Definition
"Gynecomastia" is defined as an abnormal development of breast tissue in the male, the result of an "alteration in the synthesis of estrogen and testosterone hormones; in general, gynecomastia occurs in the child (pubertal variant) and in the" elderly. Although it should not be considered a serious pathology, gynecomastia can cause serious psychological disturbances to the subject, who feels different from others, and embarrassed.
Causes
In most cases, the cause of gynecomastia lies in hormonal abnormalities: the drop in serum testosterone levels and the increase in estrogen can increase the volume of one or both breasts. Beyond hormonal factors, gynecomastia can be affected. heavily also from the administration of some drugs: anabolics, drugs against AIDS, anti-androgens, anxiolytics (eg Diazepam), antibiotics, anti-ulcers, chemotherapy and digoxin.
- Risk factors: alcohol abuse, amphetamines, heroin, methadone, hypogonadism, old age, testicular cancer, kidney failure, malnutrition.
Symptoms
Gynecomastia occurs with noticeable swelling of the breasts, associated with pain and milky secretion from one or both nipples. To the touch, the abnormal breasts are rather flaccid and obviously swollen.
- N.B. false gynecomastia occurs when the increase in breast volume depends exclusively on localized lipid accumulation, in the absence of a hormonal alteration or the administration of certain pharmacological specialties.
The information on Gynecomastia - Drugs for the Treatment of Gynecomastia is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Gynecomastia - Gynecomastia Treatment Drugs.
Medicines
Numerous cases of gynecomastia regress on their own, without the need to intervene with drugs or surgical treatments; however, should the condition be generated by a specific underlying cause - such as hypogonadism, malnutrition or cirrhosis - it is recommended to intervene promptly on the cause of origin. In the event that the gynecomastia is due to the administration of medicines, it will be the duty of the doctor intervene by modifying the treatment with a similar pharmacological substitute.
Normally, pubertal gynecomastia that occurs without any obvious cause is not treated with drugs: in fact, the child is subjected to periodic clinical checks, very useful for monitoring the progression or regression of the disease. It is good to remember, in fact, that gynecomastia independent of pathologies or drugs tends to self-resolve within a few months or a few years (max. 2) from its onset.
Pharmacological or surgical treatment is necessary both when the condition does not regress over time (within two years of its onset), and when gynecomastia causes excessive pain or embarrassment.
Among the most used surgical treatments, we mention:
- Liposuction under local anesthesia
- Removal of the mammary gland (mastectomy)
The regression of gynecomastia can only occur in puberty: adult men and the elderly who manifest this disorder will have to undergo pharmacological or surgical interventions for the regression of the condition.
The following are the classes of drugs most used in the therapy for gynecomastia, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:
The drugs used for the treatment of gynecomastia not dependent on secondary pathologies and not spontaneously reversible, are currently few: however, it seems that a treatment with tamoxifen and raloxifene - chemotherapy drugs with antiestrogenic activity used for the treatment of breast cancer - can, in some way, also alleviate the symptoms of gynecomastia. Although other drugs have been approved by the Food and Drug Administration, their therapeutic effect does not appear to be particularly beneficial for reversing the disease. Sometimes, anastrozole is also used. Let's analyze them in more detail:
- Tamoxifen (eg Nolvadex): the drug exerts its therapeutic action by interacting with the estrogen receptor: we briefly recall that the serum levels of testosterone in patients suffering from gynecomastia are low, to the advantage of those of estrogens. Precisely to prevent the link between the receptor and estrogen, this drug is used in therapy for the treatment of gynecomastia (the active principle, by binding with the estrogen receptor, prevents the latter from carrying out its activity). it is available in tablets of 10 or 20 mg; the dosage and duration of treatment must be established by the doctor.
- Raloxifene (eg Evista): the drug can be used for the treatment of pubertal gynecomastia, where the condition has persisted for more than 2 years. Continue therapy with this drug for 3-9 months, depending on the severity of the condition. It is a drug belonging to the class of selective estrogen receptor modulators (SERM); this drug appears to exert a better therapeutic effect in relieving the signs and symptoms that characterize gynecomastia. For the posology: consult your doctor (drug generally available in 60 mg tablets).
- Anastrozole (eg Arimidex): it is an aromatase inhibitor, an enzyme involved in the conversion of testosterone (the male sex hormone par excellence) into estradiol (the most important human estrogen of all). Starting from this assumption, the drug is also used for the treatment of ailments such as gynecomastia, precisely because it prevents the side effects associated with the overproduction of estrogen. For the posology: consult your doctor.
Correction of eating habits is essential when gynecomastia depends on an accumulation of lipids in the breast tissue: localized fat and muscle relaxation are, in this case, the predisposing elements; therefore it is recommended to follow a low-calorie diet, consume a lot of fiber, limit the consumption of meat and practice constant physical exercise, especially aimed at muscle toning.
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