Gyno

links: reference: 8-28-2021

Gyno #

• https://www.ncbi.nlm.nih.gov/books/NBK279105/
  • Estrogen promotes ductal growth (probably makes it pointy) while progesterone promotes alveolar differentiation (which only occurs in females?) which I think is basically what “gyno tissue” is.
    • https://www.wikidoc.org/index.php/Gynecomastia_pathophysiology
    • Alveolar glands are the milk-proucing glands;
  • “Progesterone has minimal effects in breast development without concominant anterior pituitary hormones.”
  • Maximal cell proliferation in the luteal phase when P4 is high and E is low
  • “Prolonged treatment of dogs with progestogens, such as depot medroxyprogesterone acetate or with proligestone, caused increased GH and IGF-1 levels, suggesting that progesterone may also have an effect on GH secretion.”
  • Prolactin is produced in normal mammary tissue epithelial cells and tumors, and enhances the effects of E or P4 in their presence, but seems to do nothing simply on its own.
  • The development of breast tissue in males occurs in an analogous manner to that in females.
  • The testes secrete 6-10 μg of estradiol (15% of circulating E2) and 2.5 μg of estrone (5%) per day. The remainder is derived from extraglandular aromatization of test/androstenedione.
• https://pubmed.ncbi.nlm.nih.gov/25112235/
  • mice with knockout of either the prolactin receptor or the progesterone receptor have normal breast development at puberty
• “Gynecomastia can be reversed by topical Progesterone but I think drugs like bromocriptine and Cabergoline have even stronger track record clinically. DHT is even more effective topically, and I think Pansterone (preg+DHEA) is a close approximation to DHT when used topically”. -Haidut
• Puffy nipples can be caused by:
  • High Progesterone, Estrogen, low Sodium
  • High Testosterone:DHT ratio, and
  • High Cortisol:DHEA
  • Growth Hormone and IGF-1 are required, even in the presence of E and P4.
• Interesting protocol: https://raypeatforum.com/community/threads/preventing-fatty-acid-release.19386/post-262391
  • 500mg aspirin, 500mg niacinamide, 200mg caffeine per meal. Made his tongue pink, lost fat/gyno, better metabolism, etc.

Treatment #

• https://raypeatforum.com/community/threads/supplements-to-prevent-gynecomastia.38695/
  • Letrozole: an aromatase inhibitor used for hormonally-responsive breast cancer; one or two low dose per week, no cumulative effect
    • People are saying they really regret it. AIs are fucked up.
• Pramipexole 250mcg 2x/day.
• Tamoxifene: SERM and AI

Raloxifene #

• Ray Peat said AIs are toxic to the liver and are just synthetic strogen, thus they are a bit of a fallacy. But do they work?

• Probably useless for progesterone-induced.

• People say gyno comes back the moment you get off. Is that because the cause is still present? No rebound on SERMS according to some.

• SERM. A synthetic estrogen, basically. In certain tissues they are antiestrogenic, but their systemic effects are quite estrogenic.

  • Antiestrogenic in tissues including the breast and uterus.
  • Estrogenic in tissues such as the bone and liver.

• Increases SHBG.

• Decreases LDL, C-reactive protein, homoysteine. Inhibits LDL oxidation. Decreases IGF-1.

• https://raypeatforum.com/community/threads/generative-energy-9-a-bioenergetic-view-of-weight-loss-with-haidut.8154/page-5#post-107322

  • In contrast to clomiphene, raloxifene does not exert oestrogenic effects on basal gonadotrophin secretion. Although the antioestrogenic action of these drugs was evident only after pretreatment with E2, both R and Cl stimulated GnRH-induced gonadotrophin secretion in oestrogen-deprived women. It is hypothesized that these two compounds sensitize the pituitary to GnRH through mechanisms not involving the oestrogen receptor complex (nongenomic)."

Exemestane #

• https://raypeatforum.com/community/threads/anti-estrogens-are-estrogenic.28699/post-456152
  • Aromatase inhibitor used for breast cancer. The cleanest of all AIs according to TheBeard. Destroys aromatase instead of temporarily blocking it, which would cause an estrogen rebound.
• https://raypeatforum.com/community/threads/anti-estrogens-are-estrogenic.28699/post-456152
  • Induces ER activity at higher concentrations than E2.
  • Was able to induce proliferation of breast cancer cell lines and active transcription of (certian?) estrogen-responsive genes.
• Its 17-OH metabolite is 6-methylene-boldenone, which is anabolic.

DHT #

• Good thread: https://raypeatforum.com/community/threads/anti-estrogens-are-estrogenic.28699/post-531044

• Treatment of persistent pubertal gynecomastia with dihydrotestosterone heptanoate (Eberle et al. 1986)

  • Danazol, an antigonadotrophic drug induced breast regression in 50% of 14 pubertl boys, but 21% didn’t respond.
  • 200mg DHT-hp in seasame oil intramuscularly. 2nd injection after 4 weeks (200mg = 7mg/day over 4 weeks). In order to maintain complete suppression of LH and T, 3rd+ injections was increased to every 3 weeks in 3 patients and 2 weeks in 1 patient. Lasted 14 weeks.
  • DHT at week 8 peaked at 800ng/dl, meanwhile T went to basically nothing and E2 stayed in range the whole time.

Studies on the treatment of idiopathic gynaecomastia with percutaneous dihydrotestosterone (Kuhn et al., 1983) #

• 18-220 month duration of gynecomastia. Aged 16-18 and 19-63.

• “Complete disappearance of gynaecomastia in 10 patients, partial regression in 19 and no change in 11 patients after 4 to 20 weeks of 125 percutaneously.”

  • Hydroalcoholic gel applied on the abdomen or directly on the gyno. If it’s only 8-10% absorption, this amounts to 10-12mg systemically.

• Plasma FSH showed no significant variation. T negatively correlated with DHT and positively with E2. DHT negatively correlated with LH. (Circle = treated, black square = control/no gyno, white square = placebo) (20nmol/L = 576ng/dL, 10 = 288 (just fuck my shit up)). (150pmol/L = 41pg/ml)

• Patients who showed no regression of gynaecomastia had plasma DHT levels of less than 6.8 nmol/l (198) by day 15; improvement was only in those with levels higher than that. There was observed success in somebody with gyno for 7 years.

• In 3 cases where partially effective treatment was followed by surgery, fibrous tissue was present.