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Steroids and Gynecomastia on Steroids Rx.com

Gynecomastia is swelling of breast tissues. While this condition is seen in young boys and men, the cause is typically an imbalance of the two sex hormones- estrogen and testosterone. Other causes of gynecomastia include liver and kidney disease. However, in recent years, gynecomastia has also become an obvious finding in a few bodybuilders who use illicit drugs and anabolic steroids. These drugs either contain estrogen or are converted into the body into an estrogen.

Gynecomastia is not a medical disorder that is life threatening or something to be worried about. In men, gynecomastia is simply a cosmetic disorder and causes embarrassment.

The majority of individuals who take anabolic steroids do not develop breast enlargement. For those who do, the symptoms are minimal. Initially there are no symptoms but with time most individuals will notice the obvious breast swelling. Sometimes the breasts will be tender especially around the nipples. This tender feeling around the breasts for some unknown reason is not sexual but annoying.

The chief reason gynecomastia occurs in individuals who take anabolic steroids is that there is a relatively large amount of estrogen in the body. The estrogen has the ability to stimulate breast growth. Once a bodybuilder takes anabolic steroids, the breast enlargement will occur in a matter of months. Sometimes the breast growth will occur at the end of 9-12 months of continuous use of steroids. Other substances that can also increase breast growth are alcohol, amphetamines, marijuana, heroin and use of certain pharmaceutical drugs.

Medical disorders that can cause breast enlargement include cancers of the pituitary gland, testes or the failure of the liver and kidney or starvation.

Breast enlargement has no physical complication in males. The breast will never grow to the size seen in females, no matter how long the drugs are used. At most, the breast may grow into the size of a gold ball or slightly larger. The major complication of breast enlargement after use of anabolic steroids in men is psychological. Most men get embarrassed and are shy to take off their shirt.

Treatment

The treatment of breast enlargement which occurs after the use of anabolic steroids is to stop using the substance. The breast enlargement does decrease with time and in most cases can take anywhere from 3-6 months to completely subside. A few percentage of men, will have a residual dimple of a breast enlargement remaining even after the drugs have been stopped.

In a male who has breast enlargement after taking anabolic steroids a visit to the physician is not a priority. One should stop the steroids and observe what happens. Only if the breast enlargement remains after a period of 3-6 months, a visit to the physician is recommended. The diagnosis of breast enlargement is straight forward and only requires a physical exam. If the cause is anabolic steroids, then no great deal of work up is required. X rays, CT scans or MRI are not needed in individuals who have breast enlargement after taking anabolic steroids. Even a tissue biopsy is not required.

The majority of cases of gynecomastia resolve on their own if the offending agent is discontinued. While there are some physicians who always encourage some type of surgical intervention, this is the last choice of treatment. The first treatment of breast enlargement is always conservative. Only if the breast enlargement persists, should treatment be undertaken.

There are no medications that can be taken to reverse breast enlargement in males. Surgery is only undertaken if the cosmetic appearance is emotionally disturbing. If the breast enlargement is small and not problematic, it is best left alone. The two types of surgical procedures used to treat gynecomastia include:

Liposuction can be done to remove all the fat tissue but does not remove the fibrous material. Liposuction can be done under local anesthesia but most people prefer general anesthesia. It is a short procedure and has excellent cosmetic results. It is an outpatient treatment.
Mastectomy is also done to treat gynecomastia. Today various minimally invasive endoscopic procedures have been devised to remove the fat tissue. Again the results are decent.

As a final word, the treatment of gynecomastia after the use of anabolic steroids is conservative. Discontinuation of the drugs will lead to reversal of the breast enlargement. While physicians will push for surgery, this is the last choice and only after 6-9 months have elapsed after discontinuing the steroids. If the breast enlargement is not bothersome, simply leave it alone.

Remember both liposuction and mastectomy are cosmetic procedures and no insurance company will cover the cost of the procedure. So if you go to a physician who recommends surgery as a first choice, then you should always seek a second opinion or better still keep away from surgeon.

References

Bembo SA, Carlson HE. Gynecomastia: its features, and when and how to treat it.

Cleve Clin J Med. 2004 Jun; 71(6):511-7. Review.

Galbraith RA. Sexual side effects of drugs. Drug Ther (NY). 1991 Mar; 21(3):38-40, 45.

Nordt CA, DiVasta AD. Gynecomastia in adolescents. Curr Opin Pediatr. 2008 Aug; 20(4):375-82. Review.

 
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