Understand it
Medications That Cause Gynecomastia: The List, and What to Do
Medicines and other substances cause somewhere between 10 and 25% of gyno in men, and it's the cause most often reversed. Here's the list doctors use, grouped in plain English, and how to talk to your doctor about it.
Quick answer
Many medicines and substances can cause gyno, including spironolactone, finasteride, some heart, stomach and psychiatric drugs, anabolic steroids, marijuana and alcohol, and herbs like tribulus, lavender and tea tree oil. Together they cause 10 to 25% of cases. Stopping the cause often shrinks the tissue within about three months, but only your doctor should decide whether and how to change a prescription.
On this page
Why medicines can cause gyno
Gyno happens when estrogen's effect outweighs testosterone's. A medicine can tip that balance in several ways: by blocking testosterone, by acting like estrogen, by raising estrogen, or by changing other hormones. American Family Physician groups the agents linked to gyno by how they work, and that's how I've laid them out below.
The list is long, and being on it doesn't mean a medicine will cause gyno for you. Most people who take these drugs never get it. It means it's a known possibility, and worth asking about if your chest changed after you started one.
Medicines and substances linked to gyno
| How it works | Examples |
|---|---|
| Blocks testosterone's effect | Spironolactone, cimetidine, ketoconazole, flutamide, bicalutamide, omeprazole, ranitidine, metronidazole, isoniazid, some chemotherapy drugs, marijuana |
| Acts like estrogen | Anabolic steroids, estrogens, hCG, GnRH agonists, digoxin, phenytoin, diazepam, plant estrogens |
| Speeds up testosterone breakdown | Alcohol |
| Raises prolactin | Haloperidol, metoclopramide, phenothiazines |
| Unknown mechanism | Finasteride, amlodipine, nifedipine, diltiazem, verapamil, ACE inhibitors, amiodarone, atorvastatin, rosuvastatin, fenofibrate, fluoxetine, paroxetine, venlafaxine, mirtazapine, risperidone, tricyclic antidepressants, some HIV medicines, minocycline, minoxidil, methyldopa, theophylline, amphetamines, heroin, methadone |
From Dickson, American Family Physician, 2012, Table 2. Not every example is listed; brand names omitted. Being on this list means "linked to gyno," not "will cause gyno."
The ones men ask about most
Spironolactone. A diuretic used for blood pressure, heart failure and some skin conditions. It blocks testosterone's effect, which is why it's one of the best-known causes.
Finasteride. The hair-loss and prostate pill. It's on the list, and many men starting it for hair loss don't know that.
Heartburn and stomach drugs. Omeprazole, cimetidine and ranitidine are all on the list.
Heart and blood pressure medicines. Several calcium channel blockers, ACE inhibitors, digoxin and amiodarone are there.
Psychiatric medicines. Some antidepressants and antipsychotics, including fluoxetine, paroxetine, venlafaxine and risperidone.
Prostate cancer treatments. Antiandrogens like bicalutamide and hormone therapy cause gyno often. American Family Physician notes that tamoxifen has been recommended to prevent it in men on bicalutamide; that's a decision for your oncologist.
Supplements, herbs and recreational drugs
Not just prescriptions. American Family Physician links lavender, tea tree oil, dong quai and tribulus, a common "testosterone booster" ingredient, to gyno. Soy taken in large amounts, over 300 mg a day, has been reported to cause it. Marijuana, heroin, amphetamines and alcohol are all on the list, and the article says marijuana, heroin or amphetamine use may contribute to gyno that doesn't go away. Anabolic steroids get their own page: steroid gyno.
What to do if you think a medicine caused it
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Write down the timeline
When did you start each medicine and supplement, and when did you first notice your chest changing? A clear timeline is the most useful thing you can bring.
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List everything you take
Prescriptions, over-the-counter drugs, supplements, gym products, skin products with lavender or tea tree oil, and recreational drugs. Doctors can't help with what they don't know about.
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Ask your doctor the right question
Not "should I stop this?" but "could this be causing my gyno, and is there an alternative that doesn't?" Often there is.
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Give a change time to work
American Family Physician says stopping the cause often makes breast tissue shrink within about three months. If it's been there more than a year, it may have turned fibrous and stay, as explained in will gyno go away.
Questions people ask
Which medications cause gynecomastia?
Many. Well-known examples include spironolactone, finasteride, some heartburn drugs like omeprazole, some heart and blood pressure medicines, some antidepressants and antipsychotics, prostate cancer treatments, and anabolic steroids.
Will gyno from medication go away?
Often. American Family Physician says stopping the cause often shrinks the tissue within about three months, especially if it's caught early. Gyno that's been there over a year may stay.
Can finasteride cause gyno?
Yes, finasteride is on the medical list of drugs linked to gyno. If your chest changed after starting it, talk to the doctor who prescribed it.
Should I stop my medication if I have gyno?
No, not on your own. Talk to your doctor first. Some medicines are dangerous to stop suddenly, and there may be an alternative that doesn't cause gyno.
Can supplements cause gynecomastia?
Yes. Tribulus, a common testosterone-booster ingredient, and lavender, tea tree oil and dong quai have been linked to it, as has taking a lot of soy.
Sources
- Dickson G. Gynecomastia. American Family Physician, 2012;85(7):716-722
- Vojvodic M, et al. Anabolic-androgenic steroid use among gynecomastia patients. Annals of Plastic Surgery, 2019
Medical facts last checked against these sources on .
Medical disclaimer. I'm a guy who has lived with gyno, not a doctor. This page explains what published medical sources say, in plain words, so you can have a better conversation with your own doctor. It isn't medical advice, a diagnosis or a treatment plan. Don't start, stop or change any medication without talking to a doctor. If something on your chest is changing fast, hurts, or leaks fluid, get it checked.
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