Gynecomastia confirmed: now what do I do?

helpmefindmyhair

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Well guys,

I'm afraid I'm one of the few that develop gynecomastia in response to finasteride. Two weeks ago I went to see my urologist about my puffy nipples. He sent me to a lab so that I could have my hormone levels checked. Today I returned to his office to get the results.

My testosterone level is 840. Normal range is 241-827. He said he wasn't concerned about my testosterone.

My estradiol level was 35. Normal range is 0-53. That didn't concern him either.

However, my Total Estrogens was 171. Normal range is 40-115.

And my Serum Estrone was 108. Normal range is 12-72.

Both of these levels concerned him.

He left up to me what I should do. He recommended DIM to me and said he takes it himself. I was really surprised, almost shocked, when he recommended DIM to me. I already knew about its existence but I was under the impression that it was a scam product. It is supposed to promote "healthy estrogen levels." I haven't read much about DIM but the little I've read said that it can actually increase estrogen levels instead of reducing them.

I brought up the subject of tamoxifen. He said his sister is taking it for breast cancer but that he'd never heard of it being prescribed for gynecomastia. Fortunately, I brought along 5 medical studies I found at PubMed. He read through them and then wrote a prescription for 20mg/day of tamoxifen. He wants me to return in 3 months for another blood test. It is up to me whether I try the tamoxifen.

(If you're wondering why I didn't mention arimidex to him it's because I've read studies that indicate arimidex really isn't very effective at all when it comes to gynecomastia. I've read one study in particular that found tamoxifen to be clearly superior to arimidex when it comes to taking care of gynecomastia. I think arimidex can prevent gynecomastia but as far as actually making it disappear tamoxifen is much better.)

My gynecomastia is not very advanced at all but it is enough that I've noticed a definite change in my chest. I'm really disappointed too because I started propecia at a low dose -- .5mg/day. I've reduced it even further to .5mg every other day and my gynecomastia has not reversed but seems to have increased. I'm a very lean/muscular guy. I hardly have any fat on my body. I certainly never had anything resembling gynecomastia before I took finasteride. This drug has certainly played with my hormonal levels. If I return to taking finasteride I think I'll do so at .5mg every third day. I'm very confident that level will still afford my hair some protection. I've only been on propecia for 3 months.

Right now I think my choices are to: 1) stop finasteride altogether and see if my gyno goes away by itself, 2) stop finasteride until my gynecomastia goes away and then resume finasteride at a lower dosage, 3) continue taking finasteride but at a lower dosage and also take something to battle the gynecomastia or 4) stop finasteride for now, take something to battle the gynecomastia until it goes away and then begin to take finasteride at a lower dosage.

What do you all recommend? And do you think I should take DIM, tamoxifen or some other product?
 

BadHairDecade

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I'm really suprised that your Dr. never heard of people taking Tamoxifen for Gynecomastia. It's been around for such a long time and extremely popular in the bodybuilding community.
I'm also suprised he gave you the 20mg dose when there is a 10mg dose available.
What kind of Gyno do you have? just chest fat or do you have a lump?

10mg of Tamoxifen worked very well for me. Be aware that Tamoxifen has side effects too so take as small a dose as you can. Side effects can include hair loss.
I went down to .25mg of finasteride a day for a couple weeks when I first stated using Tamoxifen. It definitely kept it at bay. that was back in April or May.
Since then I was able to slowly get back up to 1mg of finasteride/day without a problem. Then I started to reduce the dose of Tamoxifen to 5mg then to 2.5mg until about a month ago to where I no longer need to use it (knock on wood). I still have a small lump and a bit more chest fat than I usually have. But it's not getting any worse which is fine by me. It's also nothing that's visually noticeable.
PM me if you want to discuss.

BHD
 

drinkrum

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I have the same results as you for T, E2, but slightly higher total estrogens. The endocrinologist that I went to told me to ignore the total estrogen count as the assay they use is rarely accurate. E2 is the best way to measure excess estrogen.

By the way, my E2 was 34, T was 800 or so, and total estrogen was 212. The endocrinologist I went to is one of the best and works for Harvard/Mass. Gen. Hospital in Boston, Mass. If you want her name, send me a private message.

D.
 

