View Full Version : Nolvadex~Tamoxifen

12-23-2010, 03:15 PM

(Tamoxifen Citrate)

Tamoxifen is an antagonist of the estrogen receptor in breast tissue. It has been the standard endocrine (anti-estrogen) therapy for hormone-positive early breast cancer, although aromatase inhibitors have been proposed for postmenopausal women. Some breast cancer cells require estrogen to grow. Estrogen binds to and activates the estrogen receptor in these cells. Tamoxifen is metabolized into compounds that also bind to the estrogen receptor but do not activate it. Furthermore tamoxifen prevents estrogen from binding to its receptor. Hence breast cancer cell growth is blocked.Tamoxifen is a SERM.

Selective Estrogen Receptor Modulators (SERMs) are a class of compounds that act on the estrogen receptor. A characteristic that distinguishes these substances from pure receptor agonists and antagonists is that their action is different in various tissues, thereby granting the possibility to selectively inhibit or stimulate estrogen-like action in various tissues.

Nolvadex essentially blocks the action of estrogen in certain tissues like breast tissue. This is advantageous to males because Tamoxifen is an effective way to prevent gynocomastia. A daily dose of 20mg will typically protect a male from gyno. I always like to keep a bottle of Tamoxifen on hand for emergency gyno treatment as it is one of the fastest ways to mitigate gyno syptoms.

In addition to blocking the action of estrogen, Tamoxifen also increases testosterone, LH, FSH and estrogen. Estrogen is of course blocked in certain tissues leaving a circulating amount that may be beneficial to lipids. I personally would use a low dose aromatase inhibitor alongside Tamoxifen if employing it for PCT as Tamoxifen may raise E2 so much that it causes an abnormal T/E2 ratio. Users with an abnormal T/E2 ratio may benefit from a long-term cotreatment with aromatase inhibitors.

Tamoxifen is a versatile compound that may be prescribed for gyno, testosterone recovery and even for fertility in males.


12-23-2010, 03:16 PM
Tamoxifen treatment in oligozoospermia.

Bartsch G, Scheiber K.

This study of the effects of long-term tamoxifen administration on semen analysis of oligospermic males confirms the potential therapeutic efficacy in normogonadotrophic oligospermia. 38 out of the 56 patients responded well to long-term treatment with 30 mg tamoxifen daily. According to the nomenclature of Eliasson, 32 patients reached normal sperm density and 16 patients normal sperm motility after tamoxifen treatment. In the group of responders a pregnancy rate of 34% is obtained. As far as the endocrinological parameters are concerned normogonadotrophic patients (responders and non-responders) showed an increase in testosterone, 17beta-estradiol, LH and FSH levels, whereas the levels of prolactin and testosterone/estradiol-binding globulin remained unchanged. No alterations at all were seen with regard to semen volume, during the time of tamoxifen treatment.

PMID: 7250160 [PubMed - indexed for MEDLINE]

12-23-2010, 03:16 PM
Stimulation of calcitonin secretory capacity by increased serum levels of testosterone in men treated with tamoxifen.

Schopman W (http://forums.rxmuscle.com/pubmed?term=%22Schopman%20W%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Slager E (http://forums.rxmuscle.com/pubmed?term=%22Slager%20E%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Hackeng WH (http://forums.rxmuscle.com/pubmed?term=%22Hackeng%20WH%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Mulder H (http://forums.rxmuscle.com/pubmed?term=%22Mulder%20H%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract).
Department of Internal Medicine, Eudokia Hospital, Bergsingel, Rotterdam, The Netherlands.

Previous studies have suggested that sex steroids, including both oestrogen and testosterone, influence calcitonin secretion. However, a negative effect of gonadotrophins on calcitonin has not been excluded. Twelve men with infertility and low-normal serum levels of testosterone were studied before and during tamoxifen therapy. Increases in the serum levels of LH, FSH, testosterone and calcitonin were observed after treatment. Our findings suggest that testosterone has a direct influence on calcitonin secretion.

PMID: 3123401 [PubMed - indexed for MEDLINE]

12-23-2010, 03:17 PM
Hormonal effects of an antiestrogen, tamoxifen, in normal and oligospermic men.

