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Checking for gyno - good illustration


#1

Just found this, not sure if this was posted before.

Something to keep in mind if you have been on Propecia, Proscar, Avodart etc for an extended period of time.

Physical examination method to distinguish gynecomastia, due to enlargement of the glandular tissue, from pseudogynecomastia, due to excessive adipose tissue. The thumb and forefinger are placed on opposite sides of the breast and slowly brought together towards the areolar-nipple complex. Gynecomastia is appreciated as a concentric, rubbery-to-firm disk of tissue, often mobile, located directly beneath the areolar area. Pseudogynecomastia presents no discrete mass, and other masses due to disorders such as cancer tend to be eccentrically positioned. Adapted from Braunstein, GD, Hosp Pract 1993; 28:37.


#2

Copied from:

Antiandrogens/inhibitors of androgen synthesis
Cyproterone acetate
Flutamide
Finasteride

Antibiotics
Ethionamide
Isoniazid
Ketoconazole
Metronidazole

Antiulcer drugs
Cimetidine
Ranitidine
Omprazole

Cancer chemotherapeutic drugs
Alkylating agents
Methotrexate
Vinca alkaloids
Combination chemotherapy
Imatinib

Cardiovascular drugs
Amiodarone
Captopril
Digitoxin
Diltiazem
Enalapril
Methyldopa
Nifedipine
Reserpine
Spironolactone
Verapamil

Drugs of abuse
Alcohol
Amphetamines
Heroin
Marijuana
Methadone

Hormones
Androgens
Anabolic steroids
Chorionic gonadotropin
Estrogens
Growth hormone

Psychoactive drugs
Diazepam
Haloperidol
Phenothiazines
Tricyclic antidepressants

Other
Auranofin
Diethylproprion
Domperidone
Etretinate
Metoclopramide
Phenytoin
Penicillamine
Sulindac
Theophylline


#3

Excerpt from: http://patients.uptodate.com/topic.asp?file=r_endo_m/6642

PREVENTION OF DRUG-INDUCED GYNECOMASTIA — The simplest method to prevent gynecomastia is to avoid those drugs that cause gynecomastia… Gynecomastia will occur in almost every male who takes a large dose of spironolactone (100 mg/day), and in over 50 percent of those receiving estrogens or antiandrogens for advanced prostate cancer.

Even drugs within the same class do not all cause gynecomastia to the same extent. Among the calcium channel blockers, as an example, nifedipine has the highest frequency of gynecomastia and diltiazem the lowest [1,2]. Thus, in an older man who is at increased risk of gynecomastia simply on the basis of age, diltiazem would be preferable to nifedipine. Another example is the use of H2-receptor or parietal cell proton-pump blockers; the incidence of gynecomastia is highest with cimetidine and then ranitidine, and is lowest with omeprazole[3]. Thus, omeprazole would be a better choice in an older individual with other risk factors for developing gynecomastia. In addition, among the aldosterone antagonists, the frequency of gynecomastia is highest with spironolactone, but much lower with epleronone, a more selective aldosterone antagonist.

Options for treatment of gynecomastia are presented here. The special case of hormone therapy-associated gynecomastia in men with prostate cancer is discussed separately ().

DETERMINANTS OF THERAPY — A major factor that should influence the initial choice of therapy is the duration of gynecomastia. Histologic studies show that the glandular changes in the breast are the same with all inciting causes, and the extent of glandular proliferation depends upon the intensity and duration of the stimulation. The histologic picture changes over time.

Initially, there is extensive ductal epithelial hyperplasia, proliferation and lengthening of the ducts, an increase in the stromal and periductal connective tissue, and proliferation of periductal inflammatory cells. There is also extensive periductal edema and stromal fibroblastic proliferation. This is the early or florid stage of gynecomastia and generally is present for the first six months after onset (show histology 1A-1B) [4-7].
After twelve or more months, the breast tissue evolves into the late or quiescent stage. At this time, there is a slight increase in the number of ducts, with marked dilatation of the ducts and little or no epithelial cell proliferation. There is also an increase in the amount of stroma, stromal fibrosis and a disappearance of the inflammatory reaction (show histology 1A-1B).

It is unlikely that any medical therapy will result in significant regression in the late fibrotic stage. As a result, medical therapies, if used, should be tried early in the course.


#4

Ketoconazole ? Isn’t that the activ ingredient in Nizoral shampoo? Should I be worried? I ve been using Nizoral for many years, and lately I added Avodart too.


#5

» Just found this, not sure if this was posted before.
»
» Something to keep in mind if you have been on Propecia, Proscar, Avodart
» etc for an extended period of time.
»
» Physical examination method to distinguish gynecomastia, due to
» enlargement of the glandular tissue, from pseudogynecomastia, due to
» excessive adipose tissue. The thumb and forefinger are placed on opposite
» sides of the breast and slowly brought together towards the areolar-nipple
» complex. Gynecomastia is appreciated as a concentric, rubbery-to-firm disk
» of tissue, often mobile, located directly beneath the areolar area.
» Pseudogynecomastia presents no discrete mass, and other masses due to
» disorders such as cancer tend to be eccentrically positioned. Adapted from
» Braunstein, GD, Hosp Pract 1993; 28:37.
»

Phew, that’s lucky, I tried the test and I have just got cancer. No sign of gyno at all. :expressionless:


#6

» Ketoconazole ? Isn’t that the activ ingredient in Nizoral shampoo? Should I
» be worried? I ve been using Nizoral for many years, and lately I added
» Avodart too.

they are talking about oral keto not the shampoo.


#7

» Copied from:
» http://patients.uptodate.com/image.asp?file=endo_pix/gyneco_4.htm
»
» Antiandrogens/inhibitors of androgen synthesis
» Cyproterone acetate
» Flutamide
» Finasteride
»
» Antibiotics
» Ethionamide
» Isoniazid
» Ketoconazole
» Metronidazole
»
» Antiulcer drugs
» Cimetidine
» Ranitidine
» Omprazole
»
» Cancer chemotherapeutic drugs
» Alkylating agents
» Methotrexate
» Vinca alkaloids
» Combination chemotherapy
» Imatinib
»
» Cardiovascular drugs
» Amiodarone
» Captopril
» Digitoxin
» Diltiazem
» Enalapril
» Methyldopa
» Nifedipine
» Reserpine
» Spironolactone
» Verapamil
»
» Drugs of abuse
» Alcohol
» Amphetamines
» Heroin
» Marijuana
» Methadone
»
» Hormones
» Androgens
» Anabolic steroids
» Chorionic gonadotropin
» Estrogens
» Growth hormone
»
» Psychoactive drugs
» Diazepam
» Haloperidol
» Phenothiazines
» Tricyclic antidepressants
»
» Other
» Auranofin
» Diethylproprion
» Domperidone
» Etretinate
» Metoclopramide
» Phenytoin
» Penicillamine
» Sulindac
» Theophylline

ethionamide is not only used for treating bacterial infections but also used for treating tuberculosis. You can find the details of the drug at http://www.internationaldrugmart.com/ethionamide.shtml