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Tuesday, October 21, 2008

A Simple Guide to Gynecomastia


A Simple Guide to Gynecomastia
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What is Gynecomastia?
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Gynecomastia is unilateral or bilateral enlargement in the glandular tissue of the breast in males.


What causes Gynecomastia?
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The causes of gynecomastia is not completely clear.

It is believed to be caused by an imbalance of sex hormones especially during puberty.

A.Hormonal:
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1.In male babies the painless swelling of the breast may occur due to the effects of the mother's female hormones.

The swelling usually subsides after a few weeks.

2.At Puberty for boys the development of breasts is due to the increased ratio of free estradiol to free testesterone.

In most cases the breasts may disappear after 1 year.

3.Some cases of Gynecomastia may be due to ingestion of female hormones injected into chicken and ducks

B.Genetic
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Some cases of male hypogonadism causing reduced testosterone.

C.Liver cirrhosis
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Failure of metabolism of circulating estrogens can increase the female hormones in the adults and cause Gynecomastia

D.Medications:
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a.Spironolactone

b.digoxin

c.cimetidine

d.maxolon

E.Tumors
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Testicular or Pituitary Tumors may cause increased estrogen and reduced testesterone and hence increase the production of breasts.


What are the symptoms of Gynecomastia?
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The Symptoms of Gynecomastia are:

1.Pain usually present in all cases except in babies

2.swelling of the breasts or the nipple area in males

Signs:

1.redness of the breast

2.swelling of the breast tissue

3.Local tenderness of swollen area


How is diagnosis of Gynecomastia confirmed?
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1. clinical features

2. Endocrine blood tests including HCG levels

3. Liver function tests

4.Ultrasound scan of the breasts


What is the treatment of Gynecomastia?
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1.treat underlying cause

2.Medications causing Gynecomastia should be stopped.

3.cosmetic surgery-liposuction, gland excision, reduction mammoplasty,

4.Tamoxifen if necessary

5.Radiation therapy may prevent gynecomastia in patients with prostate cancer prior to estrogen therapy.


What is the Prognosis of Gynecomastia?
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Most cases has good prognosis.

Aldolescent cases usually regress spontaneously.















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