Vermeulen A (http://forums.rxmuscle.com/pubmed?term=%22Vermeulen%20A%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Comhaire F (http://forums.rxmuscle.com/pubmed?term=%22Comhaire%20F%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract).

The administration of tamoxifen, 20 mg/day for 10 days, to normal males produced a moderate increase in luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, and estradiol levels, comparable to the effect of 150 mg of clomiphene citrate (Clomid). However, whereas Clomid produced a decrease in the LH response to LH-releasing hormone (LHRH), no such effect was seen after the administration of tamoxifen. In fact, prolonged treatment (6 weeks) with tamoxifen significantly increased the LH response to LHRL. Treatment of patients with "idiopathic" oligospermia for 6 to 9 months resulted in a significant increase in gonadotropin, testosterone, and estradiol levels. A significant increase in sperm density was observed only in subjects with oligospermia below 20 X 10(6)/ml and normal basal FSH levels. When basal FSH levels were increased or oligospermia was moderate (greater than 20 X 10(6)/ml); no effect on sperm density was seen. As sperm density increased, FSH levels decreased, suggesting an inhibin effect. Sperm motility was not improved by tamoxifen treatment. In five boys with delayed puberty, tamoxifen treatment appeared to activate the pituitary-gonadal axis and pubertal development.

PMID: 640052 [PubMed - indexed for MEDLINE]

12-23-2010, 03:17 PM
Hormonal changes in tamoxifen treated men with idiopathic oligozoospermia.

Hampl R (http://forums.rxmuscle.com/pubmed?term=%22Hampl%20R%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Heresová J (http://forums.rxmuscle.com/pubmed?term=%22Heresov%C3%A1%20J%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Lachman M (http://forums.rxmuscle.com/pubmed?term=%22Lachman%20M%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Sulcová J (http://forums.rxmuscle.com/pubmed?term=%22Sulcov%C3%A1%20J%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Stárka L (http://forums.rxmuscle.com/pubmed?term=%22St%C3%A1rka%20L%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract).
Research Institute of Endocrinology, Prague/Czechoslovakia.

Three months of tamoxifen treatment of 43 men with idiopathic oligozoospermia, out of which 20 completed the study, resulted in a significant enhancement of sperm motility, but the improvement of sperm parameters was in no relation to the FSH response to short time tamoxifen treatment. There was a significant increase of testosterone, estradiol, LH, FSH, SHBG, 17 alpha-hydroxy-progesterone and also of 11 beta-hydroxyandrostenedione, an androgen of exclusively adrenal origin, during the treatment and (with the exception of the latter), on the first week after discontinuation of the therapy. Significantly elevated testosterone and SHBG concentrations were retained still 9 weeks after finishing of the therapy. The results confirm that tamoxifen treatment provides conditions more favourable for conception and demonstrate that also adrenal steroidogenesis is positively influenced by this antiestrogen.

PMID: 3243340 [PubMed - indexed for MEDLINE]

12-23-2010, 03:18 PM
Effect of tamoxifen on GH and IGF-1 serum level in stage I-II breast cancer patients.

Mandal* M, Moro C, Ferretti G, Calabro MG, Nolè F, Rocca A, Munzone E, Castro A, Curigliano G.

Division of Medical Oncology, European Institute of Oncology, Via Ripamonti 435, 20141-Milan, Italy. mario.mandala@ieo.it (mario.mandala@ieo.it)

