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Expert Opinion on Drug Safety Volume 7, 2008 - Issue 6
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Review

Drug-induced gynecomastia

Ari Eckman Johns Hopkins University School of Medicine, 1830 E. Monument Street, Baltimore, MD 21287, USA +1 410 955 2130; +1 410 955 8172; [email protected]
, MD &
Adrian Dobs Johns Hopkins University School of Medicine, 1830 E. Monument Street, Baltimore, MD 21287, USA +1 410 955 2130; +1 410 955 8172; [email protected]
, MD MHS
Pages 691-702 | Published online: 04 Nov 2008
 
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Abstract

Gynecomastia is caused by drugs in 10 – 25% of all cases. The pathophysiologic mechanism for some drugs includes exogenous estrogens exposure, medications that cause hypogonadism, anti-androgenic effects and hyperprolactinemia. This manuscript reviews common examples of drug-induced gynecomastia, discussing the mechanisms and possible treatments. Discontinuing the medication is always the best choice; however, if this is not possible, then testosterone replacement therapy may be needed for hypogonadism. When a man is euogonadal, a trial of the anti-estrogen, tamoxifen or an aromatase inhibitor may be an option.

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