Galactorrhea and Man Boobs

[Milotic]

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Some medications cause Galactorrhea and some cause Gynecomastia. I have been assuming up until now that these are through different pathways, but am I wrong?

Blocking androgen production in a male OR increasing estrogen:androgen ratio will give gynecomastia.
Blocking Dopamine --> increasing Prolactin release (galactorrhea)--> suppresses GnRH actions. Is this always going to come with gynecomastia as well? (Ex: Risperidone)

Thanks!

 

[ortnakas]

Gynecomastia is from too much estrogen (cirrhosis, etc) or drugs (spironolactone and others).

Galactorrhea is from too much prolactin-- either a prolactinoma or drug side effects (like anti-psychotics).

According to Goljan, males are more likely to just have impotence/sexual side effects with extra prolactin because you don't have enough ducts to stimulate, but that it's always the case.

 

[GUH]

Gynecomastia is from too much estrogen (cirrhosis, etc) or drugs (spironolactone and others).

Galactorrhea is from too much prolactin-- either a prolactinoma or drug side effects (like anti-psychotics).

According to Goljan, males are more likely to just have impotence/sexual side effects with extra prolactin because you don't have enough ducts to stimulate, but that it's always the case.

Antipsychotics (especially Risperidone) can also contribute to gynecomastia.

EDIT: To answer the original post, I have never seen a male without gynecomastia who had galactorrhea. But my experience is limited.

 

[Milotic]

So bottom line, if you had a drug that just decreased Dopamine, and causes galactorrhea in a female, if this drug was given to a male, would that result in gynecomastia?

 

[catzzz88]

Another mechanism you didn't mention (from Wikipedia): Cimetidine is a competitive antagonist at the dihydrotestosterone (DHT) receptor, leading to exaggerated effects of estrogens. In women, this can lead to galactorrhea, whereas in men, gynecomastia has been reported.


Also: Gynaecomastia (enlargement of breast tissue) is mentioned in many textbooks as a side effect, thought to be due to the estrogen-like steroid moiety of the digoxin molecule,[10] but when systematically sought, the evidence for this is equivocal.