OBJECTIVE: Tamoxifen suppresses insulin-like growth factor-1 (IGF-1) plasma levels in early and advanced breast cancer patients. Relationships between tamoxifen (GH) and IGF-1 are complex and not completely described yet. The present investigation was performed to evaluate the effect of acute and chronic tamoxifen administration on GH response to growth hormone-releasing hormone (GHRH), as well as on IGF-1 serum levels. MATERIALS AND METHODS: Evaluation of GH after administration of GHRH was performed (a) at baseline, (b) 3 hours after 20 mg oral administration of tamoxifen and (c) after 12 weeks of 20 mg a day oral tamoxifen treatment, in fifteen postmenopausal stage I-II breast cancer patients. IGF-I was measured at baseline and after chronic tamoxifen administration. RESULTS: The GH response to GHRH was significantly reduced after 12 weeks of tamoxifen 10 mg administered twice a day orally (mean peak 3.2 +/- 0.2 micrograms/l, mean AUC 261.3 +/- 18.2 micrograms/minute p < 0.01 versus basal AUC). A concomitant significant reduction of IGF-1 was observed after 3 months of tamoxifen treatment. Basal pretreatment levels of 113.2 +/- 15.5 micrograms/l were suppressed to 70 +/- 7.9 micrograms/l (p < 0.01). CONCLUSION: Our study confirm the inhibitory effect of tamoxifen on IGF-I and suggested, as shown in previous in vitro data, that its suppression could be directly related to GH reduction in response to GHRH stimulation

12-23-2010, 03:18 PM
Tamoxifen, serum lipoproteins and cardiovascular risk.

Bruning PF (http://forums.rxmuscle.com/pubmed?term=%22Bruning%20PF%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Bonfrer JM (http://forums.rxmuscle.com/pubmed?term=%22Bonfrer%20JM%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Hart AA (http://forums.rxmuscle.com/pubmed?term=%22Hart%20AA%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), de Jong-Bakker M (http://forums.rxmuscle.com/pubmed?term=%22de%20Jong-Bakker%20M%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Linders D (http://forums.rxmuscle.com/pubmed?term=%22Linders%20D%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), van Loon J (http://forums.rxmuscle.com/pubmed?term=%22van%20Loon%20J%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Nooyen WJ (http://forums.rxmuscle.com/pubmed?term=%22Nooyen%20WJ%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract).
Department of Clinical Oncology, The Netherlands Cancer Institute, Amsterdam.

The influence of tamoxifen on plasma lipids and lipoproteins was monitored in 46 postmenopausal and 8 premenopausal women treated for advanced breast cancer up till 6 months. Total cholesterol (total-C) did not significantly change. However, high density lipoprotein cholesterol (HDL-C) and the HDL-C/total-C ratio rose significantly. Low density lipoprotein cholesterol was significantly decreased. Triglycerides and free fatty acids did not change markedly. The concomitant rise of sex hormone binding globulin and thyroxine binding globulin indicates that the increase of HDL-C with prolonged use of tamoxifen is compatible with an intrinsic oestrogenic effect of tamoxifen on the liver. The increased HDL-C/total-C ratio lends no support to the concern that long-term administration of this anti-oestrogenic drug might lead to an increased cardiovascular risk.

PMID: 3207604 [PubMed - indexed for MEDLINE]

12-24-2010, 07:16 PM
J Clin Endocrinol Metab. (http://javascript<b></b>:AL_get(this, 'jour', 'J Clin Endocrinol Metab.');) 2010 Sep 15. [Epub ahead of print]

Neuroendocrine Regulation of Growth Hormone and Androgen Axes by Selective Estrogen Receptor Modulators in Healthy Men.

Birzniece V (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Birzniece%20V%22%5BAuthor%5D), Sata A (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Sata%20A%22%5BAuthor%5D), Sutanto S (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Sutanto%20S%22%5BAuthor%5D), Ho KK (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Ho%20KK%22%5BAuthor%5D).
Garvan Institute of Medical Research and Department of Endocrinology (V.B., A.S., S.S., K.K.Y.H.), St. Vincent's Hospital, Sydney, New South Wales 2010, Australia; and The University of New South Wales (V.B., K.K.Y.H.), Sydney, New South Wales 2052, Australia.


