Should You Try Tamoxifen for Gynecomastia?

Even when people have a strong desire to change their appearance, few rush immediately down to their local cosmetic surgeon. Whether the goal is rejuvenation or enhancement/reduction of some body part, many patients first consider whether there may be alternatives to going under the knife. Guys who ultimately consult us about man boobs are no exception.

One of the currently popular “surgery alternatives” some guys want to try for male breast reduction is tamoxifen, the drug given to some women at risk for breast cancer. Read on to find out what we know about this option, keeping in mind that this information is based on our experience and observations in these early days of tamoxifen use by men.

How Tamoxifen Works

The Susan G. Komen organization explains that tamoxifen and related medications—called SERMs, or selective estrogen receptor modulators—work for women susceptible to hormone receptor-positive tumors. The drugs attach to hormone receptors in the cancer cells, blocking them from receiving the estrogen they need to grow.
The theory for guys is similar. Since estrogen can prompt breast tissue growth for both men and women, and man boobs can be related to hormone swings, why not try a SERM to reduce man boobs?

What We Know About Tamoxifen and Gynecomastia

The problems with this theory seem to be at least two-fold. First, tamoxifen and other SERMs don’t reduce tissue once it has become established. That’s why oncologists don’t normally prescribe the drugs for breast tumors that already exist. Similarly, once breast gland has been present for a while for guys, tamoxifen will not be able to shrink it much if at all. Otherwise, everyone with man boobs would be taking the drug!

In addition, we find that nearly all our man boob patients who have seen an endocrinologist report that their estrogen levels are normal, not elevated. Therefore, blocking the effect of estrogen with medication serves no purpose.

All that said, there are a few studies that suggest tamoxifen and other SERMs may be effective for some cases of gynecomastia arising in puberty. To date, these studies tend to have limitations (small study group, no control group, etc.) Much more research is needed to know when and how to use these drugs safely.

Contraindications and Side Effects

When we talk with guys who are determined to try tamoxifen, or parents who are thinking of seeking the medication for their son, we urge them to find an experienced endocrinologist to work with. There are a few considerations to keep in mind. It’s important to know that though these types of drugs are FDA approved, they are not specifically approved to treat male breast enlargement. That means the FDA has not given the thumbs up for both safety and efficacy, and use for gynecomastia is considered “off label.”

There may be reasons not to try a SERM. Breastcancer.org notes that SSRIs such as Prozac and Wellbutrin may interfere with the medications, for example, as well as other common drugs such as Benadryl.
There are potential side effects to think over as well. According to breastcancer.org, these can include nausea, moodiness, fatigue, depression and other annoying conditions, as well as more serious effects such as blood clots and stroke.

Patient Frustrations

Along with our gynecomastia specialist colleagues on gynecomastia.org, where the question of tamoxifen and man boobs arises fairly often, we know just how vexing it can be for a teen or adult male to grow a pair of man boobs. And we understand that since they seem to grow spontaneously and randomly, it may appear that there should be a drug that can reduce them. Those of us who treat dozens or even hundreds of cases each year know it just isn’t so. Not yet, anyway. Read what three of us have to say about the topic here.

If and when the day comes that unwanted breast tissue can be banished with a pill, we’ll rejoice right along with the rest of the gynecomastia community, and with women with overly large breasts as well. For now, we are glad to offer one-and-done surgery for man boobs— the only way we know to get rid of gynecomastia for sure and forever. Give us a call at 561-367-9101 to find out more.