Beneficial effects of raloxifene and tamoxifen in the treatment of pubertal gynecomastia

J Pediatr. 2004 Jul;145(1):71-6. doi: 10.1016/j.jpeds.2004.03.057.

Abstract

Objectives: To assess the efficacy of the anti-estrogens tamoxifen and raloxifen in the medical management of persistent pubertal gynecomastia.

Study design: Retrospective chart review of 38 consecutive patients with persistent pubertal gynecomastia who presented to a pediatric endocrinology clinic. Patients received reassurance alone or a 3- to 9-month course of an estrogen receptor modifier (tamoxifen or raloxifene).

Results: Mean (SD) age of treated subjects was 14.6 (1.5) years with gynecomastia duration of 28.3 (16.4) months. Mean reduction in breast nodule diameter was 2.1 cm (95% CI 1.7, 2.7, P <.0001) after treatment with tamoxifen and 2.5 cm (95% CI 1.7, 3.3, P <.0001) with raloxifene. Some improvement was seen in 86% of patients receiving tamoxifen and in 91% receiving raloxifene, but a greater proportion had a significant decrease (>50%) with raloxifene (86%) than tamoxifen (41%). No side effects were seen in any patients.

Conclusion: Inhibition of estrogen receptor action in the breast appears to be safe and effective in reducing persistent pubertal gynecomastia, with a better response to raloxifene than to tamoxifen. Further study is required to determine that this is truly a treatment effect.

MeSH terms

  • Adolescent
  • Case-Control Studies
  • Gynecomastia / drug therapy*
  • Gynecomastia / physiopathology
  • Humans
  • Male
  • Patient Satisfaction
  • Puberty / physiology*
  • Raloxifene Hydrochloride / therapeutic use*
  • Retrospective Studies
  • Selective Estrogen Receptor Modulators / therapeutic use*
  • Tamoxifen / therapeutic use*
  • Treatment Outcome

Substances

  • Selective Estrogen Receptor Modulators
  • Tamoxifen
  • Raloxifene Hydrochloride