Context: In men, the stimulation of GH and inhibition of LH secretion by testosterone requires aromatization to estradiol. Tamoxifen, a selective estrogen receptor modulator (SERM), possesses central estrogen antagonistic effect but peripheral hepatic agonist effect, lowering IGF-I. Thus, tamoxifen is likely to perturb the neuroendocrine regulation of GH and gonadal axes. Raloxifene, a SERM, is used for therapy of osteoporosis in both sexes. Its neuroendocrine effects in men are poorly understood. Objective: The aim was to compare the impact of raloxifene and tamoxifen on GH-IGF-I and gonadal axes in healthy men. Design: We conducted a randomized, open-label crossover study. Patients and Intervention: Ten healthy men were randomized to 2-wk sequential treatment with tamoxifen (10 and 20 mg/d) and raloxifene (60 and 120 mg/d), with a 2-wk intervening washout period. Main Outcome Measures: We measured the GH response to arginine and circulating levels of IGF-I, LH, FSH, testosterone, and SHBG. Results: Tamoxifen, but not raloxifene, significantly reduced IGF-I levels by 25 ± 6% (P < 0.01) and increased SHBG levels by 20 ± 7% (P < 0.05) at the higher therapeutic dose. There was a nonstatistically significant trend toward a reduction in the GH response to arginine with both SERMs. Both drugs significantly increased LH, FSH, and testosterone concentrations. The mean increase in testosterone (40 vs. 25%; P < 0.05) and LH (70 vs. 30%; P < 0.01) was significantly greater with tamoxifen than with raloxifene treatment. Conclusions: Tamoxifen, but not raloxifene, reduces IGF-I levels. Both SERMs stimulate the gonadal axis, with tamoxifen imparting a greater effect. We conclude that in therapeutic doses, raloxifene perturbs the GH and gonadal axes to a lesser degree than tamoxifen.

PMID: 20843951 [PubMed - as supplied by publisher]

12-24-2010, 07:19 PM
Urol Int. (http://javascript<b></b>:AL_get(this, 'jour', 'Urol Int.');) 2009;83(4):446-51. Epub 2009 Dec 8.

Role of testosterone/estradiol ratio in predicting the efficacy of tamoxifen citrate treatment in idiopathic oligoasthenoteratozoospermic men.

Cakan M (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Cakan%20M%22%5BAuthor%5D), Aldemir M (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Aldemir%20M%22%5BAuthor%5D), Topcuoglu M (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Topcuoglu%20M%22%5BAuthor%5D), Altuğ U (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Altu%C4%9F%20U%22%5BAuthor%5D).
Department of 2nd Urology, SB Ankara Dişkapi Training Hospital, Ankara, Turkey. muratcakandr@yahoo.com


AIM: It was the aim of this study to investigate the effect of a low testosterone/estradiol (T/E2) ratio and the normalization of this ratio by an aromatase inhibitor, anastrozole, on the treatment results of tamoxifen citrate (TAM) in idiopathic oligoasthenoteratozoospermic patients with a normal T/E2 ratio.
PATIENTS AND METHODS: 127 normogonadotropic men were included in this study. TAM (10 mg twice daily) was applied to 103 of the patients (group 1). The control group consisted of 25 patients who did not receive any treatment (group 2). After 3 months, TAM therapy was continued in 42 of the patients with a normal T/E2 ratio (group 1A). Of the remaining 61 patients with low ratios, 30 continued with TAM (group 1BTAM), while the remaining 31 patients underwent additional anastrozole therapy (1 mg/day) to TAM (group 1BANA).
RESULTS: In the 3rd month of the study, while the sperm concentration and motility were found significantly improved in group 1 (p < 0.05), they were significantly lower in groups 1BTAM and 1BANA than in group 1A (p < 0.01). In the 6th month of the study, the mean T/E2 ratio was normal in group 1A and group 1BANA, but was lower than normal ranges in group 1BTAM. The sperm concentration and motility significantly increased in groups 1A and 1BANA (p < 0.05).
CONCLUSIONS: A significant decrease in the T/E2 ratio was seen in the majority of the patients during TAM treatment. Normalization of this ratio by addition of anastrozole to the treatment regimen improved the treatment outcomes. However, a placebo-controlled study is needed to confirm our results.

