with the results [14,15].

Two randomized double-blind studies with a total of 16 patients have been carried out with tamoxifen in doses of 10 mg orally twice a day. Neither study reported a complete remission, but there was a statistically significant reduction in pain and breast size [16,17]. Complete response rates of 50 and 80 percent have been noted in two uncontrolled trials [18,19]. Most patients who received tamoxifen for up to four months did not experience any side effects, although rarely epigastric distress and nausea have been noted.

A restrospective review of patients with persistent pubertal gynecomastia who received either raloxifene (n = 10) or tamoxifen (n = 15) reported a decrease in gynecomastia in 12 of 14 breasts (86 percent) and 20 of 22 (91 percent) breasts in the raloxifene and tamoxifen groups, respectively. More patients in the raloxifene group experienced a 50 percent reduction in the breast glandular tissue (86 versus 41 percent in the raloxifene and tamoxifen groups, respectively). However, only 3 of the 10 patients in the raloxifene group and one of the 15 patients in the tamoxifen group had complete resolution of the gynecomastia in both breasts. Forty percent of the patients in each group were not satisified with the results and underwent surgical removal of the tissue [20].

Aromatase inhibitors — Testolactone, an aromatase inhibitor, has been evaluated in an uncontrolled trial in a small number of boys with pubertal gynecomastia; there was an average 40 percent decrease in breast size, but the authors did not report the number who had a complete remission [21]. Thus, there is insufficient information to recommend testolactone as an initial therapy for gynecomastia, Although on theoretical grounds it would seem reasonable to use this drug or one of the newer aromatase inhibitors, such as anastrozole, letrozole, or formestane [22], a double-blind, placebo controlled trial of anastrozole treatment for pubertal gynecomastia failed to show any beneficial effect over placebo [23].

Recommendation — In view of its possible efficacy and low incidence of side effects, I usually recommend a three month trial of tamoxifen for patients with painful gynecomastia before referring the patient for surgical removal of the breast tissue.
We're all made up different...but can learn from one another...

Offline Paa_Paw

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Quote

There are three types of medical therapy: androgens, antiestrogens and aromatase inhibitors. Unfortunately, most of the studies of medical therapy for gynecomastia had small sample sizes, were unblinded, or were uncontrolled.

After that statement, the remainder of what you said had little to no impact.
Grandpa Dan

Offline AGS101010

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im new here im surprised i didnt find this website a while ago but anyway ive had gyno for almost 3 years and im pretty sure its gyno but im 16 and got the first sign when i was 13 and its been really annoying throughout the whole time ive had it.
I've researched alot of medications because i dont wanna go through a surgery because
1.) i hate hospitals
2.) i hate surgery
3.) i dont have that kind of money
but i found one product which you guys are probably going to say no types of medication work but honestly i would try anything to avoid surgery.
The medication is called 'diet aid of questionable value'

Offline headheldhigh01

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the other problem is that even if such things were effective, you'd have to catch them early before tissue formation advanced too far.  it would be nice if dht would help me but i doubt it would.  
* a man is more than a body will ever tell
* if it screws up your life the same, is there really any such thing as "mild" gyne?

Offline Hypo-is-here

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Actually quite a few of those trials/studies were controlled.  I recognise the language, they were reported from Glen D Braunstein and his 1993 white paper Gynecomastia.

There is no question at all that medications can be an effective form of treatment for gynecomastia in a percentage of people.  The problem is that so few endocrinologists are willing to use them due to a combination of;

Historical tendency, lack of primary licensing (shouldn't be an issue), lack of funding etc etc.

I do think that in a few years we shall see greater use of such medications in treating this condition, but it will be a long time if ever that such meds replace surgery as the number one treatment.

They are only effective at reducing glandular gynecomastia, they do not reduce pseudo gynecomastia at all.   Often they reduce but don't resolve the problem, though this fact can make it much easier for men to get on with their lives and should not be down played.  Theses medications tend to be far more effective when gynecomastia is in the proliferation phase as Headheldhigh correctly stated.  Once gynecomastia becomes fibrous- after a year and a half to two years approx- they tend to be far less effective at reducing glandular gynecomastia- though they still do sometimes work for some people.

They also do not work whatsoever for some people.

Surgery is more effective- no question.

However used at the right time in appropriate patients under the watchful control of an experienced and competent endocrinologists such medications can reduce the need for surgery in an inexpensive and non invasive fashion.
 
A pity that so little money has been spent on these medications in this setting.  Virtually nothing- despite the fact that the potential benefits were being trialed back in 1980 and prior.

Another example of the pharmaceutical industry leading the medicine/doctors and medicine standing still in an area simply because the dollars/market has not seemed worthwhile.

If anyone is looking to self medicate any of the above medications with the logic;

I have gynecomastia therefore they are worth a go....

