Gynaecomastia through the NHS

[TimeToGo]

Hi there,

I have decided to post on here about my journey thus far through the NHS and will update it as I get further along so that people can have as much information as they can. (Im in my late teen years)

Since about 2009 I have had gynaecomastia, mainly in my left chest but with a small bit of breast tissue in the right one too. Within the last year I have suffered from a lot of tenderness, so much that I have had to go from doing sport 3 times a week to nothing whatsoever. And within the last few months I have now suffered problems with sleeping since the tenderness has gotten so bad.

I went to see my GP about it who gave me a blood test to check my hormone levels, which came back as normal, and now has made me an appointment to go to a breast clinic to see what the next step should be. I received my appointment in the post with more pages of information that I found very interesting about what they would do on the day and what options I have got. (If you want to know the information on there, let me know and I'll post it)

I was very nervous about going to see my GP and I am nervous about going to the breast clinic since it is mainly females who go there, but at this stage I will do anything to get rid of the tenderness as it is horrible.

My appointment is this week so I will update once I get back or the day after and let you guys know what has happened.

[Raider Fan]

According to the info I've read, if your breasts are tender/painful, your gyne is in an active phase.  Even though your gyne has existed for a couple of years, you might ask a doctor if they think you could benefit from Tamoxifen (or Nolvadex).  It has been shown to be beneficial for precisely the tenderness you mention and has even been shown to decrease/reverse gynecomastia if given early enough in the process.  Once the tissue becomes fibrotic, however, the chances of the medicine working a miracle go down.  But it should at least help with the tenderness you're experiencing.  

As far as what they are likely to do in the breast clinic, I would think they would probably do a mammogram and possibly a sonogram, just to rule out anything sinister going on.  In all probability, these tests will simply confirm a diagnosis of gynecomastia, but at least you'll know where you stand and you can make decisions from there.

If you believe your gyne IS still in an active phase of growing, surgery should not be considered until it has stabilized for several months. 

[fingerit]

I had pretty much the same diagnoses as you TimeToGo and I went through the NHS route, breast clinic for a ultrasound (wasn't a bad experience actually) and up to having a few consultations with an NHS plastic surgeon, up until that point the experience was great, but the surgeon pretty much deflated me and put me off the surgery option for years until I found this board and ended up getting my op done privately. A few guys on this board I think have done down the NHS route and actually had surgery so I'm sure they will be able to give some more advice, I think I'm just biased due to a bad experience.

I would doubt that a doctor would prescribe Tamoxifen on the NHS and for gyno, since as far as I'm aware its a breast cancer treatment? The thing is with Tamoxifen (I'm no expert so don't take this as gospel) is its supposed to compete with estrogen at the estrogen receptor sites so that the estrogen cannot bind to it. This is the main reason that bodybuilders use this on post steroid cycles to actually prevent getting gyno because of the raised estrogen levels when they cease taking hormones and the bodys natural hormone levels are low. I'm no doctor but if TimeToGo has had his hormone levels checked and its normal than I wouldn't have thought that Tamoxifen would work.

Sorry, I hope that doesn't come across as a rant or anything!

I think as you say Raider Fan, if its caught early Tamoxifen might work but when there is a decent amount of breast tissue I think only surgery is an option. I only say this since I've tried this route and it didn't work.

[Raider Fan]

As far as I know, gynecomastia is not listed in the "Indications and Usage" section of Tamoxifen's product information.  However, there are many, many drugs that are currently being used to treat conditions other than those they were originally made for.  

Tamoxifen is a well established medication for gynecomastia, although it tends to mainly be used (or tried) by specialists (endocrinologists).  Whether it helps reduce/reverse gyne seems to be related to the onset of the gynecomastia.  The earlier it is given after the onset of gyne, the better chance it has of reducing tissue that is still in an active phase of growing.  According to my endocrinologist, it is particularly good at improving the pain/tenderness associated with gynecomastia. If that is someone's main complaint, it is definitely worth a try, according to research.

In addition to the estrogen antagonist, Tamoxifen, anti-estrogen medications (Arimidex, Letrozole) have also proven beneficial for some early gyne sufferers.  They don't work for all, but they have been shown to work for some.  As my doctor told me, all you can really do is to try one of these meds and see if it helps or works.  They are not for long established, stable gyne.  

I don't know about the NHS, but typically, meds such as this are NOT prescribed by primary care physicians in the USA.  They are usually only prescribed by specialists, probably because it is the specialists who are most aware of the newest research and using certain medications for secondary afflictions.  Since these meds might be considered unproven by some, and expensive by many, I would not be surprised at all if the NHS would refuse to prescribe medications such as Tamoxifen.  That's their business....denying care and denying costs.  I'm sure they do it well, just as the death panels will soon in the USA.

With socialized medicine coming to America through ObamaCare, who knows, drugs like Tamoxifen might not be approved for gyne much longer by physicians in the USA, either. When the government begins regulating how doctors treat their patients, and removes decision making from the doctors, it will not be surprising at all that as little money as possible will be spent.  With this type of healthcare, the patient is no longer the priority.  The only real priority is how much money is being spent, and that will govern the care that is approved.  

[fingerit]

Thanks for the information RaiderFan, I wasn't aware it was being used for treatment for gyne. Very interesting.