PMID: 19996653 [PubMed - indexed for MEDLINE]

Full study http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ArtikelNr=000251186&Ausgabe=253627&ProduktNr=224282&filename=000251186.pdf

12-24-2010, 07:21 PM
Treatment of gynecomastia with tamoxifen: A double-blind crossover study

Lawrence N. Parker a (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN4-4C2SHC4-56&_user=10&_coverDate=08%2F31%2F1986&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1508149600&_rerunOrigin=scholar.google&_acct=C0000#aff1), b (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN4-4C2SHC4-56&_user=10&_coverDate=08%2F31%2F1986&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1508149600&_rerunOrigin=scholar.google&_acct=C0000#aff2), c (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN4-4C2SHC4-56&_user=10&_coverDate=08%2F31%2F1986&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1508149600&_rerunOrigin=scholar.google&_acct=C0000#aff3), http://www.sciencedirect.com/scidirimg/entities/REcor.gif (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN4-4C2SHC4-56&_user=10&_coverDate=08%2F31%2F1986&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1508149600&_rerunOrigin=scholar.google&_acct=C0000#m4.cor*), David R. Gray b (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN4-4C2SHC4-56&_user=10&_coverDate=08%2F31%2F1986&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1508149600&_rerunOrigin=scholar.google&_acct=C0000#aff2), c (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN4-4C2SHC4-56&_user=10&_coverDate=08%2F31%2F1986&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1508149600&_rerunOrigin=scholar.google&_acct=C0000#aff3), a (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN4-4C2SHC4-56&_user=10&_coverDate=08%2F31%2F1986&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1508149600&_rerunOrigin=scholar.google&_acct=C0000#aff1), Michael K. Lai b (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN4-4C2SHC4-56&_user=10&_coverDate=08%2F31%2F1986&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1508149600&_rerunOrigin=scholar.google&_acct=C0000#aff2), c (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN4-4C2SHC4-56&_user=10&_coverDate=08%2F31%2F1986&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1508149600&_rerunOrigin=scholar.google&_acct=C0000#aff3), a (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN4-4C2SHC4-56&_user=10&_coverDate=08%2F31%2F1986&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1508149600&_rerunOrigin=scholar.google&_acct=C0000#aff1) and Ellis R. Levin b (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN4-4C2SHC4-56&_user=10&_coverDate=08%2F31%2F1986&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1508149600&_rerunOrigin=scholar.google&_acct=C0000#aff2), c (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN4-4C2SHC4-56&_user=10&_coverDate=08%2F31%2F1986&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1508149600&_rerunOrigin=scholar.google&_acct=C0000#aff3), a (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN4-4C2SHC4-56&_user=10&_coverDate=08%2F31%2F1986&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1508149600&_rerunOrigin=scholar.google&_acct=C0000#aff1)

a Medicine, Service, University of California at Irvine, USA
b Pharmacy Service, University of California at Irvine, USA
c Long Beach Medical Program, Veterans Administration Medical Center, Long Beach, Calif., USA


Benign asymptomatic or painful enlargement of the male breast is a common problem, postulated to be due to an increased estrogen/testosterone ratio or due to increased estrogenic or decreased androgenic stimulation via estrogen or androgen receptor interactions. Treatment at present consists of analgesic medication or surgery. However, treatment directed against the preponderance of estrogenic stimulation would seem to represent a more specific form of therapy. In the present double-blind crossover study, one-month courses of a placebo or the antiestrogen tamoxifen (10 mg given orally bid) were compared in random order. Seven of ten patients experienced a decrease in the size of their gynecomastia due to tamoxifen (P < 0.005). Overall, the decrease for gynecomastia for the whole group was significant (P < 0.01). There was no beneficial effect of placebo (P > 0.1). Additionally, all four patients with painful gynecomastia experienced symptomatic relief. There was no toxicity. The reduction of breast size was partial and may indicate the need for a longer course of therapy. A followup examination was performed in eight out of ten patients nine months to one year after discontinuing placebo and tamoxifen. There were no significant changes from the end of the initial study period except for one tamoxifen responder who developed a recurrence of breast tenderness after six months, and one nonresponder who demonstrated an increase in breast size and a new onset of tenderness after ten months. Therefore, antiestrogenic treatment with tamoxifen may represent a safe and effective mode of treatment for selected cases of cosmetically disturbing or painful gynecomastia.

