Drug-induced gynecomastia

Area of Science:

• Endocrinology
• Pharmacology
• Men's Health

Background:

• Gynecomastia, a condition of abnormal breast enlargement in males, has multifactorial causes.
• Drugs are implicated in approximately 20% of gynecomastia cases.
• Altered estrogen:androgen ratios and various pathophysiologic mechanisms underlie drug-induced gynecomastia.

Purpose of the Study:

• To review the existing literature on drug-induced gynecomastia.
• To offer a novel perspective by analyzing data from the FDA's Adverse Event Reporting System.
• To identify common and rare drug culprits associated with gynecomastia.

Main Methods:

• Comprehensive literature review on drug-induced gynecomastia.
• Analysis of the United States Food and Drug Administration's Adverse Event Reporting System (FAERS) data.
• Identification and categorization of drugs associated with gynecomastia.

Main Results:

• Antiandrogens, protease inhibitors, and nucleoside reverse transcriptase inhibitors are primary drug causes.
• Less common causes include first-generation antipsychotics, spironolactone, verapamil, and cimetidine.
• Various other medications have been rarely reported as causative agents.

Conclusions:

• Drug-induced gynecomastia is a significant clinical concern.
• Management may involve drug substitution, surgery, or irradiation.
• Further epidemiologic studies are required to accurately determine the incidence of drug-induced gynecomastia.