LiveHair

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drinkrum said:
I have the same results as you for T, E2, but slightly higher total estrogens. The endocrinologist that I went to told me to ignore the total estrogen count as the assay they use is rarely accurate. E2 is the best way to measure excess estrogen.

Is E2 the same as Estradiol?

If so, did she measure Serum Estrone as well or?

Thanks!

LiveHair
 

drinkrum

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Yes, E2 is estradiol -- the potent form of estrogen.

I had my total T and total estrogens measured by my local GP. Upon seeing my insanely high total est., I went straight to an expert endo. She tested my total DHT, T, and E2. My DHT was low as expected from treatment with finasteride, T was on the higher end, and E2 was 34 (within "normal" limits). She told me not to care about the total estrogens as the total assay they use is crap.

D.
 

helpmefindmyhair

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Guys,

Thanks for responding. I don't know what I'd do without this board.

Drinkrum and Badhairdecade, I'm going to PM you guys sometime within the next day. I'd like some more specific information out of each of you.

First, I wasn't satisfied with the level of care my urologist gave me. My gut tells me to go see an endocrinologist and get his/her opinion. I'm not confident that my urologist has a good enough grasp of this area of medicine.

Honestly, I felt more like the doctor than the patient. I brought in the medical studies on tamoxifen. I pointed out the dosage and duration. I definitely was not comfortable.

Badhairdecade, you're right. He should have known tamoxifen was a possible solution. At the very least he could have researched gynecomastia after my initial visit. It took me all of 5 minutes on PubMed to see that tamoxifen is a possible solution. All of the studies I've read had the patients taking between 10mg-40mg tamoxifen. Usually it was 20mg but I think I may try 10mg first since my gynecomastia isn't that advanced. I'm aware a possible side effect is hair loss.

I think it's less expensive for the 20mg pills anyway. I can always just break them in half.

(Listen to this guys. I went to my pharmacy and it was $332 for 90 20mg tablets. After insurance it was $148. I went to canadapharmacy.com and it was $70 for 90 20mg tablets, and that's not even taking into account an insurance reduction. The SAME drug made by the SAME manufacturer. No difference whatsoever. A generic was even available. 100 20mg tablets for $54. I'd get the generic if my prescription didn't say 90 tablets. There's a $10 shipping charge but so what.)

No lumps yet. My nipples are definitely puffier. The areolas are definitely puffier and the area under and around the areolas is definitely puffier. It's hard to say if I have more fat in my chest area in general.

Badhairdecade, how long did you take tamoxifen at the 10mg dose? Did you ever stop taking finasteride? And did you ever get your estradiol and estrogen levels checked before you started tamoxifen? What were the results?

Drinkrum, what did your endo say about serum estrone?

And do you guys think I should mess with DIM?
 

drinkrum

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Go to an endo and have him/her run a blood test on you. My endo (she's a reproductive endocrinologist) just did a test of T, DHT, and E2 as I mentioned. She also did some examinations (testicle size, etc.). She found no estrogen excess in any of the physical exams. My E2 was 34 as I had mentioned and she said this was within the normal limits.

I can give you her name if you'd like and you can go see her in person.

D.

P.S. Don't mess with anything until you see a specialist.
 

Thinning

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Id reccommend you keep doing what you are doing. You sound like you are on top of this thing pretty good.

But there are plastic surgery lipo procedures to help reduce your man-boobs if the drugs dont work. Thats what I would probably do. Once they remove all the fat cells and breast tissue you can take all the finasteride you want and you wont grow anymore.
 

BadHairDecade

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Thinning said:
Once they remove all the fat cells and breast tissue you can take all the finasteride you want and you wont grow anymore.

The problem is it's not recommended to do this. you need to leave some of the tissue in order to make it look normal.
IF you don't it looks horrible, kind of like some took a mellon baller to your areola.
And if it's fatty gyno. Fat will come back. Just like with any lipo procedure if you don't take care of yourself it comes back.

helpmefindmyhair:
answered your questions in a PM.
 

