Notes
Endocrine
Gynecomastia & Drug Side Effects
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Endocrine
Gynecomastia & Drug Side Effects
Spironolactone → switch to eplerenone.
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Pubertal gynecomastia
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Common in boys 12–14
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Self-resolves in 1–2 years
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Drug-induced gynecomastia
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Spironolactone: antiandrogen effects → bilateral gynecomastia, ↓libido, ED
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Eplerenone is selective aldosterone receptor antagonist with minimal antiandrogen → switch when symptomatic
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Other causes: digoxin, ketoconazole, cimetidine, alcohol, marijuana, anabolic steroids
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