About Us Disclaimer Contact Us. Toggle navigation. Please enter text to search. Search by Outlines. Set Search Limits. Unlike eplerenone, spironolactone is known to inhibit free testosterone from binding to androgen receptors in the cytoplasm of breast cells.
This inhibition of free testosterone by spironolactone results in a shift in the balance towards estrogen induced breast tissue proliferation. Editor-in-Chief: Anthony J. In short, there is a balance between the inhibition of breast epithelial cell growth by the presence of testosterone and the activation of breast epithelial cell growth by estrogen.
Unlike eplerenone, spironolactone not only competitively inhibits aldosterone from binding to the mineralocorticoid receptor, it is also known to inhibit free testosterone from binding to androgen receptors in the cytoplasm of breast cells see figure below. Glass AR. Endocrinol Metab Clin North Am. Braunstein GD. N Engl J Med. Mathur R, Braunstein GD. Gynecomastia: Pathomechanisms and treatment strategies. Horm Res. Pathophysiology of spironolactone-induced gynecomastia.
Ann Int Med. In some cases, it could be helpful reducing the doses or substituting the suspected drug with another one belonging to the same class, but with a weaker association to gynecomastia. On the other hand, laboratory tests are necessary for identifying other possible causes, checking the renal, hepatic and thyroid functions and the free-circulating hormones levels.
If drug discontinuation is not enough or not possible for example with anti-androgens , a therapy based on tamoxifene 20 mg daily might be taken into consideration.
Skip to main content. Focus on. Focus Farmacovigilanza ;77 7 Gynecomastia characteristics Male mammal glandular tissue, under particular conditions, can proliferate and increase in volume. Conflict of interest statement. None declared. The year story of the development of an anti-aldosterone more specific than spironolactone.
Google Scholar Crossref. Search ADS. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized aldactone evaluation study investigators. Eplerenone post-AMI heart failure efficacy and survival study.
All rights reserved. For Permissions, please email: journals. Issue Section:. Download all slides. Comments 0. Add comment Close comment form modal.
I agree to the terms and conditions. You must accept the terms and conditions. Add comment Cancel.
0コメント