Some studies u may find interesting
Urology 1997 Dec;50(6):929-33
Tamoxifen for flutamide/finasteride-induced gynecomastia.
Staiman VR, Lowe FC.
Department of Urology, St. Luke's-Roosevelt Hospital Center, New York, NY 10019,
USA.
OBJECTIVES: Current therapies for advanced prostate carcinoma lead to a marked
decrease in serum testosterone levels, which renders patients impotent. In preliminary
studies, combination therapy with flutamide and finasteride has been used as an
alternative therapy for the treatment of prostate carcinoma because potency can be
preserved. Both of these agents can cause gynecomastia and breast/nipple tenderness.
METHODS: Six men being treated for advanced prostate carcinoma with
flutamide/finasteride combination therapy developed painful gynecomastia, which
was treated with tamoxifen 10 to 30 mg/day for 1 month. Clinical follow-up included
breast measurements and determination of prostate-specific antigen (PSA),
testosterone, and estradiol levels. RESULTS: While on this combination therapy for
prostate carcinoma, 4 of 6 patients experienced a decrease in PSA level to less than
0.5 ng/mL. All patients remained potent. Serum testosterone increased in each patient
who had a baseline level drawn. Estradiol levels were noted to be elevated in 4 of 6
patients at the time of evaluation for gynecomastia. After treatment with tamoxifen,
circulating estradiol levels increased in 3 patients from 1.3 to 2.2 times the baseline
level. Five patients experienced complete resolution of breast and nipple pain on
tamoxifen 10 mg/day within the first month. The other patient had to be treated with
30 mg/day for 1 additional month, which subsequently resulted in pain resolution.
CONCLUSIONS: These preliminary results suggest that low-dose tamoxifen is
useful in treating painful gynecomastia for those patients on flutamide/finasteride
combination therapy for advanced prostate carcinoma.
PMID: 9426725 [PubMed - indexed for MEDLINE]
Am Surg 2000 Jan;66(1):38-40
Comparison of tamoxifen with danazol in the management of
idiopathic gynecomastia.
Ting AC, Chow LW, Leung YF.
Department of Surgery, The University of Hong Kong, Queen Mary Hospital,
Pokfulam.
Idiopathic gynecomastia, unilateral or bilateral, is a common physical finding in
normal men. Successful treatment using tamoxifen (antiestrogen) and danazol
(antiandrogen) has recently been reported. We compared the efficacy of tamoxifen
and danazol in the treatment of idiopathic gynecomastia. We reviewed the clinical
records of patients with idiopathic gynecomastia presenting to the Department of
Surgery, University of Hong Kong, between August 1990 and September 1995.
Medical treatment with either tamoxifen (20 mg/d) or danazol (400 mg/d) was offered
and continued until a static response was achieved. The treatment response was
compared. Sixty-eight patients with idiopathic gynecomastia were seen in the Breast
Clinic. The median age was 39.5 years (range, 13-82), with a median duration of
symptoms of 3 months (range, 1-90). The median size was 3 cm (range, 1-7).
Twenty-three patients were treated with tamoxifen and 20 with danazol. Complete
resolution of the gynecomastia was recorded in 18 patients (78.2%) treated with
tamoxifen, whereas only 8 patients (40%) in the danazol group had complete
resolution. Five patients, all from the tamoxifen group, developed recurrence of breast
mass. In conclusion, hormonal manipulation is effective in the treatment of patients
with idiopathic gynecomastia. Although the effect is more marked for tamoxifen
compared with danazol, the relapse rate is higher for tamoxifen. Further prospective
randomized studies would be useful in defining the role of these drugs in the
management of patients with idiopathic gynecomastia.
PMID: 10651345 [PubMed - indexed for MEDLINE]
J Urol 1998 Apr;159(4):1309
Tamoxifen as treatment for gynecomastia and mastodynia resulting
from hormonal deprivation.
Serels S, Melman A.
Department of Urology, Montefiore Medical Center, Bronx, New York, USA.
PMID: 9507867 [PubMed - indexed for MEDLINE]
South Med J 1990 Nov;83(11):1283-5
Tamoxifen therapy for painful idiopathic gynecomastia.
McDermott MT, Hofeldt FD, Kidd GS.
Department of Medicine, Fitzsimons Army Medical Center, Aurora, CO 80045-5001.
We have evaluated the efficacy of the antiestrogen tamoxifen in six men with painful
idiopathic gynecomastia. Subjects were given either tamoxifen or placebo for 2 to 4
months and then were given the other agent for an identical period. Breast size was
considered to have been reduced only if it had decreased by one or more Marshall-
Tanner stages during the treatment period. Pain reduction with tamoxifen therapy was
statistically significant for the group, occurring in five of six subjects during
tamoxifen treatment and in only one of six during the placebo period. Size reduction
with tamoxifen was only marginally significant for the entire group, but occurred in
all three subjects who were initially in Marshall-Tanner stage III and in none of the
three subjects who were initially in stage V. During tamoxifen treatment, there was a
significant increase in the serum levels of luteinizing hormone and total estradiol and
a marginally significant increment in the total testosterone level.
