448 TREATMENT OF PERSISTENT PUBERTAL GYNECOMASTIA WITH DEHYDROTESTOSTERONE HEPTANOATE (DHT-hp)

Abstract

Four pubertal boys ages 14-16 yrs. with gynecomastia for 16 mo. - 2 yrs. were treated with DHT-hp 200-400 mg IM at 2-4 wk. intervals for 4 mo. Initially, breast diameters ranged 3.8 to 7.5 cm with area of breast base (A.B.) 11.0 to 44.2 cm². Plasma testosterone (T), estradiol (E₂), LH, FSH and A.B. were measured weekly for 4 weeks and at 3-4 week intervals thereafter. The table shows the mean values (± S.E.) for the four boys at selected intervals.

Maximal suppression of T, E₂ and FSH occurred at 2 wks. followed by rebound at 4 wks. The injection frequency was increased to every 2-3 wks. On this schedule suppression of T, E₂ and FSH was maintained and clinical response improved. The two boys with initial T < 200 were relatively resistant to suppression of FSH and E₂ by DHT-hp. All four boys responded, had a 63 to 78% reduction in breast size and an acceptable cosmetic result. DHT-hp is a promising agent for the treatment of significant persistent gynecomastia.

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