Gynecomastia as a side effect of anabolic androgenic steroid doping in a Japanese amateur bodybuilder

Abstract

Unfortunately, anabolic androgenic steroid (AAS) abuse is prevalent in Japan. Most steroid abusers are amateur bodybuilders, powerlifters, wrestlers, and "fitness enthusiasists." The case presented is of a young amateur bodybuilder, who suffered gynecomastia, whose only significant risk factor was his nonmedical use of an AAS. A 27-yr-old male was admitted to our hospital in December 1992 with gynecomastia. He reported starting to use an AAS, oxymetolone (Anadrol®) 30 mg daily, at the age of 23 yrs in 1987. He had developed bilateral painful gynecomastia, impotence and decreased sex drive within 3 months of starting AAS use. He stopped using it, and was admitted to another clinic in 1991. He took testosterone propionate (Testinon®) 25 mg weekly, but, as he was anxious about the long-term use or this medication, he was adimitted to our clinic. On physical examination his gynecomastia had diminished slightly, but he still had breast tenderness. All his laboratory examination results were almost within the normal ranges. Neverthless his serum free testosterone level was slightly low, so he took tamoxifen (Nolvadex®) and Chinese medicines. Consequently, his gynecomastia improved after treatment, for 5 months. Gynecomastia develops when an AAS is converted to estrogen. In conclusion, tamoxifen administration may be useful to reverse gynecomastia caused by AAS doping in sportsmen.