Case ReportGynaecomastia and the plant product “Tribulis terrestris”
Introduction
Gynaecomastia is the commonest condition affecting the male breast.1., 2. It can occur at any age and is due to proliferation of glandular component of the breast tissue secondary to an imbalance in the sex hormones.3., 4. It is entirely benign and various conditions that affect the normal sex hormonal profile in the body such as hypogonadism, testicular neoplasms, liver failure, thyrotoxicosis and intake of certain drugs can cause gynaecomastia, although in majority of young men the exact aetiology is unknown.5 Here we describe a case of a unique plant derivative which had induced gynaecomastia in an apparently healthy individual.
Section snippets
Case report
A 21-year-old gentleman who works as an aircraft fitter and is also a keen weight-trainer was referred by his general practitioner to the breast clinic with a 5 month history of a lump in his left breast which was occasionally painful. Seven years previously, he reported a similar swelling on the right side that had settled spontaneously. He was otherwise fit and well. He smoked 2 cigarettes a day and drank about 10 units of alcohol a week. On examination there was a well-defined nodule in the
Discussion
Gynaecomastia usually presents as a unilateral tender enlargement of the sub-areolar breast tissue. It can be physiological as in neonatal, pubertal and senescent hypertrophy. It can also be associated with specific diseases and intake of certain drugs.7 In any case, the hormonal change that mediates the condition is a decrease in androgens that can be due to either reduced production or androgen resistance. Increased circulating oestrogens that can be due to increased peripheral aromatisation
References (13)
- et al.
Testicular tumours presenting as gynaecomastia
Eur J Surg Oncol
(2003) - et al.
Is surgical excision necessary for atypical ductal hyperplasia of the breast diagnosed by mammotome?
Am J Surg
(2000) - et al.
Gynaecomastia (Review)
Eur J Surg
(2001) - et al.
Endocrinology of gynaecomastia
Ann Clin Biochem
(2001) - et al.
Anabolic steroids and gynaecomastia, review of literature
An Med Interna
(2001) - et al.
Causes of gynaecomastia in young adult males and factors associated with idiopathic gynaecomastia
Int J Androl
(2002)
Cited by (19)
Anabolic steroid-induced hypogonadism: Diagnosis and treatment
2014, Fertility and SterilityCitation Excerpt :Herbal supplements such as tribulus terrestris and saw palmetto extract have no proven benefit and might cause worsening gynecomastia. As such, AAS users should be advised to discontinue these supplements (77, 78). The use of hCG has been reported in >40% of AAS users (17) and may cause, or exacerbate, gynecomastia (72).
Tribulus terrestris versus placebo in the treatment of erectile dysfunction: A prospective, randomized, double blind study
2014, Actas Urologicas EspanolasCult of the body beautiful: At what cost?
2012, Actas Dermo-SifiliograficasIs homeopathy useful in pediatrics?
2012, Anales de Pediatria ContinuadaCitation Excerpt :Aumento en los valores de estrógenos circulantes: Exógenos: se han descrito casos de ginecomastia en niños con progenitores usuarios de cremas de contenido hormonal, preparados cosméticos de fabricación casera con elevado contenido en fitoestrógenos 10,11 o tras el consumo excesivo de productos cárnicos con alto contenido hormonal. Endógenos: aunque infrecuentes en edad pediátrica, existen diversas patologías que incrementan los valores de estradiol/estrona circulantes.
Gynecomastia
2012, American Family PhysicianCitation Excerpt :Discontinuing use of the contributing agent often results in regression of breast tissue within three months. Additionally, lavender, tea tree oil, dong quai, and Tribulus terrestris (an ingredient in performance-enhancing supplements) have been linked to gynecomastia.15–17 Although soy consumption is thought to be safe, consuming more than 300 mg per day has been reported to cause gynecomastia.18
Ergogenic properties, safety evaluation and regulations of selected ingredients in testosterone booster dietary supplements
2023, Food Reviews International