Medications and Drugs That Can Lead to Enlarged Male Breasts (Gynecomastia)

Gynecomastia, which is the enlargement of breasts in a male is relatively common and is a frequent cause of embarrassment and insecurity. I have indicated elsewhere that the underlying cause of gynecomastia is related to the absolute and relative levels of the sex hormones testosterone and estrogen. Their levels are significantly affected by puberty, aging, alcohol, and a variety of medications, illicit and street drugs, and diseases.

Listed below are several broad categories of medications with some specific examples that are associated with male breast enlargement:

1. Anti-androgens used to treat prostate enlargement or cancer: finasteride (Proscar, Propecia), dutasteride (Avodart), flutamide (Eulexin); cyproterone (Androcur)
2. Anti-anxiety medications: diazepam (Valium)
3. Tricyclic antidepressants: amitriptyline (Elavil), doxepin (Sinequan) and imipramine (Tofranil)
4. Antibiotics such as ketoconazole (Nizoral) and isoniazid
5. Ulcer medications such as cimetidine (Tagamet)
6. Certain chemotherapy agents used in the treatment of cancer.
7. Cardiac medications such as digitalis (Digoxin) and calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem) and nifedipine (Procardia)
8. Certain AIDS medications especially Efavirenz
9. Products that contain tea tree oil or lavender oil
10. Miscellaneous medications such as estrogen, spironolactone (Aldactone), and HCG (human chorionic gonadotropin)

The following includes street and illicit drugs that have been found to cause gynecomastia:

1. Marijuana
2. Cocaine
3. Anabolic steroids
4. Methadone
5. Heroin
6. Amphetamines

If you have developed gynecomastia that is not related to puberty, alcohol or certain diseases and may be on one of the agents listed above or a similar medication or drug, it would be wise to investigate the situation further. You may want to discuss the situation with your primary care doctor or the appropriate prescribing physician if relevant.

To later cosmetically address the enlargement of the breasts (if appropriate), male breast reduction surgery can be considered. This procedure may involve ultrasonic assisted liposuction of the breasts with or without directly removing the enlarged glandular tissue.

If you would like more information on male breast reduction surgery for the treatment of gynecomastia such as with ultrasonic assisted liposuction or information on any other cosmetic surgery procedure, you can contact my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona