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[Unilateral] gynecomastia in an older man
    Differential Diagnosis[Top] [Nav]
sex partner uses estrogen-containing vaginal cream
    Discussion -- not available online[Top] [Nav]
    Erratum in printed version[Top] [Nav]
       *[footnote 2] Estrogens were administered by cream, not systemically. Also reports a woman whose hirsutism resolved after her hypogonadal husband stopped using testosterone cream.
    Update Comments[Top] [Nav]
  • The scrotum, by an factor of 3, has the highest transcutaneous hydrocortisone absorption rate on the body. It would not, therefore, be surprising if estrogens, given their structural similarity to hydrocortisone, were equally well-absorbed at that site. [101]
  • Cites reports of boys who developed gynecomastia after exposure to trace amounts of estrogens in fomites or foods. [102]
  • Doubts the nitrate-erection hypothesis of footnote 6, but they ignore the fact that... [see below] [104]
  • ...nitric oxide is necessary for erection. [105]
  • Animal study shows that cyclophosphamide can be transmitted from male to female during mating, and increases the rate of pre-implantation embryo loss. [106]
  • Some female sex partners of men using intraurethral alprostadil complain of vaginal itching and burning. Because alprostadil is embryotoxic, intraurethral use is not recommended when the sex partner is pregnant. [107]
  • A light-headed woman seen in the emergency was found to have her husband's nitroglycerin patch on her buttocks. [108]
    Footnotes in Print Edition[Top] [Nav]
    (1) Gynecomastia from exposure to vaginal estrogen cream [letter].
  DiRaimondo CV, Roach AC, et al.   N Engl J Med 1980 May 8;302(19):1089-90.  Pubmed  Similars
    (2) Spouse-related drug side-effects [letter].
  Moore N, Paux G, et al.   Lancet 1988 Feb 27;1(8583):468.  Pubmed  Similars
    (3) Goodman & Gilman's The Pharmacological Basis of Therapeutics. 6th ed.
  Gilman AG, et al. New York: Macmillan, 1980: 1427.   Amazon.com
    (4) Glans penis dermatitis after treatment of wife's vaginitis.
  Fried FA, Hines RG.   JAMA. 1981;245:2532.
    (5) Person-to-person transfer of transdermal drug-delivery systems: a case report [letter].
  Reed MT, Hamburg EL.   N Engl J Med 1986 Apr 24;314(17):1120-1.  Pubmed  Similars
    (6) Transdermal nitrate, penile erection, and spousal headache [letter].
  Talley JD, Crawley IS.   Ann Intern Med 1985 Nov;103(5):804.  Pubmed  Similars
    New References[Top] [Nav]

Gynecomastia from estrogens
    101.Transcutaneous drug delivery: a practical review.
  Berti JJ, Lipsky JJ.   Mayo Clin Proc 1995 Jun;70(6):581-6.  Pubmed+Abstract  Similars
    102.Gynecomastia: a continuing diagnostic dilemma [editorial; comment].
  Wilson JD.   N Engl J Med 1991 Jan 31;324(5):334-5.  Pubmed  Similars
    103.Gynecomastia [see comments].
  Braunstein GD.   N Engl J Med 1993 Feb 18;328(7):490-5.  Pubmed  Similars

Nitroglycerin and the penis
    104.Side effects of transdermal nitrate [letter].
  Becker GJ, Hicks ME.   Ann Intern Med 1986 Apr;104(4):590.  Pubmed  Similars
    105.Nitric oxide: a physiologic mediator of penile erection.
  Burnett AL, Lowenstein CJ, et al.   Science 1992 Jul 17;257(5068):401-3.  Pubmed+Abstract  Similars

More sexually transmitted medications
    106.Cyclophosphamide in the seminal fluid of treated males: transmission to females by mating and effect on pregnancy outcome.
  Hales BF, Smith S, et al.   Toxicol Appl Pharmacol 1986 Jul;84(3):423-30.  Pubmed+Abstract  Similars
    107.Intraurethral alprostadil for impotence.
  Med Lett Drugs Ther 1997 Mar 28;39(997):32.  Pubmed  Similars
    108.Transdermal medication exchange: the case of the light-headed lover [letter].
  Roberts JR, Hogan K, et al.   JAMA 1993 Jan 6;269(1):47.  Pubmed  Similars
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    ©1986-2000 John Sotos, MD. All rights reserved.  Last updated 16:33 PDT on July 4, 2000.[Top]

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