Case report: finasteride-induced gynecomastia in a 62-year-old man.
The authors describe a case of bilateral (with left prevalence) gynecomastia in a 62-year-old man after finasteride treatment because of benign prostatic hypertrophy. Finasteride is an inhibitor of 5 alpha-reductase, the enzyme responsible for testosterone metabolism to dihydrotestosterone. In this patient, nonspecific endocrine alterations were found, except for a significant decrease in dihydrotestosterone levels. In addition, there were no pathologic conditions affecting other organs or pharmacologic treatments that could be responsible for gynecomastia. Drug withdrawal started a progressive reduction of the lumps until complete their disappearance. It is possible that gynecomastia was caused by alterations of estrogen/androgen ratio because of a finasteride-induced decrease in circulating dihydrotestosterone levels. In this article, the authors confirm finasteride antiandrogenic activity and recommend a close follow-up of long-term treatments with finasteride to find out other possible side effects.
Volpi
R
R
Department of Medicine, University of Parma, Italy.
Maccarini
P A
PA
Boni
S
S
Chiodera
P
P
Coiro
V
V
D013196:Dihydrotestosterone / Q000097:blood; D018120:Finasteride / Q000009:adverse effects* / Q000627:therapeutic use; D006177:Gynecomastia / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011388:Prolactin / Q000097:blood; D011470:Prostatic Hyperplasia / Q000188:drug therapy; D013739:Testosterone / Q000097:blood
D013196:Dihydrotestosterone; D013739:Testosterone; D018120:Finasteride; D011388:Prolactin