Elsevier

The Breast

Volume 13, Issue 5, October 2004, Pages 428-430
The Breast

Case Report
Gynaecomastia and the plant product “Tribulis terrestris

https://doi.org/10.1016/j.breast.2003.10.013Get rights and content

Abstract

Gynaecomastia is the commonest benign breast condition seen in men. It is well recognised that certain drugs that alter the normal sex hormonal profile in the body can induce gynaecomastia. Recently, an increasing use of androgenic-anabolic steroids among young men especially body-builders has increased the incidence of gynaecomastia. We report a case of a young weight-trainer who developed gynaecomastia due to oral intake of a herbal tablet which he used as a steroid alternative for body-building.

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)

There are more references available in the full text version of this article.

Cited by (19)

  • Anabolic steroid-induced hypogonadism: Diagnosis and treatment

    2014, Fertility and Sterility
    Citation 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).

  • Cult of the body beautiful: At what cost?

    2012, Actas Dermo-Sifiliograficas
  • Is homeopathy useful in pediatrics?

    2012, Anales de Pediatria Continuada
    Citation 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 Physician
    Citation 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

View all citing articles on Scopus
View full text