Gynecomastia, or “gyno”, is every anabolic steroid user’s worst nightmare. In short, it is a condition in which men develop breast tissue due to an overabundance of estrogen in their bodies.
Although it is possible to reverse the condition early on, it may become permanent and require surgery in its advanced stages.
Here is everything you need to know about gyno, including the early warning signs and how to prevent it in the first place.
Some of the anabolic steroids common among athletes and bodybuilders convert to estrogen, which is the “female” hormone responsible for many feminine characteristics, including breast development.
Just as women who use anabolic steroids are prone to virilization, or the development of male physical characteristics, men who use anabolic steroids may develop certain female physical characteristics.
Gynecomastia is one of the most common – and the most bothersome. It is more common post-cycle when hormone levels fluctuate and there is not enough testosterone to balance the estrogen in the body.
Medical Causes of Gynecomastia
Of course, it is also possible to develop gynecomastia even if you have never used anabolic steroids in your life.
Some of the common medical causes include natural hormone imbalances caused by pituitary disorders, prescription medications called androgens used to treat prostate enlargement and cancer, and in some cases, the natural decrease in testosterone production that is prevalent as men age.
Per the Mayo Clinic, gynecomastia peaks in men between the ages of 50 and 69, and one in four men in this age group are affected.
The Early Warning Signs
Fortunately, gynecomastia has several unique warning signs that can tell you it is time to take action. Some men experience the symptoms below to varying degrees.
- Nipple tenderness that starts out mild and becomes worse over time.
- Itching in the nipple area; some men report itchiness in the underarm area, as well.
- A “puffy” appearance to the nipple.
- The appearance of firm lumps under or around the nipple.
- In some cases, men may experience very mild lactation.
For the most part, if you experience any of these symptoms, you should take immediate action to prevent the condition from worsening. The good news is that you can prevent gynecomastia from the outset, and you can reverse it to a certain extent.
The number one way to prevent gynecomastia when you use anabolic steroids involves using the recommended dose of an aromatase inhibitor such as Arimidex or Aromasin.
These compounds bind to the same receptors as an enzyme known as aromatase, which is directly responsible for the production of estrogen.
When the aromatase cannot form a bond, the body cannot create estrogen. Without estrogen, there is no risk of gynecomastia.
Most steroid cycles call for 0.5mg of Arimidex every other day as preventative treatment, and Arimidex is easy enough to find online. However, there are other options.
Bear in mind that Arimidex is typically the mildest of all the aromatase inhibitors, but it can be detected through standard protocol.
Letrozole can bypass detection in many cases, but it is quite harsh and has a large margin for dosage. Though the average dose is 1.25mg every other day, some men find that 1mg every other day is sufficient, while others may need as much as 2mg every other day.
For Aromasin, men can take as little as 12.5mg every other day or as much as 25mg a day. For the best results, start your dose on the low end and work your way up.
Aromatase Inhibitor Side Effects
Aromatase inhibitors possess side effects of their own, and the best way to avoid this is through careful dosing. Bear in mind that there are no real studies on the use of AIs in men, primarily because their use is contraindicated by the FDA.
The most common side effect occurs when estrogen levels become too low; men do need some estrogen in their bodies for the maintenance of their bones and visceral fat, which provides protection to the organs. Other side effects may include:
- Joint pain;
- Bone fractures;
- Changes in libido or sexual function;
- Mental changes in terms of memory, emotions, personality, and mood;
- Kidney disease; and
- Retinal hemorrhage.
Joint pain and changes in libido are the most common side effects associated with AIs. When they are used as directed, it is very unlikely that you will experience the more severe side effects.
These are generally observed in individuals who use high doses of aromatase inhibitors over long periods of time, and should not apply to men who use them for estrogen suppression during steroid cycles.
If you failed to use an AI during your steroid cycle (or if your AI dosage was not high enough) and you notice the signs and symptoms above, the products and doses that prevent gyno from occurring may not be enough to reverse the cycle.
In cases like this, many bodybuilders and athletes turn to a popular aromatase inhibitor known as Letrozole; they take 2.5mg daily until the symptoms disappear. Some men use 2.5mg every other day to prevent Letrozole side effects, though it may not be as effective at this dose.
If the gynecomastia has advanced and there is obvious breast tissue, then even Letrozole may not be enough to reverse it. Unfortunately, in severe gynecomastia cases, invasive surgeries like liposuction may be necessary to reduce the tissue and provide a normal appearance.
PCT and Gynecomastia Prevention
For many men, the real risk of gynecomastia occurs once the steroid cycle has ended.
This is because anabolic steroids suppress the male body’s ability to produce testosterone on its own.
Without the use of medications to help facilitate that steroid production, the estrogen-to-testosterone ratio becomes too high, and gynecomastia may result.
Following a cycle with AAS, it is vital to use a medication called a SERM, or Selective Estrogen Receptor Modulator, like Nolvadex or Clomid. These medications help to ensure that the body gets just the right amount of estrogen – not too much or too little. These medications will also help to facilitate testosterone production, thereby reliving some of the risk, as well.
Although gynecomastia is one of the most embarrassing situations you can find yourself in, it is possible to prevent it and even reverse it in its early stages. Understanding the signs and symptoms gives you a fantastic starting place, and knowing what to do when they occur can prevent almost all of the most severe cases.