52, on testosterone for just over a year after bloods showed I was low. Honestly it has been great, energy back, sleeping better, wife says I am less of a grump. But for about the last six weeks both nipples have been sore, like bruised sore when a t-shirt rubs, and there is a small firm button under the left one that I am sure was not there before. The right side is puffier but I cannot feel a lump as such.
I have read enough to know what gyno is. What I cannot work out is whether this is the TRT or just being 52, and whether the answer is "stop the gel", which I really do not want to do. Also slightly embarrassed to raise it with the clinic because it feels like I am complaining about the thing that fixed me.
Anyone been here? Did it go away? Did you end up needing an op?
Not TRT for me but I know the gym version of this well. Sore and puffy and a little button under the nipple is the classic early picture. The early bit matters, that is when it is most likely to respond to anything other than a scalpel. Do not sit on it out of embarrassment.
Mate at work went through this on injections. His doctor did bloods, changed how often he was injecting and gave him something for a few months, and the soreness went. He was left with a small bit on one side that never fully went, which he says he could live with. So it is not automatically surgery, but it was not nothing either.
And please do not just stop it yourself. He did that for a fortnight before telling anyone and felt rotten.
#4October 25, 2026, 10:12 am Steve, a useful question and one that comes up more than the forum would suggest. I cannot tell you what is under your nipple, but I can explain why this happens and who should look at it first.
Gynaecomastia on testosterone therapy is a recognised effect. Some of the testosterone you take is converted into oestrogen in the body, and when oestrogen builds up the breast gland can respond, with exactly the early tenderness and small firm disc you describe. It is not a sign the treatment is wrong for you, and it is not the same situation as anabolic steroid misuse, where use has to stop before anyone operates. You are on a prescribed, monitored treatment for a reason.
So the first person to see this is the doctor who prescribes your testosterone, not a surgeon. They have several levers: checking your blood levels, adjusting the dose or the formulation, and in some cases a medicine that lowers oestrogen or blocks its effect on the breast. Which of those, if any, is right for you is their decision, based on your results. Please do not stop or change the gel yourself. Marcus has written the background up in testosterone replacement and gynaecomastia, which sets out where surgery fits.
Two other points. Early, tender tissue is the stage most likely to settle once the hormones are addressed; gland that has been there for a long time tends to firm up and stay, and that is when surgery becomes a reasonable conversation. And a lump that is new, one-sided and firm should be examined regardless of the likely cause, so mention the left side specifically when you go. At 52, your GP or prescriber will want to feel it rather than assume.
Mr Julian Hart said:
It is not a sign the treatment is wrong for you
That line has made me feel a lot less daft about ringing them. I was half convinced they would just say right, that is it, off it you come.
Update for anyone who finds this later. Saw the clinic doctor yesterday. She felt both sides, said the left is gland not fat but small and still tender, which she was quite pleased about because it means it is early. Bloods booked for next week, and she said if the oestrogen side is up the first move will be changing the dose and how I take it, not stopping. She also wants the GP to have a look at the left side properly, which after Julian's post I had already asked for.
So not fixed, but a plan, and nobody has told me to come off it. Will report back after the bloods.
