Testosterone replacement therapy (TRT) in hypogonadal men has become more common as health care providers have become increasingly aware of andropause and the benefits of treatment. However, administration of exogenous testosterone can be associated with side effects that include effects on the prostate, hematocrit, fertility and the development of gynecomastia. Gynecomastia is believed to arise from peripheral conversion of testosterone to estradiol via the enzyme aromatase. The condition is embarrassing to men, and may cause discontinuation of testosterone treatment that has otherwise been successful.1
Classically, male gynecomastia has been treated with radiotherapy or surgical resection of the breast gland tissue.2 The introduction of a new generation of aromatase inhibitors has created an opportunity to treat testosterone-induced gynecomastia with oral medications alone.
We report here our experience with the use of an aromatase inhibitor, anastrozole, in the treatment of gynecomastia in hypogonadal men receiving testosterone supplementation.
