is it possible to get rid of gyne using hormone..?

[bennyha]

Is it really possible for my gyne to go away if I get some kind of testosterone replacement??  I have had gyne since about 14 but it became apparent to me recently that my testosterone had to be low. Im almost 23 years old and still have no facial hair at all and very little hair on my upper legs and have always had light hair in my armpits. I went to and endo and got my blood checked last week and am still waiting for the results, which will be done in 10-14 days. But my endo said surgery may not be needed if a hormone replacement is used because sometimes that gets rid of the gynecomastia. Does this statement have any truth to it?? I have the money and want to get the surgery done but have to wait for endo to clear me and its driving me nuts.

[Finrod]

"is it possible to get rid of gyne using hormone..?"
Yes, it can get rid of the glandular tissue if you have hormonal problems, but there is always a possibility that some fat/glandular tissue/extra skin remain.
I would wait till the tests are ready and see what the docs says.

[hypo]

It is possible that testosterone replacement therapy may reduce/resolve your gynecomastia but it is not likely to happen and may make the gynecomastia worse.

Quote verbatim from Glenn D Braustein M.D endocrinologist from his 1996 white paper entitled Gynecomastia;

Testosterone therapy was among the first treatments to be attempted, but the response rate was no higher than that in control populations of untreated patients and testosterone carries the risk of being aromatized to estradiol, which may stimulate the breast further.

unquote

This is why testosterone is no longer used as a treatment for gynecomastia.  In fact the abuse of testosterone by bodybuilders accounts for 25% of all cases of gynecomastia.

There are different forms of testosterone replacement therapy and some convert/aromatase to estradiol more than others, which is why those men that suffer from gynecomastia need to be on treatment that converts less/aromatizes less to estradiol.

In this regard Androgel and Testim are better product than injections with the exception of a new treatment which may or may not be available in the US-called Nebido.

A good form of treatment sometimes needs to be accompanied by E2 management therapy and this is something that many endocrinologists fail to recognize.

Once on a successful treatment regime that has increased testosterone to healthy levels (where you feel better, not just have normal pathology) and kept their estradiol levels within healthy levels, those who have hypogonadism can go ahead with a surgical procedure.

Below is a quote verbatim from the (American Association of Clinical Endocrinologists) AACE from their hypogonadism guidelines 2002.

Many men have psychological problems resulting from gynecomastia.  This problem should be taken seriously and discussed with the patient.

further

A breast reduction surgical procedure is often required for psychological well-being.

Given that last quote I would have thought that your insurance company would have to pay for the procedure as it has been categorized as a serious problem to men who have hypogonadism.
 
If you have hypogonadim, I'd give it a few months on treatment to make sure all is well before pressing for the operation.

If you have any further questions just ask, if you wish to talk in private just private message me.

I hope that helps.

[bennyha]

yeah hypo i would like to private message you with a few questions but im not sure how to do it. could anyone help me out how to private message someone else. thank you in advance.

[Finrod]

Just click on hypo's nick and another page will open, scroll down till the phrase "send this user a private message" appeares, just click again.

[aux513s]

Hypo,

Dr. Braustein claims the response rate to TRT is no higher than that in control populations of untreated patients. I assume it would actually be higher within the subset of gynecomastia victims whose breasts are caused by a known testosterone deficiency. Which is just ten percent right? If the study just focused on the effects of TRT on this ten percent, do you think the results would of been different?

If there is only a slight chance the gyno will be resolved by hormone therapy, what are the chances that TRT combined with anti-estrogen would prevent the gyno from getting worse? I can deal with my breasts how they are now as long as they don't get any bigger.

[hypo]

I can see your point; it is possible that the results of the study may have been different if it only focused on gynecomastia patients with hypogonadism.

However;

The fact that is it is not a successful treatment for gynecomastia generally is why it is no longer used in this setting.

Furthermore the risk of testosterone being aromatized to estradiol and increasing gynecomastia is significant!

I can say that because;

A) Dr Glen D Braustein M.D states it to be so.

B) It is stated by Eugene Shippen M.D in his book the Testosterone Syndrome.

C) I have seen it first hand in my pathology results.

D) I have studied the pathology results of many, many men on TRT and I have seen the common side effect of significantly increased estradiol levels.

E) Because I have read the prescribing guidelines on most TRT and the pharmaceutical companies that manufacture the therapies often state that levels of estradiol are significantly elevated.

F) Significantly elevated estradiol has been reported as a side effect for some men on TRT from the US to the UK.

