Has anyone had your gynecomastia improve (or go away) after taking Testosterone?

[Raider Fan]

I have been told I have Total Testosterone in the normal range, but my free T is low and my estriadol (estrogen) is high.  That's not a ratio you want to have.  I also have a vitamin D deficiency.  Therefore, my endocrinologist wants me to use testosterone supplementation (Androgel - a very low dosage), as well as vitamin D supplements.  I have reservations about using the Androgel. 

My primary care doctor said he didn't think using a T supplement would help my gyne.  My endocrinologist said he thought it "could" help my gyne.  So which doctor is right?  There is nothing in the literature about using Androgel for gyne, but there is plenty in the literature that says Androgel can CAUSE gyne. 

Besides this, T supplementation has all kinds of possible side effects, some of which can be very bad. 

I asked my endo if I would have to use the T supplementation forever, and he said I wouldn't.  I think he said that because unless I show a clearly improved response from it, there's really no point in taking it.  So if it obviously doesn't help anything, I would stop using it. 

My question is......has anyone used Androgel and had their gyne improve or go away?  Doctors, have you ever known T supplementation to help gynecomastia, especially the pain associated with it? 

I'm a middle aged, overweight guy and my gyne started suddenly about 5 months ago.  The main symptom (besides breast growth on only one side) is pain.  So this isn't adolescent gyne. 

[Paa_Paw]

The Endocrinologist is a specialist. His specialty is the Endocrine glands and their hormones. Given the situation you describe, I think you should go along with the treatments the Endocrinologist has suggested.

You are right, of course, there are potential problems with medications such as Androgel but leaving your condition untreated also has its risks. I think overall that your best outcome will result from following the advice of the Dr.

Will the androgel make your breasts shrink? I don't think so, at least I have not heard from anyone who reported this though the question arises not infrequently.

The use of Androgel by a patient not needing more Testosterone can actually result in an increase of Estrogen through aromatase. This should not be an issue in your case as the drug will be used in an effort to balance things and the drug is not expected to result in a surplus of Testosterone. Likewise, I suspect that your hormone levels will be monitored in some way while you are using the medication.

There is a certain degree of safety provided by the very choice of the type of androgen the Dr. has prescribed. Specifically, using a low dosage of a topical gel instead of using injected Testosterone. I think your Dr. is using a rather conservative approach. The topical gel is used regularly and provides a fairly consistent result whereas the injections tend to produce a roller coaster effect. with periods of high and low levels.

Sorry to be so repetitious, but I'm agreeing with the Endo. Even though I doubt if it will make any significant difference in your Gynecomastia, The fact is that it might and I think your overall health will benefit.

[Dr. Cruise]

I agree with Paw Paw.  I do not expect there to be much change in your gynecomastia by taking a low dose testosterone. Although improving the ratio of T to Estrogen will be helpful. Weight loss will be more helpful to improve Test. to Estrogen, as this is the primary location of the aromatases. More importantly are the other bodily functions that will be helped by getting your testosterone levels back to normal, such as muscle mass, bone density, libido, state of mind, etc. I think your endo's coservative, but still proactive approach, is the right way to go.

[Raider Fan]

Yes, "conservative" is certainly the right word.  The usual starting dosage of Androgel for low T is 5 mg. per day (4 pumps of gel daily....2 on each shoulder), but he has prescribed exactly half of that for me (only 2.5 mg. per day....1 pump daily per shoulder). 

I question exactly what this small amount would do for me.  Why am I at half the usual starting dosage?  And if I'm only using half the usual starting dosage, I question whether it's even needed. 

I also wonder about the long-acting shots of T.  If they work, seems like that's the way to go (cheaper, easier, and don't have to worry about others touching it). 

[DrBermant]

I have been told I have Total Testosterone in the normal range, but my free T is low and my estriadol (estrogen) is high.  That's not a ratio you want to have.  I also have a vitamin D deficiency.  Therefore, my endocrinologist wants me to use testosterone supplementation (Androgel - a very low dosage), as well as vitamin D supplements.  I have reservations about using the Androgel. 

My primary care doctor said he didn't think using a T supplement would help my gyne.  My endocrinologist said he thought it "could" help my gyne.  So which doctor is right?  There is nothing in the literature about using Androgel for gyne, but there is plenty in the literature that says Androgel can CAUSE gyne. 

Besides this, T supplementation has all kinds of possible side effects, some of which can be very bad. 

I asked my endo if I would have to use the T supplementation forever, and he said I wouldn't.  I think he said that because unless I show a clearly improved response from it, there's really no point in taking it.  So if it obviously doesn't help anything, I would stop using it. 

My question is......has anyone used Androgel and had their gyne improve or go away?  Doctors, have you ever known T supplementation to help gynecomastia, especially the pain associated with it? 

I'm a middle aged, overweight guy and my gyne started suddenly about 5 months ago.  The main symptom (besides breast growth on only one side) is pain.  So this isn't adolescent gyne. 

Yes, I have seen quite a few patients who had an underlying endocrine problem see a major change in their chest after stabilizing their problem. Swollen gland from hormone stimulation usually does shrink once that stimulation is removed. This is called the active phase of gynecomastia. It is the same process as a woman's breast goes through during pregnancy and menstrual cycles. However, once the swelling goes down residual gland can still cause a deformity. So although I have seen a major change in size, the most spectacular improvements were in the subtle deformities that when the swelling resolved, residual tissue was trivial. The other issue that is important is to stop the continued growth and symptoms that the unresolved hormonal problem causes.  Surgery on someone who is still growing their breasts will result in a recurrence. This is nowhere as rare a problem as some doctors will tell you. I have seen just too many examples: breast regrowth after another surgeon operated on an unstable gynecomastia with the patients then coming to me for help for revision. Many of these patients told me that their doctors told them not to worry: "recurrence is rare."

The important issue here is getting the problem stabilized first.

For those truly with low testosterone, the medication is much more than for the gynecomastia. Testosterone has many different effects on the body from thinking, to libido, to nerve function, and many other factors. Replacement is no trivial matter as it will suppress remaining testicular function. Injections are not a good way for administration. The peaks and valleys are in no way physiologic. The topical medications come much closer.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[Raider Fan]

Doctors say you should not have surgery while the gyne is in an active phase or that is unstable, because the breast tissue can grow back if the gyne has not stabilized.  How does this differ from women who have a mastectomy?  I've never heard of it being a problem that THEIR tissue grows back.  What's the difference? 

Does a woman's tissue grow back after a mastectomy?  If not, why not? 

[DrBermant]

Doctors say you should not have surgery while the gyne is in an active phase or that is unstable, because the breast tissue can grow back if the gyne has not stabilized.  How does this differ from women who have a mastectomy?  I've never heard of it being a problem that THEIR tissue grows back.  What's the difference? 

Does a woman's tissue grow back after a mastectomy?  If not, why not? 

This is not a male female issue, but one of mammal breast. There are mutipotential cells that seem to be able to convert to gland and grow breasts. Yes, a woman's breast can continue to grow even after Female Breast Reduction. Radical mastectomy, removing disfiguring amounts of tissue will for both men and women significantly lower the chance of regrowth. These patients have fascia, fat, and connective tissue removed in a severely deforming surgery. Yet put the right stimulating hormones at play, even these patients can regrow tissue from the remnants that no surgery can completely target.

http://www.guardian.co.uk/science/2009/nov/12/mastectomy-regrow-breasts-trial

You cannot get beyond basic physiology of tissues.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction