Global InformationGynecomastia information
| Gynecomastia | |
|---|---|
 | |
| Adult male with significant gynecomastia | |
| Pronunciation |
|
| Specialty | Endocrinology, plastic surgery |
| Usual onset | Any age |
| Duration | Usually up to 2 years, but can be lifelong |
| Causes | Increased estrogen/androgen ratio (physiologic, medications, chronic kidney disease, obesity, cirrhosis, malnutrition, certain cancers) |
| Diagnostic method | physical exam, mammography (if indicated) |
| Differential diagnosis | Pseudogynecomastia, breast cancer |
| Treatment | Lifestyle modifications, aromatase inhibitors, SERMs, or surgery |
Gynecomastia (also spelled gynaecomastia)[a] is the abnormal non-cancerous enlargement of one or both breasts in males due to the growth of breast tissue as a result of a hormone imbalance between estrogens and androgens.[4][5] Gynecomastia can cause significant psychological distress or unease.[6]
Gynecomastia can be normal in: newborn male babies, due to exposure to estrogen from the mother; adolescent boys going through puberty; older men, over age 50; and obese men.[4] Most occurrences of gynecomastia do not require diagnostic tests.[4][5] Gynecomastia may be caused by abnormal hormone changes, any condition that leads to an increase in the ratio of estrogens/androgens such as liver disease, kidney failure, thyroid disease and some non-breast tumors. Alcohol and some drugs can also cause breast enlargement.[4][7] Other causes may include Klinefelter syndrome, metabolic dysfunction, or a natural decline in testosterone production.[4][6][8] This may occur even if the levels of estrogens and androgens are both appropriate, but the ratio is altered.[7]
Gynecomastia is the most common benign disorder of the male breast tissue and affects 35% of men, being most prevalent between the ages of 50 and 69.[5][9] It is normal for up to 70% of adolescent boys to develop gynecomastia to some degree.[6] Of these, 75% resolve within two years of onset without treatment.[10] If the condition does not resolve within 2 years, or if it causes embarrassment, pain or tenderness, treatment is warranted.[11][12] Medical treatment of gynecomastia that has persisted beyond two years is often ineffective. Gynecomastia is different from "pseudogynecomastia",[5][6] which is commonly present in men with obesity.[13][14]
Medications such as aromatase inhibitors have been found to be effective[15] and even in rare cases of gynecomastia from disorders such as aromatase excess syndrome or Peutz–Jeghers syndrome,[16] but surgical removal of the excess tissue can be needed to correct the condition.[17] In 2019, 24,123 male patients underwent the procedure in the United States, accounting for a 19% increase since 2000.[18]
- ^ "Gynaecomastia | Definition of Gynaecomastia by Oxford Dictionary on Lexico.com". Lexico Dictionaries | English. OxfordDictionaries.com. Archived from the original on 8 March 2021. Retrieved 17 November 2020.
- ^ "Definition of Gynecomastia". www.merriam-webster.com. Retrieved 17 November 2020.
- ^ Iuanow, Elaine; Kettler, Mark; Slanetz, Priscilla J. (March 2011). "Spectrum of Disease in the Male Breast". American Journal of Roentgenology. 196 (3): W247–W259. doi:10.2214/AJR.09.3994. PMID 21343472.
- ^ a b c d e "Breast enlargement in males: MedlinePlus Medical Encyclopedia". medlineplus.gov. 2018. Retrieved 25 November 2020. Updated by Brent Wisse (10 November 2018)
- ^ a b c d Thiruchelvam, Paul; Walker, Jonathan Neil; Rose, Katy; Lewis, Jacqueline; Al-Mufti, Ragheed (22 September 2016). "Gynaecomastia". BMJ. 354: i4833. doi:10.1136/bmj.i4833. PMID 27659195. S2CID 220098795.
- ^ a b c d Niewoehner, CB; Schorer, AE (March 2008). "Gynaecomastia and breast cancer in men". British Medical Journal. 336 (7646): 709–713. doi:10.1136/bmj.39511.493391.BE. PMC 2276281. PMID 18369226.
- ^ a b Cite error: The named reference
Narula2014was invoked but never defined (see the help page). - ^ Johnson RE, Murad MH (November 2009). "Gynecomastia: pathophysiology, evaluation, and management". Mayo Clinic Proceedings. 84 (11): 1010–1015. doi:10.4065/84.11.1010. PMC 2770912. PMID 19880691.
- ^ Cite error: The named reference
Chau2016was invoked but never defined (see the help page). - ^ Shulman, D. I.; Francis, G. L.; Palmert, M. R.; Eugster, E. A.; Lawson Wilkins Pediatric Endocrine Society Drug and Therapeutics, Committee. (1 April 2008). "Use of Aromatase Inhibitors in Children and Adolescents With Disorders of Growth and Adolescent Development". Pediatrics. 121 (4): e975–e983. doi:10.1542/peds.2007-2081. PMID 18381525. S2CID 39852740.
- ^ "Gynecomastia: Surgery, treatment, causes, and symptoms". www.medicalnewstoday.com. 11 January 2018. Retrieved 16 April 2021.
- ^ Dickson, Gretchen (1 April 2012). "Gynecomastia". American Family Physician. 85 (7): 716–722. ISSN 0002-838X. PMID 22534349.
- ^ Z. Hochberg (1 January 2007). Practical Algorithms in Pediatric Endocrinology. Karger Medical and Scientific Publishers. pp. 21–. ISBN 978-3-8055-8220-9.
- ^ Seth Thaller; Mimis Cohen (28 February 2013). Cosmetic Surgery After Massive Weight Loss. JP Medical Ltd. pp. 133–. ISBN 978-1-907816-28-4.
- ^ de Ronde, W., de Jong, F.H. Aromatase inhibitors in men: effects and therapeutic options. Reprod Biol Endocrinol 9, 93 (2011). https://doi.org/10.1186/1477-7827-9-93
- ^ Cite error: The named reference
Wit2011was invoked but never defined (see the help page). - ^ Cite error: The named reference
Drugswas invoked but never defined (see the help page). - ^ "Plastic Surgery Statistics Report" (PDF). American Society of Plastic Surgeons. 2019. Archived from the original (PDF) on 19 February 2021.
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