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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