The University of Toledo Translation Journal of Medical Sciences 
Pulmonology Abstract, Department of Medicine Research Symposium UTJMS 2023 May 5; 11(1):e1-e1 

Reversal of Spironolactone-Induced 
Gynecomastia: A Review and Case Report 
of Spironolactone-Induced Gynecomastia 
Alex Carsel1*, Nicholas Stimes1, Dhanushya Battepati1, Ragheb Assaly, MD1 

1Division of Pulmonology and Critical Care Medicine, Department of Medicine, The 
University of Toledo, Toledo, OH 43614 

*Corresponding author: alexander.carsel@rockets.utoledo.edu

Published: 05 May 2023 

Introduction: Gynecomastia, an enlargement of male breast tissue is a common, asymptomatic 
condition that increases with aging and obesity; however, the condition can be detrimental to one’s 
mental health. Medications account for approximately 20-25% of the new cases of gynecomastia in 
adults, and the anti-hypertensive agent spironolactone. Eplerenone, a more selective aldosterone 
inhibitor compared to spironolactone, is cited as an alternative that can reverse spironolactone-induced 
gynecomastia in patients with hyperaldosteronism and cirrhosis. Therefore, we have reviewed the recent 
literature to assess the reports relating spironolactone-induced gynecomastia reversal after 
discontinuation of spironolactone and replacement with eplerenone, and we present a case of 
spironolactone-induced gynecomastia.  

Methods: The PubMed database was queried to identify all original articles on this topic from January 
1, 2005 through August 1, 2022 based on the search term “gynecomastia, spironolactone, eplerenone.” A 
manual search of the works cited included original articles.  

Results: The search yielded 42 articles. In total, 4 articles were included in the final review with a total 
of 204 patients. Systematic or meta-analytic reviews were excluded.  All included studies demonstrated 
resolution of gynecomastia with discontinuation of spironolactone or replacement with eplerenone.   

Conclusion: Based on the results of this review, it is clear that there is a significant gap in the literature 
pertaining to the importance of identifying and treating gynecomastia, and reversing spironolactone-
induced gynecomastia in patients with heart failure and cirrhosis. Future studies should aim to 
investigate the therapeutic benefits of discontinuing spironolactone in medication-induced gynecomastia 
or replacing treatment with eplerenone. 

https://dx.doi.org/10.46570/utjms.vol11-2023-775 

https://dx.doi.org/10.46570/utjms.vol11-2023-775
mailto:alexander.carsel@rockets.utoledo.edu