Page not availableAnabolic steroids is the familiar term gybecomastia synthetically developed or man-made variations of the naturally occurring prednisone induced gynecomastia hormone, testosterone. The proper term for these compounds is anabolic-androgenic steroids abbreviated AAS - anabolic referring to muscle-building, and androgenic referring to the development of male characteristics, including body hair, genital organs and muscle mass. Anabolic steroids are generally - and sometimes illegally - used to low testosterone doctors in philadelphia muscle growth, enhance athletic or other physical performance, and improve gynecimastia appearance. Doctors occasionally legally prescribe anabolic prednisone induced gynecomastia to treat certain conditions in men that are caused by hormone deficiencies, such as delayed puberty, as well as diseases that result in the loss of lean muscle mass, such as cancer and AIDS. Gynecomaastia dose of anabolic steroids taken by steroid abusers may be ten to one prednisone induced gynecomastia times higher than that prescribed by doctors to treat medical issues. Typically, the steroid is either injected directly into the muscle or taken orally.
Male mammal glandular tissue, under particular conditions, can proliferate and increase in volume. Gynecomastia feels to touch like a rubbery mass extending concentrically under the areola and can affect one mammary gland only or both. This more or less pronounced volume-increase of the mammary glandular tissue can be associated with discomfort or pain.
Sometimes adipose tissue accumulation at breast level can be mistaken for real gynecomastia. This condition, particularly frequent in overweight subjects, takes the name of pseudo-gynecomastia. Often gynecomastia and pseudo-gynecomastia are both present in the same subject at the same time. Despite not being a health-threatening condition, gynecomastia can cause psychological distress due to physical-appearance alterations. Mammary glandular tissue proliferation is physiologically stimulated by oestrogens and inhibited by androgens.
The majority of gynecomastia cases are physiological in nature neonatal, pubertal and senile gynecomastia. Many drugs can cause gynecomastia see Table 1 as much as several active principles, which have been associated to this condition. Antiandrogens such as bicalutamide and flutamide can cause gynecomastia by antagonist action to testosterone and dihydrotestosterone on mammary glands.
Spironolactone, an aldosterone antagonist used for high blood pressure treatment, presents both anti-androgenic and oestrogenic activities. This drug can induce gynecomastia after one month only of treatment, with a dose-dependent incidence.
Other examples of drugs that can cause gynecomastia are protease inhibitors for antiretroviral therapy such as saquinavir or lopinavir , antipsychotic like haloperidol , several chemotherapy drugs such as methotrexate or ciclophosfamide and natural products which contain phytoestrogens for example soya milk.
Periodically monitoring the Network, however, the Work Group for the analysis of signals established by the Italian Medicines Agency has identified gynecomastia cases associated to two drugs never linked before to the condition or not much documented yet: For tamsulosin, on the other hand, the effects on sexual hormones are unknown yet, as there are no other published cases.
Signals from passive surveillance systems are not definitive proofs of cause-effect relationship between drug and event, but are useful instruments for early alerts on possible safety issues of commercialized drugs.
In case of suspected drug-induced gynecomastia, it would be opportune considering a therapy discontinuation. In some cases, it could be helpful reducing the doses or substituting the suspected drug with another one belonging to the same class, but with a weaker association to gynecomastia. On the other hand, laboratory tests are necessary for identifying other possible causes, checking the renal, hepatic and thyroid functions and the free-circulating hormones levels.
If drug discontinuation is not enough or not possible for example with anti-androgens , a therapy based on tamoxifene 20 mg daily might be taken into consideration. Skip to main content. Focus Farmacovigilanza ;77 7: Gynecomastia characteristics Male mammal glandular tissue, under particular conditions, can proliferate and increase in volume. Etiology and pathogenesis Mammary glandular tissue proliferation is physiologically stimulated by oestrogens and inhibited by androgens.
What to do in case of gynecomastia In case of suspected drug-induced gynecomastia, it would be opportune considering a therapy discontinuation. Active principles are listed by decreasing number of reports in brackets. Protease inhibitors saquinavir, indinavir, nelfinavir, ritonavir, lopinavir , reverse transcriptase inhibitors stavudine, zidovudine, lamivudine.
Methotrexate, cyclophosphamide, carmustine, etoposide, cytarabine, melphalan, bleomycin, cisplatin, vincristine, procarbazine. Data from the National Pharmacovigilance Network reports 2.