Question
I am a man and my breasts got larger on ART – what can i do?
26 March 2021. Related: All topics, Side effects.
I am taking Ranega (dolutegravir/lamivudine/tenofovir DF). Over the past few months I have noticed an enlargement of my breasts and as a man it’s really embarrassing. What can I do to reduce my breasts or what kind of diet should I follow?
Answer
Thanks for getting in touch.
You didn’t say how old you are but this is also a common symptoms for older men who put on weight.
These changes might be gynecomastia. This is a medical term for a type of breast enlargement in men. Although it has been reported with ART (antiretroviral therapy), this has only been liked with efavirenz:
https://i-base.info/htb/4758
However, this study (from 2004) reported this as being linked to lower levels of testosterone, rather than HIV meds.
https://academic.oup.com/cid/article/39/10/1514/460011
Integrase inhibitors – including dolutegravir – can cause weight gain, but this is more likely to be total weight, not just in your breasts. This was more common in an African study in both men and women, though worse in women.
Checking testosterone levels might help. If you put on weight after ART, then diet and exercise might also help.
Talking to your doctor is important as this can be a stressful change in your body. If you are finding this difficult to talk about, take these two studies (both in African men) to show your doctor. Study 1 (Zimbabwe) and Study 2 (Malawi).
More info from UK NHS site:
https://www.nhs.uk/common-health-questions/mens-health/what-is-gynaecomastia/
Technical report on the ADVANCE study showing weight gain with dolutegravir.
https://i-base.info/htb/38493
Hello Kgolane and thanks for getting in touch.
Is it only your breasts getting bigger and is it both of them or just one?
What has your doctor said about this?
Your doctor needs to review and assess whether this is happening to just one breast, both, or your entire body.
Your clinic should also be monitoring your weight at least once a year.
This is not a side effect of the ARVs (breasts getting bigger) but should be examined by a doctor before deciding on a diagnosis and treatment
I’m 66yrs n hiv positive. My breast is growing big to my embarrassment. I’m taking dolutegravir, lamivudine, abacavir
Hello Sarah and thanks for getting in touch.
DLT doesn’t have that effect on breasts unless this is combined with weight gain.
It is more likely that other reasons are behind this, especially if you have been on DLT for 15 years and just now notice the effect.
It’s best to discuss this with your doctor who can run tests to identify why this is happening.
Do you also have any other symptoms?
Im a woman 56 years old. I have taken dolutegravir/lamivudine/tenofovir DF for the past 15 years and realised excessive breast enlargement. What should I do?