A 65-Year-Old Man with Benign Prostatic Hyperplasia Comes to the Office

A 65-year-old man with benign prostatic hyperplasia comes to the office for a follow-up appointment.  He has a history of obstructive urinary symptoms that were unrelieved with tamsulosin, and a new medication was prescribed at his last visit 8 months ago.  Since starting the new medication, the patient has experienced gradual improvement in urinary hesitancy and strength of urinary stream.  However, he also has noticed a significant increase in the size of his breasts.  The patient reports no pain or changes in weight.  Glandular tissue, approximately 2 cm in diameter, is palpated under the nipples and is mildly tender to palpation.  There is no nipple discharge, breast asymmetry, or rash.  This patient's breast findings are most likely due to which of the following drug effects?

A) Blockade of androgen receptors
B) Decreased testicular production of testosterone
C) Displacement of estrogen from sex hormone-binding globulin
D) Increased peripheral conversion of testosterone to estradiol
E) Increased prolactin production

Correct Answer:

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