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August 26, 1974


Author Affiliations

Miami Beach, Fla

JAMA. 1974;229(9):1168. doi:10.1001/jama.1974.03230470020011

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To the Editor.—  Regarding the editorial on gynecomastia (228:1423, 1974), the concluding sentence states: "When the condition is drug-induced, withdrawal of the offending drug, when feasible, is the sole treatment needed. Otherwise, the only recourse is to surgical removal."Perhaps because I practice in a geriatric area, I see a substantial number of gentlemen who are treated with digitalis glycosides and develop gynecomastia of varying degree.If the thickening is nodular, if the center of the thickened area coincides with the center of the nipple, and further, if the area is tender, we elect to give modest doses of male hormone, the equivalent of fluoxymesterone, 5 mg two or three times a day. We watch for edema, for increased cardiac failure, and for increasing prostate problems.Usually, the process decreases significantly or disappears entirely after two to four weeks of therapy.Thus, surgery is avoided and the patient's fear of