Studies on the Treatment of Idiopathic Gynaecomastia With Percutaneous Dihydrotestosterone

Abstract

We have studied clinical and endocrine parameters in a group (group A) of forth men referred to us because of persistent idiopathic gynaecomastia (of more than 18 months duration), before and during the administration of percutaneous dihydrotestosterone (DHT). The endocrine parameters (testosterone (T), 17 beta-oestradiol (E2), DHT, gonadotrophins (FSH and LH) and prolactin (PRL), were compared to those of control groups of 12 healthy men on DHT therapy (group B) and 10 on placebo (group C). Local administration of DHT was followed by the complete disappearance of gynaecomastia in 10 patients, partial regression in 19 and no change in 11 patients after 4 to 20 weeks of percutaneous DHT (125 mg twice daily). Before treatment the T + DHT/E2 ratio was significantly (P less than 0.001) lower in group A 244 +/- 21 (SEM) than in groups B and C (361 +/- 21) while T, DHT and E2 concentrations were all within the normal range. During DHT treatment plasma hormone levels were measured in 26 patients from group A: DHT levels increases significantly (day 0: 1.63 +/- 0.14 nmol/l; day 15: 12.8 +/- 1.6 nmol/l, P less than 0.001) while T and E2 levels fell significantly (T: day 0: 22.6 +/- 1.2 nmol/l; day 15: 11.0 +/- 1.5 nmol/l, P less than 0.001; E2: day 0: 110.5 +/- 7.12 pmol/l; day 15: 86.79 +/- 9.4 pmol/l, P less than 0.01). The T/E2 ratio decreased from 231 +/- 20 to 164 +/- 27 (P less than 0.05) while the T + DHT/E2 ratio increased significantly (P less than 0.02) to a normal mean value (day 15: 354 +/- 57).(ABSTRACT TRUNCATED AT 250 WORDS)

Gynecomastia: Pathomechanisms and Treatment Strategies

“…Testosterone therapy has yielded disappointing results, possibly because of its peripheral aromatization to estro gen. Nonaromatizable dihydrotestosterone has shown some benefit w'hen given either intramuscularly or percutaneously. In one study [34], 75% of the patients treated with dihvdrotestosterone saw some improvement in re duction of breast volume, and 25% had a complete response, with minimal side effects. Danazol has been tried as well, however, undesirable side effects such as edema, acne, cramps, and weight gain may limit its use.…”

Percutaneous dihydrotestosterone (DHT) treatment

“…In one study conducted for 18 months in 40 men with idiopathic gynecomastia, twice daily application of 125 mg of percutaneous DHT resulted in complete disappearance of gynecomastia in 10 patients, partial regression in 19 and no change in 11 patients after 4 to 20 weeks (Kuhn et al 1983). Thus, the conclusion was that chronic percutaneous DHT administration was an efficient treatment for persistent idiopathic gynecomastia since it caused a reduction in 29 out of 40 cases.…”

Déficit androgénique lié à l’âge. Que faut-il attendre de l’androgénothérapie?

“…La r6duction de la masse grasse et cons~cutivement du potentiel tissulaire d'aromatisation des androg6nes est un premier facteur de traitement de la gyn6comastie. Le renforcement de I'influence androg6nique apport~ par la substitution en est un deuxieme surtout si I'androg~ne utilis6 est la dihydrotestosterone [27].…”