Bare in mind that the success rates shown are only taken from those in whom it was appropriate to medicate based on a medical evaluation.  B) They were looked after in a medical setting by highly qualified doctors.  C) They had their endocrine and general health status evaluated and observed prior to, on and post treatment.

Flying blind and messing with your own endocrine system by self medicating is a terrible idea that will most likely end badly- whether it is with medical problems or the loss of money and no benefit because of the inappropriateness of drug, dosing etc

People do not try self surgery- similarly they should not try self medication.

P.S

I got bored posting on the issue of medications, because it always used to lead to arguments, was divisive and so few people could actually obtain the services of an endocrinologist willing to treat, irrespective of merit unless a blatant hormone condition existed.  If anyone disagrees with this post then that is fine- I am not arguing/ looking for any final say as I am too tired to hop on the merry-go-round again.  


« Last Edit: November 05, 2006, 11:24:19 PM by Hypo-is-here »

Offline AGS101010

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wat about 6-oxo ive heard some good things about that product and im also using Yohimburn ES on my chest its my 2nd day using it so im gonna continue and hopefully it some what removes puffy nipples.

I believe that I'm in good shape its just that im pretty sure this is gyno because im much skinner than alot of people i know and i still have the puffy round nipples. So if this Yohimiburn ES works i will update you guys, i also chose Yohimiburn ES because i heard some people saying that they had it remove it somewhat and i became interested.

But wat i really was wondering about was 6-oxo and if anyone has any information about it because ive seen a huge amount of reviews saying that it reduced their gyno.

Oh yea one more thing once u stop taking the 6-oxo or any medication like that would the results that happened return after being lost

Offline rockin813

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i think if u find success with tamoxifen or any other medication that is a synthetic estrogen or an AntiEstogen..the key is to taper off so no rebound effect occurs.

Offline Hypo-is-here

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Rebount XT

Firstly;

This product has not been created for the medical community by a significant pharmaceutical company, it has not been through stringent double-blind placebo based controlled studies in order to obtain a medical license for its use.  To obtain a medical license a drug must not only go through the aforementioned studies involving huge numbers of participants over a number of years; it must also pass earlier phased studies before it is even taken by a single human volunteer.   All of this costs millions of dollars to prove the efficacy/effectiveness and safety of given treatments.

So all the anti-estrogens, aromatase inhibitors and androgen medications created by significant pharmaceutical companies have obtained their licenses only after spending millions of dollars and years to make sure that they work and are safe.  Not only that, but the side effects or potential side effects are also well detailed.  

Now this product/drug might be effective, it is possible.  Certainly I am well aware of it and many that have taken it.  Now those that have taken it obviously did not do so in controlled observed and measured conditions by clinicians, but some have claimed it helped (others said it did not).  Now even if it has helped some, we still do not know how successful this is in percentage terms in comparison to other drugs/medications that do have a medical license.  It might be far less effective than Tamoxifen or dihydrotestosterone, then again it might be more effective we just don’t know.  Let us take a leap in the dark and suppose for one moment that it is effective.  We still have a problem, or at least I do when looking at this product/drug and it is a HUGE problem;

We simply have no information whatsoever that provides evidence as to the safety of this drug either in the short or long term; also we have no list of potential side effects, contraindications or potential drug interactions.  This is no small issue, pharmaceutical giants do not spend millions of dollars and years going through various phases of the stated studies for nothing, and neither does the medical community insist that all drugs pass stringent studies for nothing

So my first reservation is that A) it may not be as effective as claimed and B) we have no idea how safe or unsafe it might be..

Secondly;

Because this is not a medically prescribed drug it means that you cannot obtain it from an endocrinologist (hormone expert).  For this reason most people do not get blood pathology to see how they are doing on the medication to ensure all is well and those that do, still may misinterpret test results or not fully test for potential problems and so if something was to go wrong the warning signs/symptoms could easily be ignored.  This is in contrast to a drug being prescribed by an endocrinologist, as they would keep an eye on hormone pathology, CBC, liver and kidney function, lipids and biochemistry.

It is possible that this drug is effective and safe, but without evidence I would prefer not to be a human guinea pig.  What other people choose to do is there prerogative.

With regard to self medicating tamoxifen or any other drug as mentioned by rockin813 the second point highlighted above are grounds enough to make self medication a bad idea and that is before considering the fact that an individual’s/your gynecomastia might not even be caused by high estradiol to begin with.  If it is not and estradiol is lowered too much then the individual will likely suffer one or more of the following;

Thyroid problems
Bone pain
Faitigue/lethargy
Lowered libido
Erectile dysfunction

You will have had little to no impact on the gynecomastia and you could cause other problems for yourself.


Think about it.


 

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