Original ArticleBeneficial effects of raloxifene and tamoxifen in the treatment of pubertal gynecomastia
Section snippets
Methods
A retrospective chart review was conducted of all patients with pubertal gynecomastia who presented to the Endocrinology Clinic at the Children's Hospital of Eastern Ontario between July 1995 and September 2000. Patients had been treated with either reassurance alone, tamoxifen 10 to 20 mg orally twice a day for 3 to 9 months, or raloxifene 60 mg orally once daily for 3 to 9 months. The choice of therapy was based on current clinical practice in the clinic with an increasing trend over time
Results
A total of 37 patients were assessed for gynecomastia, of whom 12 received no specific medical therapy. Eighteen patients were treated with tamoxifen and 10 with raloxifene. Three subjects treated with tamoxifen were excluded for lack of follow-up.
A baseline hormonal profile was normal in all treated patients including luteinizing hormone (LH), follicle-stimulating hormone, testosterone, and estradiol. Human chorionic gonadatropin and thyroid function tests, when measured, were also normal.
Discussion
Pubertal gynecomastia is defined as benign breast enlargement occurring during male puberty without evidence of endocrinopathy, underlying disease, or drug effect. Typically, it appears at least 6 months after male secondary sexual characteristics are seen and peaks at Tanner growth stage 3 to 4 of puberty. Prevalence studies have varied widely, ranging from a peak prevalence of 8.2% at 13 years of age8 to 64.6% of boys 14 years of age.1 In the latter study, the gynecomastia persisted for 2 or
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2022, Surgical Clinics of North AmericaCitation Excerpt :Offending medications and drugs should be discontinued when possible. For idiopathic and pubertal cases, selective estrogen receptor modulator (SERM) therapy with raloxifene and tamoxifen can be effective.18,25 SERM therapy can also be trialed in patients who have refractory gynecomastia in which the underlying cause has been treated.
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