Endocrine
Gynecomastia & Drug Side Effects
Endocrine

Gynecomastia & Drug Side Effects

Spironolactone → switch to eplerenone.

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Pubertal gynecomastia

  • Common in boys 12–14
  • Self-resolves in 1–2 years

Drug-induced gynecomastia

  • Spironolactone: antiandrogen effects → bilateral gynecomastia, ↓libido, ED
  • Eplerenone is selective aldosterone receptor antagonist with minimal antiandrogen → switch when symptomatic
  • Other causes: digoxin, ketoconazole, cimetidine, alcohol, marijuana, anabolic steroids
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