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ismaele00 escribió:El Letrozole dicen que ha ayudado en algunos casos, es un potentísimo inhibidor de la aromatasa, y se desconoce el motivo, pero se han reportado casos (en http://www.steroid.com y en http://www.elitefitness.com) de mejora.

Ahora bien, quizás esa mejora fuese únicamente por el hecho de que se cortó la cantidad de estrógenos, no lo sé. Si te interesa, puedes buscar "ginecomastia" en ambos foros, y te saldrán los posts que te cito.

Saludos.

PlastiKe escribió:Buenas leyendo dicen que en 1 mes tiene ke remitir asi

1 semana: 80mg tamoxifeno
2 semana:; 60mg
3 semana: 40mg
4 semana: 20mg hasta que remita casi totalmente

De todas formas creo ke es mucha caña 80mg pero igualmente

tomo los 80MG antes de acostarme o lo reparto en 2 tomas al dia? como lo ven? un saludo y gracias


PD: El año pasao cuando me salio en una teta la gyne, si ke me dolia tela y con bultito pero esta vez no me duelen ni tengo bultito pero vamos se de sobra que es ginecomastia por la forma.

PD2: Es posible que sea por algun nivel bajo de testo o prolactina o algo asimilar? muchas gracias

MEDICAL TREATMENT
If the gynecomastia is severe, does not resolve, and does not have a treatable underlying cause, some medical therapies may be attempted.

There are 3 classes of medical treatment for gynecomastia: androgens (testosterone, dihydrotestosterone, danazol), anti-estrogens (clomiphene citrate, tamoxifen) and aromatase inhibitors such as testolactone.

Testosterone treatment of hypogonadal men with gynecomastia often fails to produce breast regression once gynecomastia is established. Unfortunately, testosterone treatment may actually produce the side effect of gynecomastia by being aromatized to estradiol. Thus, although testosterone is used to treat hypogonadism, its use to specifically counteract gynecomastia is limited.

Dihydrotestosterone, a non-aromatizable androgen, has been used in patients with prolonged pubertal gynecomastia with good response rates. Since dihydrotestosterone is given either intramuscularly or percutaneously, this may restrict its usefulness.

Danazol, a weak androgen that inhibits gonadotropin secretion, resulting in decreased serum testosterone levels, has been studied in a prospective placebo-controlled trial, whereby gynecomastia resolved in 23 percent of the patients, as opposed to 12 percent of the patients on placebo. Unfortunately, undesirable side effects including edema, acne, and cramps have limited its use.

Investigators have reported a 64 percent response rate with 100 mg/day of clomiphene citrate, a weak estrogen and moderate antiestrogen. Lower doses of clomiphene have shown varied results, indicating that higher doses may need to be administered, if clomiphene is to be attempted.

Tamoxifen, also an antiestrogen, has been studied in 2 randomized, double-blind studies in which a statistically significant regression in breast size was achieved, although complete regression was not documented.

One study compared tamoxifen with danazol in the treatment of gynecomastia. Although patients taking tamoxifen had a greater response with complete resolution in 78 percent of patients treated with tamoxifen, as compared to only a 40 percent response in the danazol-treated group, the relapse rate was higher for the tamoxifen group.

Although complete breast regression may not be achieved and a chance of recurrence exists with therapy, tamoxifen, due to relatively lower side effect profile, may be a more reasonable choice when compared to the other therapies. If used, tamoxifen should be given at a dose of 10 mg twice a day for at least 3 months.

An aromatase inhibitor, testolactone, has also been studied in an uncontrolled trial with promising effects. Further studies must be performed on this drug before any recommendations can be established on its usefulness in the treatment of gynecomastia.

Newer aromatase inhibitors such as anastrozole and letrozole may have therapeutic potential but no study has been published to confirm its efficacy in treatment of gynecomastia.

SURGICAL TREATMENT
When medical therapy is ineffective, particularly in cases of longstanding gynecomastia, or when the gynecomastia interferes with the patient's activities of daily living, or when there is suspicion of malignancy of breast, then surgical therapy is appropriate. This includes removal of glandular tissue coupled with liposuction, if needed. In our experience, uses of delicate cosmetic surgical techniques are warranted to prevent unsightly scarring.

* Generally, no treatment is required for physiologic gynecomastia.
* A major factor that should influence the initial choice of therapy is the duration of gynecomastia. It is unlikely that any medical therapy will result in significant regression in the late fibrotic stage (a duration of 12 mo or longer). As a result, medical therapies, if used, should be tried early in the condition's course.
* Pubertal gynecomastia resolves spontaneously within several weeks to 3 years in approximately 90% of patients. Breasts greater than 4 cm in diameter may not completely regress.
* Identifying and managing an underlying primary disorder often alleviates breast enlargement.
* If hypogonadism (primary or secondary) is the cause of gynecomastia, parenteral or transdermal testosterone replacement therapy is instituted. However, testosterone does have the potential to exacerbate gynecomastia through the aromatization of the exogenous hormone into estradiol.
* For patients with idiopathic gynecomastia or with residual gynecomastia after treatment of the primary cause, medical or surgical treatment may be considered.
* Clomiphene,10 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.11
* Other drugs used less frequently include danazol and testolactone.12

o 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.

o Testolactone, a peripheral aromatase inhibitor, has been used with varying success rates in doses of 150 mg 3 times per day for 6 months. Nausea, vomiting, edema, and worsening of hypertension have been reported with its use.