With the administration of clomiphene, an antiestrogen,
approximately 50% of patients achieve partial reduction in breast size,
and approximately 20% of patients note complete resolution. Adverse
effects, while rare, include visual problems, rash, and nausea.
Tamoxifen, an estrogen antagonist, is effective for recent-onset and
tender gynecomastia. Up to 80% of patients report partial to
complete resolution. Nausea and epigastric discomfort are the main
adverse effects.
Other drugs used, albeit less frequently, include danazol. Danazol,
a synthetic derivative of
testosterone, inhibits pituitary secretion of
LH and follicle-stimulating hormone (
FSH), which decreases estrogen
synthesis from the testicles.
Breast Surgery
Reduction mammoplasty is considered for patients with macromastia
or long-standing gynecomastia or in persons in whom medical
therapy has failed. It is also considered for cosmetic reasons (and
for accompanying psychosocial reasons).
More extensive plastic surgery may be required in patients with
marked gynecomastia or who have developed excessive sagging of
the breast tissue due to weight loss. If surgery is necessary for
patients with pseudogynecomastia, liposuction may be warranted...consult plastic surgeon they will help you