Gynecomastia is the enlargement of breast tissue in men. Gynecomastia is triggered by a decrease in the ratio between testosterone and estrogen, according to MayoClinic. There are many causes of gynecomastia, which include normal hormone changes, certain diseases and a variety of prescription and illegal drugs. Men who are taking these medications need to understand that they may experience some breast tissue enlargement.
AIDS Medication
Medication that is prescribed to help HIV/AIDS patients has been listed by the Mayo Clinic as a cause of gynecomastia. AIDS patients who are undergoing highly retroactive antiretroviral therapy (HAART) have reported that they have experienced breast enlargement. The retroviral efavirenz is the most common HIV drug that is associated with gynecomastia.
Anti-Androgen Medicines
Prostate cancer is treated by drugs that block male hormones (androgens) and indirectly increase the actions of female hormones. These drugs are collectively called anti-androgen medications and, according to RingSurf, these drugs can cause gynecomastia. The most commonly prescribed anti-androgen drugs used are finasteride and flutamide.
Antibiotics
There are many antibiotics that have been noted to cause gynecomastia. According to EndoText, ketoconazole and metronidazole are examples of antibiotics that can cause breast enlargement in men. These drugs cause the condition by blocking the effect of androgens (male sexual hormones). This blockade makes the effects of estrogen more apparent in the patient.
Heart Medication
Some heart medications have been linked to the development of gynecomastia, according to MayoClinic. Digitalis is a medicine used by patients with congestive heart failure. Digitalis increases the heart rate of the patient. Digitalis also binds with some estrogen receptors and has estrogen-like effects. Spironolactone is a potassium-sparing diuretic (water pill) that is known to cause gynecomastia. Spironolactone lowers blood pressure, but blocks testosterone production. Without testosterone to balance it, estrogen begins to have more effect in the patient.
Psychoactive Medication
There are numerous drugs used in psychiatric patients that have gynecomastia as one of their main side effects. Diazepam, phenytoin, and haloperidol are all examples listed by EndoText. Diazepam and haloperidol are anti-anxiety and anti-depression medications, while phenytoin is a drug that helps prevent seizures. The method by which these drugs cause gynecomastia is still not fully understood.
Illegal Substances
There are numerous illegal substances that are listed by the Mayo Clinic as causes of gynecomastia. Alcohol, amphetamines, and heroin are linked with gynecomastia. The mechanism by which these drugs cause the condition is unknown, but it may be due to the drugs effects on the liver. Marijuana has a estrogen-like configuration that can lead to an increased in breast tissue size in men who use the drug.
Anabolic steroids and androgens cause gynecomastia, according to the Mayo Clinic. These illegal performance-enhancing drugs provide ample sources of androgen and testosterone, which can easily be converted to estrogen.
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