HairlossTalk

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helpmefindmyhair said:
He left up to me what I should do. He recommended DIM to me and said he takes it himself. I was really surprised, almost shocked, when he recommended DIM to me. I already knew about its existence but I was under the impression that it was a scam product. It is supposed to promote "healthy estrogen levels." I haven't read much about DIM but the little I've read said that it can actually increase estrogen levels instead of reducing them.
Take it from the horses mouth. You do not want to mess with your hormones like popping vitamins. The endocrine system is in control of everything from your muscle development to about 100 possible diseases you could develop by the time you're 80. You don't want to screw with it. We all considered Propecia a worthwhile cause for our hair loss, and put our endocrine systems out of whack in the name of keeping hair with it, but the last thing you want to do is take another hormonal modulator on top of that to further kick things off kilter. Doctors amaze me with their recklessness with prescription meds sometimes.

My rule of thumb for Propecia users (after my own bout of an insanely high estrogen test result while on Propecia) is that you need to, as with everything, use good judgement. Moderation in everything. And Listen to your body. Above all else listen to your body. People who use propecia and have zero adverse responses to it - more power to them. They'll be fine and im quite sure of it. For those of us poor saps whose bodies go haywire on it, we need to bite the bullet and stop torturing our bodies.

I can assure you it was the hardest decision I'd made in years to drop the most clinically proven product on the planet and try something I had much less confidence in (spironolactone + Revivogen + Nizoral Regimen) as a replacement. Maybe God was making me put my hair where my mouth was, as such a big proponent of Revivogen's science and ingredients. Honestly in the world of unproven products, Revivogen is # 1 as far as scientific efficacy goes, but I still didn't want to drop Propecia for it.

For awhile it crossed my mind to take an Estrogen inhibitor. I spoke with Bryan about it, and several other trusted friends who are doctors and pretty much all agreed that it was my choice but I would be kicking things off kilter even further. There are feedback loops and intricacies and a domino effect when you inhibit even 1 hormone that can affect the whole system. I just didn't want to risk it even further.

Of your listed choices, I would say you need to definitely stop finasteride until the gyno goes away. That's 100% for sure. After that, I believe your decision is whether to go on Finasteride again at a lower dose, or to try a topical DHT inhibiting regimen. The inconveniences of that are well known. Trust me. My vote is to give it another try. I did read a couple times about a guy who had gyno, stopped, and when he went back on it, he didn't have a problem again. Maybe that will happen. Otherwise, i really strongly suggest listening to your body and nuking the finasteride. I personally chose not to try the estrogen inhibiting method at all.

However, I run this site, so Im bound to give very conservative advice that will ensure safety for my users bodies, and effectiveness for their hair loss. That's my only concern. Other guys here have given their input and you should definitely talk with them about it as some have some firsthand experiences.

HairLossTalk.com
 

drinkrum

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First he needs to make sure he has gyno. For that he should go to a good endo. His E2 is within normal ranges but he should have it checked out again.

D.
 

BadHairDecade

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drinkrum said:
First he needs to make sure he has gyno. For that he should go to a good endo. His E2 is within normal ranges but he should have it checked out again.

D.
I agree
 

spaceace

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Need some advice

Hey, guys

I've been on propecia + spironolactone for almost 5 years and I've developed some gyno. My question is if I drop both of these what are the chances that my gyno will go away and my chest will go back to normal and how long might it take? I've included a pic so that you can determine the severity of my condition.

My pic:
http://members.msn.com/default.msnw?mpp ... gK06r7M38$ [/img]
 

BadHairDecade

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It doesn't look bad at all. You just look a little out of shape. No offense meant.
Did you go to the Dr. or is this a self-diagnosis. Chest fat doesn't always = Gyno.
 

spaceace

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You just look a little out of shape

I hope that that is all it is. I took that picture before I started working out about 10 days ago after a three month hiatus. When I started to workout I cut down my intake of propecia to every two to three days. Yesterday I did chest and abs and took propecia within a hour after my morning workout. Later that day my breasts felt numb and I noticed that my left breast had sort of ballooned a bit.

Today I had an ultrasound and I will see my Doctor next week for the results
 

SoonToBeBaldEgg

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I hope that that is all it is. I took that picture before I started working out about 10 days ago after a three month hiatus. When I started to workout I cut down my intake of propecia to every two to three days. Yesterday I did chest and abs and took propecia within a hour after my morning workout. Later that day my breasts felt numb and I noticed that my left breast had sort of ballooned a bit.

Today I had an ultrasound and I will see my Doctor next week for the results
Any updates?
 
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