Drug which does not cause gynaecomastia: March 2011
**Core Concept**
Gynaecomastia is a condition characterized by the enlargement of breast tissue in males, often caused by an imbalance of estrogen and testosterone levels. This imbalance can be induced by various medications, including those that affect hormone levels, metabolic pathways, or have anti-androgenic effects.
**Why the Correct Answer is Right**
The correct answer is a drug that does not significantly disrupt the estrogen-testosterone balance or has minimal anti-androgenic effects. This is likely a medication with a different mechanism of action that does not interfere with the hormonal pathways involved in gynaecomastia.
**Why Each Wrong Option is Incorrect**
* **Option A:** A medication that induces gynaecomastia would be one that increases estrogen levels or blocks androgen receptors, such as spironolactone, which is known to cause gynaecomastia due to its anti-androgenic effects.
* **Option B:** Certain antipsychotics, such as risperidone, can cause gynaecomastia by altering hormone levels and blocking dopamine receptors, which can lead to an increase in prolactin levels.
* **Option C:** Some medications, like digoxin, can cause gynaecomastia by increasing estrogen levels, possibly due to its effect on the hypothalamic-pituitary-gonadal axis.
**Clinical Pearl / High-Yield Fact**
Be aware that certain medications, especially those with anti-androgenic effects or those that alter hormone levels, can cause gynaecomastia. This is a common side effect of many medications, and clinicians should be vigilant in monitoring patients for this condition.
**Correct Answer:** D.