Gynecomastia in athletes and bodybuilders

When taking anabolic steroids, a large amount of testosterone and other components enter the body, which create a disruption in the hormonal system. If there is a lot of testosterone, then estrogens try to find a balance and are also produced in large quantities, which leads to acquired gynecomastia.

There is an opinion that there are “dangerous” and “safe” steroids, and taking “safe” drugs will not cause any complications. This statement is not entirely true, since any intervention in the hormonal system, and especially a spontaneous increase in incoming testosterone, can lead to serious consequences. That is why the selection of the drug must be taken seriously: consult a doctor, take tests and be observed by a doctor.

Symptoms of gynecomastia in jocks

Usually, the development of pathology is difficult not to notice; the signs of gynecomastia during and after the course are expressed as follows:

• discomfort in the nipple area;
• the occurrence of pain when palpating the nipples;
• an inflammatory process may begin, as a result of which the nipples change their shape and become swollen;
• the breasts take on a more feminine shape;
• Rarely, nipple discharge may occur.

To make an accurate diagnosis, based on the symptoms, the doctor will prescribe a series of diagnostic tests.

Anastrozole and its effects

If during the course you are taking drugs that exhibit aromatization, in this case you should include the use of anastrozole in the course regimen. Frequent, obvious side effects during the course are: gynecomastia, fluid retention, pressure, acne. All this happens due to an increase in estradiol levels above normal. Thanks to the correctly selected dosage of anastrozole, we can get rid of common side effects during a course of steroids:

• decreased libido during the course
• decreased performance, drowsiness, sweating
• manifestations of gynecomastia, itching in the nipples
• the appearance of a large number of acne, pimples
• increased blood pressure

Causes of gynecomastia in athletes

The life of athletes involves serious physical activity and some resort to the help of drugs that are designed to improve body shape, strength, endurance, etc. Each organism is individual, so often these drugs cause dysfunction of the hormonal system. Gynecomastia usually occurs in men from steroids. These substances, when they enter the body, perform their function, but also, men begin to produce female sex hormones estrogens in large quantities, which leads to excess production of prolactin and progesterone, which are responsible for the growth of the mammary glands.

Less often, but the cause may be a sudden refusal of medications, after which the body is under stress. Testosterone continues to be actively produced from serious physical exertion, and the body compensates for it with a large production of estrogen and again everything results in gynecomastia after steroids, swelling and accumulation of fat in places inherent in the female body type.

It is important to understand that gynecomastia does not necessarily occur from steroids. It all depends on the individual characteristics of the athlete’s body, especially on genetic factors and predispositions.

Exemestane

Of the described triad of direct AIs, Exemestane is the only one of steroid origin (similar to androstenedione). Exemestane has neither estrogenic nor progestogenic effects, but it has slight androgenic activity and does not affect the secretion of cortisol or aldosterone. Like other AIs, it causes an increase in gonadotropic hormones (even when taken in small dosages).

In Sports it is used as a means to block estrogenic side effects; to combat emerging signs of gynecomastia, dosages of 25 mg per day are used, but prevention requires 12.5-25 mg every other day. The maximum concentration of the drug after administration appears 2 hours after administration; its absorption (unlike the previous two drugs) improves by 40% if taken after a meal.

Consequences

The consequences of gynecomastia after the course look like this:

• severe fluid retention in the body, resulting in swelling of the entire body or individual parts;
• breast enlargement and its resemblance to a woman’s;
• either glandular tissue or fatty tissue grows inside the breast (due to this, there is an increase in breast volume);
• breast cancer.

This disease can be successfully treated if you consult a specialist in time and do not wait for complications that may lead to the need for surgery.

The downside of estradiol, negative functions

• Provokes swelling (retains fluid), risk of increased blood pressure (hypertension)
• the rate of blood clotting increases
• appearance of acne (pimples)
• there is an increased risk of cardiovascular disease
• swelling, itching in the nipples (gynecomastia), in case of transition to the stage of fibrotic changes, surgical intervention will be required
• decreased sexual desire and potency
• profuse sweating, sleep disturbance
• malfunction of the gastrointestinal tract

Thanks to the use of aromatase inhibitors, in this article we are talking about anastrozole, we can control the levels of estradiol, bringing it to normal, reference values. By selecting the correct dosage of AIs, the results from the use of anabolic and androgenic steroids can be significantly improved, while avoiding most of the above side effects.

Diagnostics

Diagnostic tests for accurate diagnosis and prescribing effective treatment for athletes are usually as follows:

• donating blood from a vein to determine the concentration of male and female sex hormones (the doctor himself will prescribe a list of hormones, which must include prolactin, testosterone, estradiol);
• ultrasound examination of the mammary glands (detect the general structure of the tissues, and also find out whether there are tumors in the breast).

Gynecomastia during the course rarely causes the development of breast cancer. However, if neoplasms are detected, then a puncture is prescribed to identify benign or malignant nature.