Publication Types:
? Clinical Trial
? Randomized Controlled Trial
PMID: 2237557 [PubMed - indexed for MEDLINE]
TAMOXIFEN AS TREATMENT FOR
GYNECOMASTIA AND MASTODYNIA
RESULTING FROM HORMONAL
DEPRIVATION
SCOTT SERELS; ARNOLD MELMAN
THE JOURNAL OF UROLOGY 1998; 159: 1309-1309
Klin Padiatr 1987 Nov-Dec;199(6):389-91
[Treatment of marked gynecomastia in puberty with tamoxifen]
[Article in German]
Konig R, Schonberger W, Neumann P, Benes P, Grimm W.
Kinderklinik, Universitat Mainz.
Based on the good results of another author 10 boys with marked pubertal
gynecomastia were treated with the antioestrogen Tamoxifen (Nolvadex) at a dose of
20-40 mg/d orally for 2-12 months. In most cases the gynecomastia decreased totally,
only two patients experienced palpable subareolar glandular tissue at the end of
therapy. Side effects were not noted. During therapy levels of estradiol and
testosteron increased, with a more pronounced elevation of estradiol. Basal values of
LH and FSH remained nearly unchanged, but LH showed an increased response to
LH-RH, which could be explained by the antioestrogenic effect of Tamoxifen at the
hypothalamic level. The reduction of breast size in spite of increased estradiol levels
on the other hand, suggests that the mean therapeutic effect of tamoxifen is through
estrogen receptor blockade of breast tissue.
PMID: 3123765 [PubMed - indexed for MEDLINE]
Metabolism 1986 Aug;35(8):705-8
Treatment of gynecomastia with tamoxifen: a double-blind crossover
study.
Parker LN, Gray DR, Lai MK, Levin ER.
Benign asymptomatic or painful enlargement of the male breast is a common
problem, postulated to be due to an increased estrogen/testosterone ration or due to
increased estrogenic or decreased androgenic stimulation via estrogen or androgen
receptor interactions. Treatment at present consists of analgesic medication or
surgery. However, treatment directed against the preponderance of estrogenic
stimulation would seem to represent a more specific form of therapy. In the present
double-blind crossover study, one-month courses of a placebo or the antiestrogen
tamoxifen (10 mg given orally bid) were compared in random order. Seven of ten
patients experienced a decrease in the size of their gynecomastia due to tamoxifen (P
less than 0.005). Overall, the decrease for gynecomastia for the whole group was
significant (P less than 0.01). There was no beneficial effect of placebo (P greater
than 0.1). Additionally, all four patients with painful gynecomastia experienced
symptomatic relief. There was no toxicity. The reduction of breast size was partial
and may indicate the need for a longer course of therapy. A followup examination
was performed in eight out of ten patients nine months to one year after discontinuing
placebo and tamoxifen. There were no significant changes from the end of the initial
study period except for one tamoxifen responder who developed a recurrence of
breast tenderness after six months, and one nonresponder who demonstrated an
increase in breast size and a new onset of tenderness after ten months. Therefore,
antiestrogenic treatment with tamoxifen may represent a safe and effective mode of
treatment for selected cases of cosmetically disturbing or painful gynecomastia.
Publication Types:
? Clinical Trial
? Randomized Controlled Trial
Dtsch Med Wochenschr 1984 Nov 2;109(44):1678-82
[Testosterone and estradiol levels in male gynecomastia. Clinical and
endocrine findings during treatment with tamoxifen]
[Article in German]
Eversmann T, Moito J, von Werder K.
Oestradiol-(E2) levels in serum were significantly higher in a group of 91 males with
gynaecomastia than in a control group. The levels were highest in patients with
testicular tumour, hyperprolactinaemia and idiopathic gynaecomastia. In
gynaecomastia of puberty and primary or secondary hypogonadism, the E2 level was
within normal limits, but the testosterone/oestradiol ratio was significantly reduced.
Tamoxifen, at a daily dose of 20 mg, was administered over 2-4 months to 16 patients
with gynaecomastia. Of twelve patients with painful gynaecomastia ten became
painfree. Gynaecomastia regressed partially or completely in 14 patients, in only 2
was it unchanged. There was no recurrence of gynaecomastia after discontinuing
tamoxifen. Side-effects did not occur. It is concluded that tamoxifen is a promising
alternative to the surgical treatment of gynaecomastia.
PMID: 6489180 [PubMed - indexed for MEDLINE]
Australas J Dermatol 2000 Feb;41(1):55
Reversible painful gynaecomastia induced by low dose finasteride (1
mg/day)
Wade MS, Sinclair RD.
Publication Types:
? Letter
PMID: 10715905 [PubMed - indexed for MEDLINE]