12-24-2010, 07:22 PM
[Influence of size and duration of gynecomastia on its response to treatment with tamoxifen]

[Article in Spanish]
Devoto C E (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Devoto%20C%20E%22%5BAuthor%5D), Madariaga A M (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Madariaga%20A%20M%22%5BAuthor%5D), Lioi C X (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Lioi%20C%20X%22%5BAuthor%5D), Mardones N (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Mardones%20N%22%5BAuthor%5D).
Sección Endocrinolog*a, Servicio de Medicina, Hospital Cl*nico San Borja Arriarán, Santiago, Chile. edevoto@vtr.net (edevoto@vtr.net)


BACKGROUND: Gynecomastia is treated when it is painful, there are psychosocial repercussions or it does not revert in less than two years. It is treated with the antiestrogenic drug tamoxifen, but there are doubts about its effectiveness in high volume gynecomastias or in those lasting more than two years.

AIM: To assess the effectiveness and safety of tamoxifen for gynecomastia and the influence of its volume and duration on the response to treatment.

PATIENTS AND METHODS: Forty three patients with gynecomastia, aged 12 to 62 years, were studied. Twenty seven patients had a pubertal physiological gynecomastia, in eight it was caused by medications, in four it was secondary to hypogonadism, in three it was idiopathic and in one it was due to toxic exposure. Twenty patients had mastodynia and in 33, gynecomastia had a diameter over 4 cm. It lasted less than two years in 30 patients, more than two years in nine and four did not recall its duration. All were treated with tamoxifen 20 mg/day for 6 months. A follow up evaluation was performed at three and six months of treatment.

RESULTS: Mastodynia disappeared in all patients at three months. At six months gynecomastia disappeared in 26 patients (62%), but relapsed in 27%. All gynecomastias caused by drugs with antiandrogen activity disappeared. Fifty two percent of gynecomastias over 4 cm and 90% of those of less than 4 cm in diameter disappeared (p<0.05). Fifty six percent of gynecomastias lasting more than two years and 70% of those of a shorter duration disappeared (p=NS). Two patients had diarrhea or flushes associated to the therapy.

CONCLUSIONS: Tamoxifen is safe and effective for the treatment of gynecomastia. Larger lesions have a lower response to treatment.

12-27-2010, 01:39 PM
Women & Nolvadex
*Note: * caveat about this is general information & not medical recommendations *

Nolvadex, being a Selective Estrogen Receptor Moderator (SERM), is one of the only compounds that directly affects the estrogen produced by the ovaries. As opposed to most other "anti-estrogens", which are actually Aromatase Inhibitors (AIs), such as Arimidex, Aromasin, etc. These work to prevent convertion of testosterone to estrogen. The sources of such estrogen are things like exogenous testosterone (e.g. Deca) and adrenal androgens.

Typical Use
Nolvadex is often used for short-term manipulation of estrogen to control estrogen-driven bodyfat depositing such as around the waist, hips and thighs. This is not intended as a "maintenance protocol for fat loss" - meaning it should be used for a specific goal such as a photoshoot or a competition, where you expect to rebound some after coming off.

Typical Cycle
Dose: 20 mg / day - split the dose 1/2 in the AM, 1/2 in the PM
Duration: 4-8 weeks max
Suggested to taper down the dose over the last week to reduce estrogen rebound

Typical Sides
- interrupted period / flow - may take a few months for the flow to come back as normal.
- may still experience usual menstrual sides (cramps, bloating, etc.) on your regular menstrual schedule
- post-cycle estrogen rebound

12-31-2010, 07:04 AM
J Clin Oncol. (http://javascript<b></b>:AL_get(this, 'jour', 'J Clin Oncol.');) 1996 Mar;14(3):1018-26.

Tamoxifen-associated eye disease. A review.

Nayfield SG (http://www.ironmagazineforums.com/pubmed?term=%22Nayfield%20SG%22%5BAuthor%5D), Gorin MB (http://www.ironmagazineforums.com/pubmed?term=%22Gorin%20MB%22%5BAuthor%5D).
Chemoprevention Branch, National Cancer Institute, Bethesda, MD, 20892, USA.


PURPOSE: The oral antiestrogen tamoxifen has demonstrated efficacy in the treatment of metastatic breast cancer and as adjuvant therapy in early-stage disease. Clinical trials of tamoxifen in chemoprevention of breast cancer among high-risk women have focused attention on potential adverse effects of long-term tamoxifen use, including the possibility of ocular toxicity. This review evaluates the published case reports, clinical series, and clinical trial data on ocular toxicities attributed to tamoxifen. Clinical issues of surveillance, differential diagnosis, and management of tamoxifen-related eye disease are discussed.