Anastrozole

It is one of the most used AIs in the practice of modern bodybuilding to suppress estrogen-related side effects due to the intake of AS. It is a third generation selective aromatase inhibitor. This anti-estrogen appeared on the pharmacological market relatively recently (in the mid-90s of the 20th century), for the treatment of receptor-positive disseminated breast cancer in women.

It is a very effective means for inhibiting aromatization (conversion into estrogens) of even high doses of AS (such as all types of testosterones, methyltestosterone, and in case of high sensitivity to estrogens - boldenone). However, the downside of blocking estrogen activity is an increase in LDL, which not only increases the risk of developing atherosclerosis leading to the development of cardiovascular pathologies, but also leads to an increase in the density of cell membranes, reducing the efficiency of AS molecules entering the cell, and the potential for gaining muscle mass is also reduced, since in the presence of estrogens, muscle mass increases faster and more. {banner_st-d-1}

This drug is used either in case of the first signs of gynecomastia (then take 1 mg per day until the symptoms appear to be suppressed) or as a prevention of possible estrogenic side effects (then 500 mcg every other day). Take before meals with the required amount of water, maximum concentration is achieved within 1-2 hours after consumption.

How to treat gynecomastia in men after steroids

At different stages, pathology is treated with different methods. The basis of treatment is drug therapy, which is aimed at reducing the level of estrogen in the athlete’s blood.

When treating gynecomastia in bodybuilders, the most commonly used drugs are tamoxifen, additional testosterone, anastrozole, Proviron, exemestane, aromatase inhibitors, etc.

In some of the most advanced cases, the patient may require surgical intervention, since the breasts no longer have a “male appearance” and cannot be returned to their previous state. Such operations to correct the mammary glands or nipples are extremely rarely necessary; usually drug therapy produces results in the first months.

Positive effects of estradiol

• Regulates nitrogen metabolism, is a modulator of libido and sexual activity in men, ensures male fertility
• affects the concentration of thyroxine and iron in the blood
• participates in the process of ejaculate production
• supports the functioning of the cardiovascular and immune systems
• has a positive effect on cholesterol levels
• maintains the “health” of bone tissue (decreased levels lead to osteoporosis), regulates bone metabolism
• necessary for the synthesis of growth hormone and IGF-1
• affect cognitive functions

How to avoid gynecomastia on the course

There are several rules that must be followed during the course, however, the appearance of gynecomastia largely depends on a person’s genetic predisposition.

Let's consider the basic rules that must be followed to prevent the occurrence of the disease:

• proper balanced diet - you need to saturate your body with useful micronutrients, maintain the norm and proportions of proteins, fats and carbohydrates;
• before taking medications, it is best to exclude deficiency conditions in the body;
• a well-designed training program, that is, all loads should be normalized and there should be no serious jumps, then the body gets used to it faster and no serious hormonal disruption occurs;
• There are special drugs that to some extent block the adverse effects of steroids, however, they also have their own side effects and the appropriateness of their use is considered by the doctor based on the patient’s medical history.

Possible side effects of anastrozole during a course of anabolic steroids

Any medicine has both a pronounced effect and negative manifestations when taken. Problems can arise if an athlete exceeds the dose selected for him, takes the drug for too long, or does not conduct regular blood tests to identify hormonal indicators.

For the normal functioning of the male body, estrogens are necessary. If you take anastrozole for a long time and uncontrollably during a course of anabolic steroids, the level of this hormone can reach critically low levels. This can cause a number of side effects:

• memory impairment, apathy, drowsiness, fatigue;
• deterioration in sports form;
• frequent mood swings up to depression;
• disturbance of oxygen exchange in tissues;
• worsening blood clotting;
• disruption of the functionality of nerve cells;
• decreased stimulation of metabolic processes (anabolism worsens);
• joint pain;
• decreased bone strength (osteoporosis);
• headache, dizziness;
• decreased libido;
• leads to low sperm motility;
• increase in blood cholesterol levels;
• anemia, thromboembolism, thrombophlebitis;
• development of ENT diseases;
• skin rashes and itching;
• thinning hair, baldness;
• lack of appetite when gaining weight;
• liver disease.

All this suggests that anastrozole should be used in bodybuilding with caution, monitor blood counts, and follow the recommendations of professionals.

Which doctor should I contact?

In order not to seriously worsen your health, it is better to consult with a specialist about which drug causes gynecomastia, the advisability of its use, and you can also be under the supervision of a specialist while taking this type of drug.

An endocrinologist deals with changes in hormonal levels in the body and treatment of hormonal dysfunction.

I, Romanov Georgy Nikitich, am an experienced specialist in the field of endocrinology, I have extensive experience working with athletes who take or have taken steroid drugs. As a specialist, I have more than 20 years of work experience, received a Candidate of Medical Sciences degree, and manage a private clinic.

Anyone can sign up with me for a paid in-person or online consultation, where I will consider your situation, help you make a diagnosis, prescribe treatment and monitor this process.

You can sign up on one of the social networks or messenger listed on this page.