G Because testosterone is a prohormone that as a fact only converts to DHT and estradiol.

H) I myself had gynecomastia prior to TRT and TRT  increased my gynecomastia.

I could go on and on and on, but I won’t.

The above is not to say that your gynecomastia will increase on TRT it might not and it could even be reduced as that also does happen in some men.

But the above does show why it is very important for those men that already suffer from gynecomastia (because of hypogonadism) should choose a therapy with a low testosterone to estradiol conversion/aromatase factor.

If it is possible to get Nebido get that, if not get Androgel.

Do not accept old style shots/injections such as  Sustanon, as they would drive your estradiol level up higher than the therapies I have mentioned and are probably less appropriate for you.

Following on from choosing the right therapy, you would need to have pathology to see how your estradiol levels are.

If they are at the upper end of normal (dependent on the reference range) or if your gynecomastia appears to be getting worse in any way, you need some form of estrogen management, something many hypogonadal men require.

It all sounds really bad and tricky but if you get your hormones balanced, which most men do, whether this is via the correct therapy with or without estrogen management- then you can go for the operation.

P.S

I think I said it is important for your endocrinologist to diagnose what form of hypogonadism you have.  This is still very important, because if your problem is a result of a hypothalamus or pituitary problem- hypogonadotropic hypogonadsim, then you may not wish to be on TRT at all (depends on whether the problem occurred pre or post puberty).

This is because it is often possible to restore correct testicular function and production of your own testosterone in such cases.  The positives being retained fertility, no decrease in testicular size and the fact that it is a more natural for your body to produce its own testosterone.  Such therapies are hCG, Tribulus.

Again these therapies may or may not require estrogen management, but the same pathology tracking should be put in place.

I hope that helps I apologise if It doesn't.

As I say Pm me if you need to ask me anything in private.  

[aux513s]

I realize that TRT has the potential to increase gynecomastia in some cases. However, I was asking about TRT combined with anti-estrogen, not just TRT alone.

I'm going to try to make an appointment with an endo soon. I'm not very concerned with the other effects of low testosterone, all I really care about is getting rid of my gynecomastia.

I think what I'm going to do is ask to be put on anti-estrogen at first. Do you think just this will stop my gynecomastia from getting worse? What are the side effects of this medication?

Also my hypogonadism isn't a result of pituitary problems, it's primary.

[Paa_Paw]

I had a Doctor tell me years ago that he would be able to ungrow breast tissue about as successfully as I would be able to uncook an egg.

There may come a day when it can be done, but we are not there yet.

[hypo]

Quote
I'm going to try to make an appointment with an endo soon. I'm not very concerned with the other effects of low testosterone, all I really care about is getting rid of my gynecomastia.  
Unquote

In some men low testosterone is enough to cause gynecomastia even if estradiol isn't elevated due to a poor androgen to estrogen ratio/balance.  For this reason you should be concerned about treating the hypogonadism.

Other reasons to treat hypognonadism is that hypogonadism significantly increases the risk of developing;

Cardio Vascular Disease, Osteoporosis, Diabetes, Metabolic Syndrome, strokes, Alzheimer’s and obesity!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!  

I think you can see why that would be important.

And this is not just something that happens to other people, my long term untreated hypogonadism has resulted in me having osteopenia in my spine and osteochondritis in my arm.

Quote
I think what I'm going to do is ask to be put on anti-estrogen at first. Do you think just this will stop my gynecomastia from getting worse? What are the side effects of this medication?
Unquote

If you have a primary problem then this sounds like a bad idea.

The idea of taking an anti-estrogen is that A) it lowers estradiol in the body and B) in doing so LH increases and this tells the testicles to produce more testosterone.

In your situation being primary (something I didn't know before) may well mean that your estrogen is already low, something pathology will clarify.

If it is already low it would not warrant lowering further.

Also an anti-estrogen will raise LH but in your case may have little or even no effect on your testosterone production given the nature of your problems.

If you have primary hypogonadism then you need appropriate TRT.  

If you tend to suffer from elevated estrogen status get Nebido prescribed if it is available as it does not convert much testosterone to estradiol.

If you cannot get Nebido prescribed get Androgel and keep an eye on estradiol levels via regular pathology, if it goes into the upper third of the normal reference range or if your gynecomastia appears to be getting any worse, then get an anti estrogen prescribed.

Your hormones can be balanced out and you can get an operation.  It is just about understanding the issues involved and taking an active role in your own healthcare.