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Is tamoxifen use directly related to the increased gyno occurrences seen with modern day steroid usersand therefore a possible increased risk?The question above raised the question of whether tamoxifen use should be regarded as a 'procedural' factor that could potentially increase the risk of the gynecomastia with modern day steroid users. Is it? Is it a potential factor for developing gynecomastia and subsequent gynecomastia in men?The purpose of this review was to examine whether tamoxifen use or a known pattern of tamoxifen use is a significant factor in developing gynecomastia.MethodsThe Medline databases of 1970 to the present (December 2001) were searched by the following keywords and any relevant literature were searched until the search terms were exhausted:Tamoxifen: "female" or "female hormone" or "female hormone" or simply "female hormone"; "women"; "female"; "female hormone"; "female hormone"; "estrogen"; "estrogen", "testosterone"; "male"; or use tamoxifen (tamoxifen and sildenafil) or anabolic or androgenic steroids or anabolic steroids; and steroid or androgen or androgenic steroid.We used two main approaches to the analysis; comparing the risk from tamoxifen use to that of an androgen receptor/beta-blocker-only steroid or an androgen-only steroid (which are often used), comparing the risk from tamoxifen use to that of other drugs with high androgenicity (which are often used), comparing the risk from tamoxifen use to that from other hormone-sensitive drugs which are often used, comparing the risk from tamoxifen use to that from anabolic androgens (which are commonly thought to be anabolic), etc. When comparing the risk from tamoxifen use to that from other factors, all factors combined were considered.ResultsTable 1 summarizes the results of the literature review, which indicates that while the risk of gynecomastia has been increasing dramatically in contemporary men, the risk associated with tamoxifen and sildenafil use has been increasing in men over recent decades.Table 2 shows the incidence of gynecomastia in men, compared with the incidence in women, before and after the introduction of tamoxifen and sildenafil as an antiandrogen in 1970/71. The incidence of gynecomastia as aRelated Article: