Dawaa Reference

chronic

Gynaecomastia (Adult)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources2 sources

Endocrine Society Guideline on Gynecomastia 2012 · Tamoxifen 20 mg Tablets SmPC sections 4.1-4.4 (eMC product 12524)

Verified against1 document
  • Tamoxifen 20 mg Tablets SmPC sections 4.1-4.4 (eMC product 12524)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (3)

  • Ask when it started and how long it has been there, and about any accompanying symptoms
  • It can be silent and turn up first on an MRI or CT of the chest done for another reason
  • Family and genetic history, prescribed medicines and recreational drug use all matter

Signs — what you find (4)

  • Breast findings that count: the feel of the tissue, a mass, skin change, nipple discharge, unequal sides, and tenderness, plus the axilla [nipple discharge]
  • Examine the testes for unequal size, a lump, enlargement or shrinkage
  • Check the head and neck for any abnormal lump or a thyroid abnormality
  • Pseudogynaecomastia is fat alone all round the areola, usually on both sides and unchanged in size for years

Tests (9)

  • A well man with no symptoms, a normal examination and breast tissue present over 12 months needs nothing further
  • A testicular lump calls for scrotal ultrasound plus testosterone, LH, oestradiol and DHEAS
  • A thyroid lump calls for thyroid function tests, thyroid ultrasound and an endocrine opinion
  • A palpable breast lump needs mammography or ultrasound and a biopsy, with a surgical opinion if indicated
  • With hypogonadism: LH and FSH, oestradiol, testosterone, DHEAS, a karyotype, and possibly an adrenal scan
  • An abdominal mass or an enlarged liver: liver function tests, LH and FSH, oestradiol, testosterone, DHEAS, and abdominal CT if needed
  • Kidney and liver function should be checked
  • Thyroid studies when an overactive thyroid is suspected
  • Men who are developing female characteristics need endocrine and genetic testing

If not this — what else fits (3)

  • Breast cancer
  • Lymphoma
  • Dermoid cyst

SourceStatPearls "Gynecomastia" - disease-level clinical article

Presentation findings are traced to the source above.

1

TAMOXIFEN

1st line

Strength20 mg

Formoral.solid

Adult dose and duration

10-20 mg once daily for 3-6 months for painful, recent-onset (<6 months) glandular gynaecomastia x 3-6 months

Paediatric dose

Specialist pediatric/adolescent endocrinology evaluation

Dose source

Tamoxifen 20 mg Tablets SmPC sections 4.1-4.4 (eMC product 12524)

Why

Selective oestrogen-receptor modulator that blocks oestrogen's proliferative effect on glandular breast tissue, used for painful, recent-onset gynaecomastia once secondary causes such as drug-induced, testicular, hepatic, or hypogonadal causes have been excluded.

Cautions
  • First exclude secondary causes: drug-induced (spironolactone, digoxin, finasteride), testicular tumor, hepatic failure, or hypogonadism.
  • Pubertal gynaecomastia is physiological and usually resolves spontaneously within 1-2 years without medical therapy.
  • Gynaecomastia is not a licensed indication. The label covers breast cancer, its prevention, and ovulation induction - nothing else. This is an off-label use with reasonable evidence behind it, but say so.
  • Two to three times the clot risk. Stop it at least six weeks before planned surgery or any long stretch of immobility.
  • There is an increased risk of deep vein thrombosis and thromboembolism.
Egyptian brands
Egyptian brandManufacturerIndicative price
TAMOXIFEN 20 MG 20 TABS.TECHNOPHARMA68.00 EGP (3.40/unit)

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.