Different Treatments Depending On The Type of Patient Gynecomastia

Depending on the age and other characteristics of the patient, different treatments are employed to address gynecomastia :

Teens:

• In most adolescents with gynecomastia observation and reassessment after 3-6 months is recommended, since most of the time it resolves spontaneously.
• Manifested in young with gynecomastia, where it has been found that there is indeed glandular tissue in the breast, and that are complexed by the severity of gynecomastia, can be used for three months as a SERM tamoxifen. It is not advisable to use raloxifene (lack of experience with this drug in patients as young).
• We do not recommend using aromatase inhibitors, since there seem to be effective.

Grown Ups:

• In most adult men with gynecomastia initially recommended observation and watchful waiting. Monitoring of patients presenting drug induced gynecomastia caused by a treatable underlying disorder (such as hypogonadism or hyperthyroidism) because once the trigger has been treated gynecomastia disappears is performed.
• In those men in whom the cause of gynecomastia is identified and this more than three months persists, we recommend starting treatment with a SERM for 3-6 months being the most used tamoxifen (there is little experience with raloxifene). Aromatase inhibitors are not very effective as the results of recent studies.
• In men with persistent gynecomastia (more than one or two years), where they involve a stigma and a complex, plastic surgery is recommended, because breast tissue after so long is because fibrotic and will not be responding to drugs.

Patients with prostate cancer:

• For prevention of gynecomastia in men with advanced prostate subjected to high doses of antiandrogen monotherapy cancer treatment is recommended tamoxifen to reduce the risk of developing gynecomastia. Radiation may be performed prophylactically to prevent the occurrence of gynecomastia in some cases.
• The use of aromatase inhibitors for the prevention of gynecomastia is not recommended, as they seem not to be effective.
• In those men who have already developed gynecomastia treatment with antiandrogens, we recommend therapy with tamoxifen.