DESIGN: National Library of Medicine online bibliographic services were used to identify case reports and clinical studies of ocular adverse effects that occurred in patients receiving tamoxifen published through the fall of 1994. The medical literature relevant to issues raised by the reports and studies was similarly identified and reviewed.

RESULTS: Case reports and case series identify crystalline retinal deposits, macular edema, and corneal changes as potential tamoxifen ocular toxicities. Extensive retinal lesions and macular edema with visual impairment have been reported in a few patients receiving high-dose tamoxifen. Less extensive retinal changes may occur in patients receiving low doses for long periods, and isolated retinal crystals may be observed in patients without visual symptoms.

CONCLUSION: Ocular toxicity is uncommon in the current clinical setting of long-term, low-dose tamoxifen use. Physicians should be aware of the potential for ocular toxicity among patients receiving the drug and should assure appropriate surveillance and prompt evaluation of visual complaints.

PMID: 8622006 [PubMed - indexed for MEDLINE]

01-02-2011, 07:39 AM
Appl Radiat Isot. (http://javascript<b></b>:AL_get(this, 'jour', 'Appl Radiat Isot.');) 1998 May-Jun;49(5-6):643-5.

Body composition measurements using DXA and other techniques in tamoxifen-treated patients.

Ali PA (http://www.ironmagazineforums.com/pubmed?term=%22Ali%20PA%22%5BAuthor%5D), al-Ghorabie FH (http://www.ironmagazineforums.com/pubmed?term=%22al-Ghorabie%20FH%22%5BAuthor%5D), Evans CJ (http://www.ironmagazineforums.com/pubmed?term=%22Evans%20CJ%22%5BAuthor%5D), el-Sharkawi AM (http://www.ironmagazineforums.com/pubmed?term=%22el-Sharkawi%20AM%22%5BAuthor%5D), Hancock DA (http://www.ironmagazineforums.com/pubmed?term=%22Hancock%20DA%22%5BAuthor%5D).
Department of Medical Physics and Radiotherapy, Singleton Hospital, Swansea, U.K.


Tamoxifen is an anti-oestrogenic drug which is widely used in the treatment of patients with breast cancer. There is increasing interest in using the drug both for benign breast disease and as a chemo-preventative agent of the drug in women at high risk of breast cancer. Despite the fact that the acute side-effects of the drug are few, its agonistic and antagonistic oestrogenic effects are not fully known and may have some undesirable effects for patients treated with the drug for several years. A number of studies carried out recently indicate a varying degree of change in bone mineral content following treatment with tamoxifen. These studies concentrated mainly on bone mineral density measurements only and non of them reported the effects of tamoxifen on lean body mass and fat mass. In this study we measured lean body mass and fat mass in tamoxifen-treated females and a comparison group to determine the difference between the two groups. Twenty-six women receiving tamoxifen (20 mg/d) have participated in this study. The control group comprised 31 healthy women of a similar age. Total body bone mineral (TBBM) was measured using a dual-energy X-ray absorptiometry (DXA) (Hologic INV., Waltham, U.S.A.). Similarly, regional and total body soft tissue (lean and fat tissue) were measured using the DXA system. In addition to DXA measurements, percentage body fat (%BF) was measured using total body potassium counting (TBK), skinfold anthropometry (SF), infrared interactance (i.r.) and bioelectric impedance analysis (BIA). Results from DXA alone showed that there were no significant differences between the two groups for TBBM, regional and total body lean tissue mass. However, there was a significant difference between the two groups (P < 0.05) for %BF measurement. Similarly there was a significant difference between the two groups (P < 0.05) for %BF measured by other body composition techniques. Although there is no other research reported on the effects of tamoxifen on %BF, this retrospective study indicates that tamoxifen may lead to increase in fat content in women who are subjected to this treatment. We conclude that this observation is probably related to the agonistic oestrogenic effect of Tamoxifen on body fat. To our knowledge this deleterious effect has not been reported before and it should be taken into considerable when comprising different types of anti-oestrogenic drugs. Furthermore, patients should be warned about this side-effect when they are prescribed Tamoxifen therapy.

