Gynecomastia -- some info regarding T/E ratio & treatments

From emedicine.com/med/topic934.htm

Found the following bits interesting, maybe something we can somehow measure via bloodtests to see how far off we are after Finasteride usage:

Estrogen production in males is mainly from the peripheral conversion of androgens (testosterone and androstenedione) through the action of the enzyme aromatase, mainly in muscle, skin, and adipose tissue in the forms of estrone and estradiol.

The normal production ratio of testosterone to estrogen is approximately 100:1. The normal ratio of testosterone to estrogen in the circulation is approximately 300:1.


Treatments (more listed in the above link):

Clomiphene, an antiestrogen, can be administered on a trial basis at a dose of 50-100 mg per day for up to 6 months. 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 when used in doses of 10-20 mg twice a day. Up to 80% of patients report partial to complete resolution. Tamoxifen is typically used for 3 months before referral to a surgeon. Nausea and epigastric discomfort are the main adverse effects.

Danazol, a synthetic derivative of testosterone, inhibits pituitary secretion of LH and follicle-stimulating hormone (FSH), which decreases estrogen synthesis from the testicles. The dose used for gynecomastia is 200 mg twice a day. Complete resolution of breast enlargement has been reported in 23% of cases. Adverse effects include weight gain, acne, muscle cramps, fluid retention, nausea, and abnormal liver function test results.


Hypo, perhaps you can comment about your claim Danzol reduces SHBG? If Danazol inhibits LH/FSH as they state above, is this not a problem for us when it comes to blunting our Testosterone/sperm production?

Further, Table 1 shows an example of T/E ratios in young and old men, from a patent for the Aromatase Inhibitor “atamestane”:

freepatentsonline.com/5861389.html

I recommend Andractim for treating gynecomastia. It’s very effective. Arimidex is the number 1 drug when it comes to shifting the T/E ratio, but it’s very potent and hard to dose correctly. A very small amount each week, and contiunous blood work will be needed until the T/E ratio is stable.

Do we know of any research reporting T:E2 and DHT:E2 ratios in the same subject? Or DHT:E2 ratios in general? Not sure if we’ve found this info already.

After Fin I’ve been very reluctant to take drugs for cosmetic reasons. Its been about two years since Fin I believe (gotta check with my GP kinda lost track) so the window for chemical treatment is closing or might already be closed.

Has anyone had any side effects or even worse libido problems with these drugs?

I started forming gyno within a year of taking Propecia and have been seeking help ever since. Stopped the drug gradually but gyno hasn’t subsided. Had considered surgery but since my case is mild I would like to investigate less invasive options first. I have researched drugs previously but have heard conflicting viewpoints of whether they work on gyno (including tamoxifen, above), am concerned about further sides that may develop as a result of these, and am not sure how to obtain them in my country anyway. I have recently started trying a low-calorie diet (simply working out didn’t seem to do much) to see whether this does anything before further considering drugs or surgery. Of course, I could ignore it altogether, but acceptance of breasts for life isn’t something I can easily muster at my age.

A friend of mine had undergone a surgery for gynecomastia. The treatment was very effective.

Do you have any update on this man? How are you doing? Did you have fat accumulation around your midsection and hips?