T Nation

Nolvadex and natural gyno...

First I’m not sure if it’s gyno or fat since I’ve got a quite high BF%, plus i’ve never take any steroids or prohormones. But if it’s a natural case of gyno, will nolvadex get me rid of it ? Is surgery the only option…? Any input would be greatly appreciated.

i also have natural gyno and i’ll post some pics on my thread in the photo forum since someone asked about it. for me its mostly just puffy nipples and nothing i’ve tried has helped, so i am also considering using nolva to try to end this problem

xome,

There have been studies that show it works, and just as many if not more that show it doesnt.

In short if you have the extra cash it would be worth a try if you are that worried about it.

Really, from what I gather. The only tried and true method though is surgery.

I will try and find the studies I speak of for a little reference. Been a while though so no promisses.

Phill

Phill

Another option to try might be

Found one of the studies. It’s a little long but here you go.

[quote]British Medical Journal August 9, 2003 v327 i7410 p301(2)

Endocrine treatment of physiological gynaecomastia: tamoxifen seems to be effective. (Editorials) Khan, Hamed N; Blamey, RW 

Full Text: COPYRIGHT 2003 British Medical Association

Gynecomastia is a common condition among normal healthy men of varying ages. Tenderness may be one of its symptoms, but the usual reason for presentation is that young men don’t like having breasts and older men are worried about the possibility of cancer. Diagnosis is primarily by clinical examination and where necessary ultrasound and needle biopsy. Traditional methods of management of gynaecomastia have included simple analgesia for pain, and surgery. The most common reason for the patient to request surgery is cosmetic. However, although surgery in experienced hands is safe and effective, with minimal stay in hospital, the cosmetic results cannot always be guaranteed–noticeable scars, permanent pigment changes in the breast area, and mismatched breasts or nipples have been reported (1) An uncommon but particularly ugly effect is tether of the subareolar area to the chest wall. These possible complications are balanced by the immediate therapeutic effect of surgery on gynaecomastia, especially in adolescents, for whom any form of prolonged treatment may not be appropriate.

At our hospital we recognise two forms of gynaecomastia; “lump” and “fatty” types. The former is a single firm retro-areolar lump, often tender, whereas the latter is a diffuse fatty lesion in the whole breast area. Adolescents usually have the lump form, and elderly people often have the fatty type.

Most cases of gynaecomastia have no known cause, especially in patients presenting in adolescence. Gynaecomastia secondary to underlying pathologies such as testicular tumours (very rare), liver dysfunction, or to a broad spectrum of drugs (notably oestrogens, cimetidine, and spironolactone) tends to be bilateral (by no means always) and is of the more diffuse fatty type. (2)

Primary breast cancer, although rare, is an important differential diagnosis. It usually presents as a lump–not centrally placed–and in male patients often shows skin tether. Ultrasound examination and core biopsies confirm the diagnosis. (3)

An altered ratio between serum free oestradiol (which stimulates mammary epithelium) and testosterone (which inhibits it) is believed to underlie the pathophysiology of physiological gynaecomastia (2) Antioestrogens such as tamoxifen have therefore been suggested in the non-surgical treatment of this condition. Other suggested endocrine treatments have included clomiphene (4) and danazol, (5) both given for one to three months. Clomiphene is a non-steroidal agent with a weak oestrogenic activity. It acts on the hypothalamic-pituitary axis to increase gonadotrophin releasing hormone and therefore luteinising hormone releasing hormone and follicle stimulating hormone release. Its efficacy as a satisfactory medical treatment for gynaecomastia has not been proved. Danazol inhibits the production of oestrogen by suppressing the pituitary-ovarian axis due to the inhibition of the output of both follicle stimulating hormone and luteinising hormone from the pituitary gland. It also has androgenic side effects. It has proved effective in the management of gynaecomastia compared with placebo, (5) but adverse effects such as weight gain limit its application in general use.

