Steroids and Gynecomastia: Some Thoughts

If a substance is a known cause of gynecomastia, or man boobs, you shouldn’t take it, right? Seems simple enough, but for some folks it’s not that easy. Certain heart medications can cause breast growth in men, for instance, but the health benefits of taking them outweighs that possible side effect for those with a life-threatening condition.

We have found that, for some of our male bodybuilder patients with gynecomastia, the motivation to try courses of steroids is almost as compelling. Honing and sculpting their body is a way of life for some—central to who they are. For many, it’s worth the risk of what they call “gyno” or “bitch tits” to achieve their goals. It’s our place to educate, not judge, so we offer some thoughts in that spirit.

How Do Steroids Cause Gyno?

Testosterone and a few other steroids popular with bodybuilders “aromatize,” or convert, to estrogen in the body. This triggers breast growth in some who use them. Other types of steroids can cause bitch tits by mimicking the effect of estrogen or progesterone. Suffice to say, the effect of steroid use is quite unpredictable. The exact same regimen can cause gyno for one guy and not another. In addition, a bodybuilder can embark on a course of steroids once without developing breasts, but not be so lucky the second time.

Can You Avoid Gyno While “Cycling?”

Many experienced bodybuilders maintain that gynecomastia can be avoided when steroid-using bodybuilders are vigilant. Forums and articles all over the Internet offer advice on how to “cycle,” or plan a course of steroid treatment, and not grow a set of moobs. One article in an online bodybuilding publication goes so far as to say there’s no excuse for someone using steroids to grow permanent breast tissue.

This online magazine, like many other articles and posts, recommends bodybuilders take a substance that will counteract the potential breast growth-triggering action of the particular steroid they plan to use. For some, that means tamoxifen (the drug best known for reducing the risk of breast cancer). For others, that means an anti-estrogenic steroid. The key, experienced bodybuilders say, is to educate yourself about the way various steroids work and incorporate a counteracting treatment into your regimen.

Is this approach effective? Undoubtedly it is for some guys. But here’s what American Family Physician has to say:
Anabolic steroid use often causes irreversible gynecomastia. The injection of exogenous testosterone inhibits natural production of testosterone, which cannot recover rapidly enough between steroid-injecting cycles to prevent estrogen predominance. Attempts to prevent gynecomastia with the use of concomitant tamoxifen or other aromatase inhibitors may result in irreversible adverse effects.

Our Thoughts on Steroids and Gyno

When bodybuilders with gynecomastia consult us, we can perform male breast reduction surgery to eliminate the problem. We have done so for hundreds of guys who pump iron regularly; see some before and after gynecomastia photos of bodybuilders here.

When we’re asked for our advice about taking steroids, it’s simple: we feel strongly that it’s not worth the risk. Taking testosterone over and above what the body produces naturally can cause the testes to shrink and lower libido, since the body senses it has enough of the hormone and cuts back. There can be other issues as well, such as the infamous “roid rage.”

Any physician will tell you that the body’s endocrine system is delicately balanced. Taking steroids that disrupt it is simply not a good idea, no matter how much self-education you might be willing to do and how much advice you may read from other bodybuilders. And we caution our bodybuilder patients with gynecomastia in Boca Raton: if you go back to using steroids after male breast reduction, you may be visiting us again.
If you’re a bodybuilder with questions about gynecomastia, fill out our short online form. We’ll get back to you as soon as we can.