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Gynecomastia and Medications: What You Need to Know

May 7, 2025

Medications are one of the most overlooked causes of male breast enlargement. In fact, gynecomastia and medications are strongly linked, with dozens of common drugs known to interfere with hormone levels or directly stimulate breast tissue growth.

If you’ve noticed puffy nipples or breast swelling after starting a new prescription, the medication could be to blame. In this guide, we’ll break down which drugs are commonly involved, how they affect the body, and what to do if you suspect medication-induced gynecomastia.

How Medications Can Cause Gynecomastia

Gynecomastia occurs when testosterone and estrogen levels become imbalanced, often tilting toward excess estrogen activity. Some medications trigger this imbalance by:

  • Increasing estrogen production
  • Blocking testosterone or androgen receptors
  • Stimulating breast tissue directly
  • Affecting liver metabolism, which alters hormone clearance

Even medications that seem unrelated to hormones—like heart or mental health drugs—can have gynecomastia as a side effect.

Common Medications That May Cause Gynecomastia

The list of medications associated with gynecomastia is extensive. Some of the most common include:

1. Anti-Androgens

  • Finasteride (Propecia, Proscar)
  • Spironolactone
  • Flutamide

These medications block testosterone activity, often leading to breast tissue growth.

2. Anabolic Steroids and Testosterone Therapy

While intended to boost testosterone, improper dosing or cycling off steroids can lead to estrogen rebound, causing gynecomastia.

3. Heart Medications

  • Calcium channel blockers (e.g., amlodipine)
  • Digoxin
  • ACE inhibitors

These may affect hormone metabolism or directly stimulate glandular tissue.

4. Psychiatric Medications

  • SSRIs (e.g., fluoxetine, sertraline)
  • Tricyclic antidepressants
  • Antipsychotics (e.g., risperidone, olanzapine)

Some of these increase prolactin levels, which can mimic estrogen effects on the breast.

5. Other Notable Drugs

  • Cimetidine (heartburn medication)
  • Ketoconazole (antifungal)
  • Anti-HIV drugs (e.g., efavirenz)
  • Some antibiotics (e.g., isoniazid)

Is Drug-Induced Gynecomastia Permanent?

It depends. If caught early, stopping or changing the medication may reverse the tissue growth, especially if it’s still soft and recent. However, if the glandular tissue has been present for more than a year, it often becomes fibrotic and permanent—meaning it won’t go away on its own or with medication changes.

What to Do If You Suspect a Medication Is Causing Gynecomastia

  • Don’t stop your medication without speaking to your doctor.
  • Request a full hormonal panel to assess testosterone and estrogen levels.
  • Discuss alternative medications that may carry fewer hormonal side effects.
  • Schedule a consultation with a gynecomastia specialist if symptoms persist.

We regularly see patients in Los Angeles and Newport Beach who develop gynecomastia as a side effect of prescription or over-the-counter drugs. Many of them go months or years before realizing the connection.

Treatment Options for Medication-Induced Gynecomastia

When the tissue does not resolve, surgery is the most effective and permanent solution. At our practice, we focus on:

  • Gland excision to remove dense breast tissue
  • Liposuction for surrounding fat
  • Precise contouring to restore a masculine chest shape

The procedure is performed under local or general anesthesia with minimal downtime. Patients report dramatic improvements in confidence and body image.

Plastic Surgeon | Website |  + posts

Dr. Joseph Cruise is a board-certified plastic surgeon with over 20 years of experience. Regarded as one of the top gynecomastia surgeons in the world, Dr. Cruise has gynecomastia-specific content that can be found at lagynecomastia.org. Dr. Cruise has dedicated his career to cosmetic surgery but has also had extensive training in General Surgery, Hand Surgery, and Microvascular Surgery. Dr. Joseph Cruise is also a member of the Rhinoplasty Society as well as the American Society of Plastic Surgeons.

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