I just found an abstract of an article from the journal Clinical Infectious Diseases about 4 men who had persistant drug induced gynecomastia, and were later successfully treated with a topical DHT gel.
"The use of tamoxifen for gynaecomastia has been studied previously in several centres. The table shows the various published studies on the use and efficacy of tamoxifen for physiological gynaecomastia in the English literature.6-9 Only two of these studies have more than 10 patients and both showed resolution of lump and pain in 80% of cases." (Ting AC, Chow LW, Leung YF. Comparison of tamoxifen with danazol in the management of idiopathic gynecomastia. Am Surg 2000;66: 38-40.[ISI][Medline], and Alagaratnam TT. Idiopathic gynecomastia treated with tamoxifen: a preliminary report.Clin Ther 1987;9: 483-7.[ISI][Medline])
HRT in general is still a fairly young branch of medicine. Obviously there's not huge amounts of research being done in the area. And further, what research is being done will probably not end up on your general practitioner's reading list.
Not wanting to sound like a synic but how the hell is a hormone going to get rid of extra TISSUE!!!
unless it attacks the tissue HRT will do nothing.
Everyone knows that taking steroids makes your testicles shrink. I'm sure you saw those videos in school about body builders who took anabolic steroids (synthetic testosterone analogues). All those guys ended up with tiny nonfunctional (or barely functional) nuts. Everybody knows this, but why does this happen though? Obviously testosterone does directly target the testes and attack them to make them shrink, so how could this be happening? Here's how: exogenous testosterone raises the total testosterone above the body's normal limit. This excess T is then converted to estradiol which signals the hypothalamus to stop producing GnRH (gonadotropin-releasing hormone) which signals the pituitary to stop producing LH (luteinizing hormone) which causes the testes to shut down (T production stops). Normally, once T levels drop, this limiting system stops and T production resumes. This is a feedback loop the body uses to keep optimal levels. But when the body is getting T from an outside source, the testes are never turned back on b/c they don't need to be and as a result they atrophy. This can cause permanent damage. Oh and on the by and by, the extra estradiol also causes some body builders to get gyno. Proper cycling can help minimize this, but the new tech is taking aromatase inhibitors to stop the conversion of testosterone to estrogen, and it works. But the point I'm trying to illustrate here is that you don't have to be specifically targeting a particular tissue to make it grow or shrink.
So... basically what I'm trying to get at is that I think there are other valid forms of treatment aside from surgery that guys aren't really looking at. And I think they should at least be aware that these options exist.