The use of tamoxifen for gynaecomastia has been studied previously in several centres. The table shows the various published studies on the use and efficacy of tamoxifen for physiological gynaecomastia in the English literature. (6-9) Only two of these studies (6 9) have more than 10 patients and both showed resolution of lump and pain in 80% of cases. A recent study from our own unit in 36 cases confirms this figure (83% resolution of lump) (10) Ting et al also found tamoxifen to be more efficacious than danazol. (6) Importantly only minor and reversible side effects were reported. This confirms findings that tamoxifen used in male breast cancer appears to have no serious side effects. (11) Tamoxifen appears to be successful, safe, and avoids operation and on present evidence should be regarded as the first line treatment of gynecomastia.
Previous studies of tamoxifen on physiological gynaecomastia Tamoxifen dose

Tamoxifen
{dose-daily in mg} [Duration in months] -Total # of patients-
No of Successfull treatments to total patients #/#
(Percentage of Success)

Ting (6) – {20} [3] -23- Lump: 18/23 (78)
Pain: 19/23 (82)

Parker (7) – {10} [2] -10- Lump: 7/10 (70)
Pain: 4/4 (100)

McDermott (8) – {20} [2-4] -6- Lump: 3/6 (50)
Pain: 5/8 (83)

Alagaratnam (9) – {40} [2] -61- Lump: 49/61 (80)
Pain: 49/61 (80)

Hamed N Khan clinical research fellow

RW Blarney emeritus professor of surgery

Nottingham City Hospital, Nottingham NG5 1PB

Competing interests: None declared.

(1) McGrath MH, Mukerji S. Plastic surgery and the teenage patient. J Pediatr Adolesc Gynecol 2000;13 :105-18.

(2) Carlson HE. Gynecomastia. N Engl J Med 1980;303:795-9.

(3) Yang WT, Whitman GJ, Yuen EH, Tse GM, Stelling CB. Sonographic features of primary breast cancer in men. Am J Roentgenol 2001;176:413-6.

(4) Plourde PV, Kulin HE, Santner SJ. Clomiphene in the treatment of adolescent gynecomastia. Clinical and endocrine studies. Am J Dis Child 1983;137:1080-2.

(5) Jones DJ, Holt SD, Surtees P, Davison DJ, Coptcoat MJ. A comparison of danazol and placebo in the treatment of adult idiopathic gynecomastia: results of a prospective study in 55 patients. Ann R Coil Surg Engl 1990;72:296-8.

(6) Ting AC, Chow LW, Leung YF. Comparison of tamoxifen with danazol in the management of idiopathic gynecomastia. Am Surg 2000;66:38-40.

(7) Parker LN, Gray DR, Lai MK, Levin ER. Treatment of gynecomastia with tamoxifen: a double-blind crossover study. Metabolism. 1986;35:705-8.

(8) McDermott MT, Hofeldt FD, Kidd GS. Tamoxifen therapy for painful idiopathic gynecomastia. South Med J 1990;83:1283-5.

(9) Alagaratnam TE. Idiopathic gynecomastia treated with tamoxifen: a preliminary report. Clin Ther 1987;9:483-7.

(10) Khan HN, Rampaul R, Blamey RW. The use of tamoxifen for gynaecomastia at Nottingham Breast Unit. Br J Surg 2003; 90(s1):100.

(11) Ribeiro G, Swindell R. Adjuvant tamoxifen for male breast cancer (MBC). Br J Cancer 1992;65:252-4.

Document Number: A106865067
Last edited by Jimmy_4 : 04-11-2004 at 11:54 AM.
[/quote]

In short, the success went up with a raise in dose in general. With one exception.

20mg ED for 3months = 78% success
10mg ED for 2months = 70% " "
8mg ED for 2-4months = 50% “”
9mg ED for 2months = 80% “”

Hope that helps,
Phill

so taking nolva without steroids, won’t harm anything?

reggc, actually you normally dont take it with steroids anyway, unless you start to get signs of gyno. You take it after to recover.

Try reading T-man vs. E-man article from way back. It will explain a lot about various suups of this type. Not only their use as PCT but also for raising test and controll of est.

Hope that helps.
Phill