PMID: 9569566 [PubMed - indexed for MEDLINE]

01-29-2012, 08:24 PM
Klin Padiatr. (http://www.ncbi.nlm.nih.gov/pubmed/3123765#) 1987 Nov-Dec;199(6):389-91.

[Treatment of marked gynecomastia in puberty with tamoxifen].

[Article in German]
König R (http://www.ncbi.nlm.nih.gov/pubmed?term=%22K%C3%B6nig%20R%22%5BAuthor%5D), Schönberger W (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Sch%C3%B6nberger%20W%22%5BAuthor%5D ), Neumann P (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Neumann%20P%22%5BAuthor%5D), Benes P (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Benes%20P%22%5BAuthor%5D), Grimm W (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Grimm%20W%22%5BAuthor%5D).

Kinderklinik, Universität Mainz.


Based on the good results of another author 10 boys with marked pubertal gynecomastia were treated with the antioestrogen Tamoxifen (Nolvadex) at a dose of 20-40 mg/d orally for 2-12 months. In most cases the gynecomastia decreased totally, only two patients experienced palpable subareolar glandular tissue at the end of therapy. Side effects were not noted. During therapy levels of estradiol and testosteron increased, with a more pronounced elevation of estradiol. Basal values of LH and FSH remained nearly unchanged, but LH showed an increased response to LH-RH, which could be explained by the antioestrogenic effect of Tamoxifen at the hypothalamic level. The reduction of breast size in spite of increased estradiol levels on the other hand, suggests that the mean therapeutic effect of tamoxifen is through estrogen receptor blockade of breast tissue.

PMID:3123765 [PubMed - indexed for MEDLINE]

01-29-2012, 09:20 PM
In the cancer subjects that upregulation of PGR occurs, 100% see down regulation after 4 weeks of Nolva.

Cancer Res. (http://www.ncbi.nlm.nih.gov/pubmed/7214366#) 1981 May;41(5):1984-8.

Effects of tamoxifen on estrogen and progesterone receptors in human breast cancer.

Waseda N (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Waseda%20N%22%5BAuthor%5D), Kato Y (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Kato%20Y%22%5BAuthor%5D), Imura H (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Imura%20H%22%5BAuthor%5D), Kurata M (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Kurata%20M%22%5BAuthor%5D).


Twenty patients with primary breast cancer were treated with tamoxifen (10 mg p.o. twice a day) for 1 to 4 weeks. Before and after the tamoxifen administration, tumor specimens were obtained and assayed for estrogen receptors and progesterone receptors (PGR). Total cytosol estrogen receptor (ERC) and occupied nuclear estrogen receptor (ERN) were measured by hydroxylapatite assay, and unoccupied PGR was measured by the dextran-coated charcoal assay. ERC, ERN, and PGR were detectable in 11, 8, and 6 tumors, respectively, before tamoxifen administration. After tamoxifen treatment, ERC decreased in 10 of 11 ERC-positive tumors. Occupied ERN increased in three of five ERN-positive tumors treated with tamoxifen for a short period (1 to 2 weeks), but they decreased in all of three ERN-positive tumors after longer administration (3 to 4 weeks). PGR increased in three of five ERN-positive tumors after short-term tamoxifen treatment, but they decreased in all of three tumors treated by the drug for a longer period. Increased PGR responses were accompanied by an increase of ERN in two of three ERN-positive tumors. These results suggest that tamoxifen interacts with the estrogen receptor system in human breast cancer tissue and may be estrogenic during short treatment, while longer treatment results in an antiestrogenic response.

PMID:7214366 [PubMed - indexed for MEDLINE]

01-29-2012, 09:42 PM
Great read heavy..................when i see guys in the gym[where i work ]..that are fat...guys in their 40's to 60' with that blubbery fat.....i think clomid or nolva might really
help......and young boys with 'bitch tit's'........but you can't suggest they use clomid or nolva.........you have to tell them to go to the doctor.....