What Is The Treatment For Gynecomastia?
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Your doctor must treat the underlying reason for your gynecomastia. For example, you may require cancer chemotherapy or radioactive iodine for goiter. Expect to make lifestyle changes, like stopping anabolic steroids or marijuana use. You will likely need tamoxifen to combat your estrogen increase, or testolactone to inhibit your testosterone from being converted to estrogen, but these drugs alone will not cure it. If you have low self-esteem because of poor body image, psychotherapy and group
If you or your son have a genetic disorder, have been castrated, or the testicles have failed, then you will require testosterone replacement therapy (TRT).
When your son is 11 or 12 years old, the doctor will commence testosterone supplementation. Testosterone treatment options include injections, gels and scrotal cream. Common testosterone injections options include:
| DRUG NAME | TRADE NAME |
|---|---|
| Testosterone enanthate | Delatestryl® Primoteston® Depot |
| Testosterone esters | Sustanon® |
| Testosterone cyprionate | Depo-Testosterone |
| Testosterone undeconate (slow release) | Reandron®, Nebido® Not available in the USA |
Testosterone injection treatment (using short-acting injections) usually begins with a 50 mg dose on a monthly basis.
In teenagers the doctor will closely monitor your son’s growth and the development of male secondary sex characteristics. Your son will need to have blood drawn to check his gonadotropin hormone levels.
In years past, adult males with Klinefelter syndrome and other genetic disorders that produce testosterone deficiency visited the doctor every two or three weeks to receive an intramuscular injection of 200 to 250 milligrams of testosterone enanthate, esters or cyprionate or at 6-monthly intervals for 600 to 1,000 milligrams testosterone implants.
More recently, testosterone gels (AndroGel®, Testogel® and Testim®) and testosterone creams (AndroForte® 2% and AndroForte® 5%) have allowed patients to self-administer their testosterone requirements. Testosterone gels are applied to the abdomen, chest, shoulders and arms. Because testosterone gels are alcohol-based they cannot be applied scrotally, due to the sensitivity of scrotal skin.
AndroForte® 2% and AndroForte® 5% scrotal testosterone creams are the most recent and user friendly advance in testosterone administration. Scrotal skin is significantly more receptive to testosterone absorption due to its high blood flow, thin skin and low fat content. Testosterone cream applied to the scrotum achieves significantly higher testosterone blood levels than the equivalent amount of testosterone applied to other areas of the body. This represents significant cost savings to patients.
Unlike intramuscular injections and implants, the cream is painless. The daily dose you receive with cream is even. Injections produce uneven testosterone blood levels because they wear off and have to be replenished every 7 to 22 days.
Testosterone production increases when a boy enters puberty. Testosterone production decreases when a man turns 50. A good testosterone target range for an adult Klinefelter man to maintain is 300 to 1,000 nanograms per deciliter (ng/dl) of blood serum (or 10.5 to 35 nmol/L). Applying 1 gram (50 mg testosterone) of AndroForte® 5% natural testosterone cream every night to your scrotum will help maintain this target range. Allow the cream to absorb into the skin before dressing. Wash your hands well with soapy water after use.