This case is from Text book of clinical Pharmacology by Laurence on significance of absorption of medication from vaginal secretions." An old man reported with gynecomastia of one side, Investigations done failed to reveal any cause and hence surgical treatment was given. After Few months, he again came with gynecomastia of other side. This time, complete detailed history was also taken along with investigations. Sexual history revealed that his wife was advised estrogen cream to apply in vagina for menopausal problems.
Per chance, couple made sexual relationship after application of estrogen cream and found it comfortable. After that,husband made it a regular practice. Absorption of estrogen through penile mucosa during intercourse was the cause of gynecomastia. Thus,couple need to be advised to prevent adverse events when woman is on medications which is excreted in vaginal secretions…
