[Gynecomastia Column] Can Gynecomastia Develop After Taking Hair Loss Medication?

Hello. This is AB Plastic Surgery.

I am writing a series of posts to provide accurate medical information about gynecomastia.

In my previous post,

I looked at whether gynecomastia can develop as body weight increases.

A member asked in the comments recently

whether hair loss medication is related to gynecomastia, so I would like to explain in a bit more detail.

Can gynecomastia develop after taking hair loss medication?

After reviewing the literature, the conclusion is the same as what I mentioned last time.

"It cannot be said that hair loss medication and gynecomastia are unrelated. However, at present, the benefits obtained from taking hair loss medication are generally considered to be greater, but if symptoms suspected to be gynecomastia appear and psychological distress resulting from them occurs, discontinuing the medication may be considered."

That is the conclusion. Then I will explain the basis for it. First, here are reports of cases in which gynecomastia developed after taking hair loss medication (brand name Propecia / drug name finasteride).

[Reference] Finasteride-induced gynecomastia. Parvin Mansouri et al. Indian J Dermatol Venereol Leprol | May-June 2009 | Vol 75 |

Issue 3

• In a 19-year-old man with alopecia, after taking 1 mg finasteride (the usual dose we take for hair loss) daily for about 7 months, the left breast became painful and enlarged.

• In a 43-year-old man with alopecia, 20 days after taking 1 mg finasteride (that is, Propecia), the right breast became painful and enlarged.

[Reference] Finasteride Induced Gynecomastia: Case Report and Review of the Literature. Yuval Ramot et al. International Journal of

Trichology / Jan-Jun 2009 / Vol-1 / Issue-1

• In a 21-year-old man with alopecia, both breasts enlarged together 4 months after taking 1 mg finasteride (that is, Propecia).

[Reference] Finasteride Induced Gynecomastia: Case Report and Review of the Literature. Yuval Ramot et al. International Journal of

Trichology / Jan-Jun 2009 / Vol-1 / Issue-1

#In fact, there were quite a few reported cases, far more than I had known or expected. If I looked further, there seem likely to be even more.

#However, when using medication, "because all medicines have side effects, it is most important to weigh the benefits and risks."

#If you look at the table above, cases are being reported at about 0.26/1,000 people, so it seems reasonable to think of it as a frequency of about 2 to 3 people per 10,000.

In other words, conversely, out of 10,000 people, about 9,997 would not develop gynecomastia even if they use hair loss medication.

#For now, compared with the effectiveness of the medication, the frequency of reported side effect cases can still be considered small.

[Reference] Finasteride: A Review of its Use in Male Pattern Hair Loss. Karen J. McClellan et al. © Adis International Limited. All rights

reserved

#There is also literature stating that there is no basis for saying that 1 mg of finasteride (Alopecia), the daily dose commonly taken by patients with alopecia, causes breast enlargement. In the end, it comes down to how much the probability is, and to the balance of benefits and harms. In the literature above, gynecomastia is mentioned as a very minor side effect compared with sexual dysfunction and ejaculatory/erectile problems.

Here is the conclusion.

Gynecomastia can develop after taking hair loss medication.

However, the frequency is not very high, and the benefits obtained from taking hair loss medication are generally considered greater.

Therefore, when a patient is prescribed hair loss medication, it is important for the patient to be clearly aware of this, and for the doctor to carefully monitor whether there are other side effects from the medication.

If symptoms suspected to be gynecomastia appear and psychological distress resulting from them occurs, I think discontinuing the medication may be considered.

I hope this post was helpful for men who are worried about gynecomastia.

Thank you.