T Nation

Anyone Familiar with HIV Med Related Gynecomastia?

I have recently noticed a small amount of fat in the nipple area (along with small fibrous lumps which have been checked out and are just that), very odd on me cause I am in very good shape with a very low body fat.

(Never on steroids and my testosterone alway is in the med to high normal range) That being said I am on many things that are said to cause this, Sustiva (hiv med) propecia (hair loss med) xanax, antidepressant, sleeping pills.

I am wondering if anyone on here has had experiance with HIV med related gynecomastia and what their doctor did. I am not sure it causes the fat build up by the same means that low testosterone or high estrogen or steriod use would.

I did have my hormones checked and will soon know the results but I suspect it will likely be the medicines I am on as so many of them have potential to cause this. Sustiva and propecia are at the top of the list.

Also anecdotally does anyone think my use of Whey Protien (80 grams a day) or using Creatine might be a part of the problem. I have been on the above meds for years and years and only just now having this problem. The only thing thats really changed in the last year is my consumption of Whey and Creatine… although I realize its unlikely…

Thanks, Roscoe

Sounds like you have gyno. Sometimes people get this without drugs. If you want to get rid of it, you need surgery.

Excuse my ignorance, but would someone be taking HIV medication for any other reason than to prevent/treat symptoms of HIV?

Hiv Poz here thats why I am on them… No problems health is great but I am betting the hiv meds are causing my problems, or maybe the list of other gyneo inducing drugs I am on…lol

Sustiva (hiv med) has been known to cause the problem in a small amount of people. But so is the propecia I take to prevent hair loss (just from getting a little older)>

i would reccomend viewing the following link


seems that Sustiva does cause problems after a prolonged period of use, potentially a build up of the drug in the system, or a gradual alteration of adipose storage and endocrine functionality.

By the sounds of things from that article, it is an estriadol related cause as opposed to pro-lactin etc.

Obviously, talk to your doctor first and foremost, i would question him about the use of arimidex, an aromatose inhibitor which you could use a small amount of to prevent further aromotisation. I would also, maybe as a starting point, ask about letrozole femara, again another aromatose inhibitor, but a more aggressive drug, in many cases, letro has been seen to shrink exsisting gyno down to an unoticable size.

Obviously more research is needed on your part, and i think it is important that you find out how Sustiva is causing the gyno, i.e is it causing testosterone to aromatise and into which form of estrogen - these must be proven.
As said though, talk to your doc before attempting any self treatment as i lack muchos knowledge when it comes to how HIV effects standard hormone regulation.

Please keep us informed in this thread of your progress as this will be of interest to us all. Hopefully some of the guys with a med background will shout up.

[quote]roscoedog wrote:
Hiv Poz here thats why I am on them… No problems health is great but I am betting the hiv meds are causing my problems, or maybe the list of other gyneo inducing drugs I am on…lol
Sustiva (hiv med) has been known to cause the problem in a small amount of people. But so is the propecia I take to prevent hair loss (just from getting a little older)>[/quote]

I bet you are right - i have had a few friends/family etc with the disease and i have heard of such problems. The drugs are meant to be horrible, but the people i have met just take it in their stride.

I generally hate the human race as a whole, then i meet a few who make me forget that for a while…

Not that you are special by having HIV - it is just that i am in awe of people who live with the knowledge of that, and other such potentially life ruining news - and just deal. Human adaptation is something i marvel at occasionally, i like it when i get another chance to be proud of someone whether i know them or not.

Respect to you brother. You may have taken offence, as i am sure you have heard that BS a million times! If so i apologise, just talking here… :wink:


Thanks man for you kind words, yeap 20 years latter almost, and I am doing fine, and your right the meds have horrible side effects. I am actually healthier than most folks, never been sick with this thing, but the meds have had some bad side effects. Its helpful to meet someone who has heard of these side effects before, I am guessing its kinda rare.

I have been very surprised by the helpful people on this site, some really good folks on here.
Its kind funny, when I realized this was happening I am like, damn I am not on steroids but I am getting bitch tits almost!
Trying to stop it now before it becomes noticeable to others… wanna nip it in the bud now…lol.
Take care man, Thanks again!

Bit of an update about my medicine related GYNO.(and never on steriods of any kind here) And my hormone levels are all normal.

I got gyno (confirmed) from use of Sustiva (hiv med) and or Propecia/proscar. Finally got the doc to let me get a scrip of DHT from compounding pharmacy. We had seen a very small study that this helped in many cases, of course its the form of test that causes hair loss. WOO HOO!

Been on it almost three weeks and really no change cept maybe some hair loss. The plan “B” the doc talked about was Tamoxifen, but in reading about it I am not sure. I see it works in some cases but has a tendancy to return, well at least more than other drugs.

I am doing lots of reading on Arimidex/anastrozole and it looks the best way to go. Either that or Letrozole.

I have not had the Gyno that long, less than a year I guess, so hopefully most of it is not permanent. Of course I stopped the propecia back during Christmas but there was not effect. So its basically got to be the Sustiva.

This is a pretty new side effect from this med, not many docs that familiar with treating gyno from this. I read it likely causes the gyno messing up the Estrogen not the prolactin.
Just hoping to get some peoples thoughts and advice here… I am leaning so far to the Letrozole or the Arimidex. Thanks, Al

In some instances, side effects of finasteride do not show up until after years of use. I was doing some research thinking about getting on it for my hairloss and came across this site propeciahelp.com and am strongly reconsidering it now.

Yeap I even her rumors of it possibly contributing to male breast cancer (well gyno can anyway and propecia clearly can cause that) and its not the great fix for prostate problems like they thought. But it did help with my hair loss. Got a great head of hair now, but have been on rogaine and propecia/proscar for many years.

After stopping the proscar/propecia during last Christmas, the gyno did not improve and I still kept my hair. But I still use Rogaine and though its not studied to be of help for thinning in the front of your scalp I swear it really really helped in my case. So I do not know where your thinning is but I would recomend rogaine, just get the cheap store brand version.

Unfortunatly mine may get thin in the front due to the doc getting me DHT/andractim. I am gonna only give it a month, cause I really want to go with an Estrogen blocker or something like that. Hard to decide, nice head of hair and man boobs or balding…

One note though, I swear the gyno did not start till I had the doc switch me to Proscar instead of Propecia. Its supposed to be the same, you just cut the proscar into five pieces to get the right dose (so insurance would cover it).

However I wish I had never used proscar… When I did the propecia, the dose is one pill, 1mg I think and I cut them in half to lessen the sexual side effects, and it still worked for me.