One of the primary pharmaceutical options to which men suffering from gynecomastia turn is Letrozole. Quite often this is done too late (or when it never would have helped) and the result is a low risk-to-reward payoff.

This course of treatment may be prescribed legitimately by a doctor or possibly acquired in the shadowy corner of the locker room by that guy with the sunglasses, track suit and tightly zipped gym bag that’s half-hidden behind his back.

Letrozole is taken orally and it is an extremely powerful aromatase inhibitor. Whereas Tamoxifen acts by interfering with the function and uptake of estrogen already circulating in the body, Letrozole prevents the production of estrogen by the body.

Letrozole’s primary legitimate use is in the treatment of breast cancer in women, and it is not without side effects. The human body (including the male body) does require a normal amount of estrogen to function optimally. Letrozole significantly affects the body’s natural balance by doing its best to obliterate estrogen…period.

Any prolonged use of Letrozole does run the risk of osteoporosis and kidney problems.

Its efficacy in treating gynecomastia in men is questionable. In cases of gynecomastia that has been established, with glandular tissue having developed and solidified, Letrozole is unlikely to get rid of existing breast tissue. Letrozole may temporarily shrink existing breast tissue as the body’s estrogen level plummets, but is unlikely to provide long term benefits.

In cases where gynecomastia is in the early stages of development due to steroid use (typically signified by tingling in the nipple area and extremely mild tissue development), Letrozole may be effective in halting and reversing gynecomastia if it is caught at this very early developmental phase. If you are at risk of (or fearful of) developing gynecomastia due to recent or current steroid use, you are advised to consult your physician about possible pharmaceutical remedies.

Gynecomastia presents a particular and unique problem for bodybuilders.

First of all, the activity of bodybuilding is, by its nature, very appearance-oriented. Furthermore, within this focus on appearance, there is a microscopic attention to detail, whether it be proportionate comparative mass between muscle groups, striation and tone of muscles, or visible separation of muscle groups.

This attention to detail (and requirement for detail) can make even a minor case of gynecomastia noticeable among a bodybuilder’s peers and doubly so to the bodybuilder’s own trained and critical eye. Even minor breast gland development can obscure all lower pectoral definition and go a long way to negating the efforts, time, pain and study that have gone into developing the physique in question.

Furthermore, bodybuilders who use hormone manipulation subject themselves far more greatly to the risk of developing gynecomastia. Steroids and various other chemicals to facilitate training are abundant in the bodybuilding communities. Unfortunately, however, most bodybuilders are not also professors in body chemistry. A little bit of knowledge can be a dangerous thing, and a little bit of knowledge often results in a manipulation of body chemistry that leads first to muscle gains, then to gynecomastia.

The intricacies and subtleties of estrogen balance and androgen aromatization are too often learned after the fact in a desperate battle to undo gynecomastia that could probably have been prevented with either:

(1) extensive research on supplemental androgens, their mechanisms, consequences and dealing with swings in the androgen-estrogen balance, or
(2) abstinence from steroids, which does not mean that an excellent physique can not be achieved.

Bodybuilders tend to spend a great deal of time learning the proper form and technique to trigger various muscle groups, which requires a great deal of study. Muscle gains from exercise can come and go, and they can be rebuilt after a layoff. Gynecomastia will not come and go on its own. It will only come and stay. So it is incumbent upon you to research body chemistry and the effects and pathways of hormones at least as fanatically as you studied exercise if you intend to turn toward steroids to enhance your physical gains. And do that research beforehand.

Gynecomastia is one instance where an ounce of prevention is worth about a ton of cure.

Some cases of gynecomastia arise naturally, often when hormonal balances are shifted during puberty or later in life when endogenous production of androgens decreases (andropause).

However, a very common cause of gynecomastia is the use of anabolic steroids by bodybuilders. When external sources of testosterone are introduced, the body reduces its own natural production of testosterone in response. Naturally, when the external source of testosterone is removed, the body now has a shortage of androgens and the androgen-estrogen balance swings in favor of the female hormones.

In men, the natural state is generally a dominance of androgens. With an estrogen-dominant scenario, the body is in a state similar to female puberty, and the mechanisms that cause development of breast tissue are triggered. Both men and women have the genetic capability for breast development; in men it is just usually not unlocked.

As well, when there is a significant excess of testosterone in the body, as occurs with steroid use, the body clears this excess by converting some of the excess androgens to estrogens through the function of aromitase. This contributes to the estrogen dominance that occurs when external testosterone is removed.

It is for this reason that bodybuilders using steroids are often advised to use estrogen inhibitors when they come off a cycle of added testosterone. Even a short cycle of a relatively mild androgen supplement like M1T have the potential to induce gynecomastia, and the potential increases with longer cycles of more potent supplements.

Recommended estrogen inhibitors can vary from herbal remedies to (probably illegal) breast cancer medications such as Nolvadex (Tamoxifen) or Letrozole, which are designed to interfere with the body’s ability to produce or utilize estrogens. If you were able to get your hands on steroids in the first place, you’ll probably be able to hunt down the estrogen inhibitors as well.

This is the manner in which steroid use can result in gynecomastia. Its ramifications are discussed further in GYNECOMASTIA AND BODYBUILDERS.