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- Patient Comments: Gynecomastia - Symptoms
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- Gynecomastia definition and facts
- What is gynecomastia (enlarged male breasts)?
- What are the signs and symptoms of gynecomastia?
- Who gets gynecomastia?
- What does gynecomastia look like?
- What causes gynecomastia during puberty, and how long does it last?
- What diseases and conditions cause gynecomastia?
- What medications cause gynecomastia?
- How do I know if I have gynecomastia (diagnosis)?
- What treatment drugs and surgery procedures reduce or cure the condition?
- How long does it take for gynecomastia to go away?
- Can gynecomastia be prevented?
- Are gynecomastia and male breast cancer related?
What causes gynecomastia during puberty, and how long does it last?
Gynecomastia results from an imbalance in hormone levels in which levels of estrogen (female hormones) are increased relative to levels of androgens (male hormones). Gynecomastia that occurs in normally-growing infant and pubertal boys that resolves on its own with time is known as physiologic gynecomastia.
All individuals, whether male or female, possess both female hormones (estrogens) and male hormones (androgens). During puberty, levels of these hormones may fluctuate and rise at different levels, resulting in a temporary state in which estrogen concentration is relatively high. Studies regarding the prevalence of gynecomastia in normal adolescents have yielded widely varying results, with prevalence estimates as low as 4% and as high as 69% of adolescent boys. These differences probably result from variations in what is perceived to be normal and the different ages of boys examined in the studies.
Gynecomastia caused by transient changes in hormone levels with growth usually disappears on its own within six months to two years. Occasionally, gynecomastia that develops in puberty persists beyond two years and is referred to as persistent pubertal gynecomastia.
What diseases and conditions cause gynecomastia?
A number of medical conditions may also result in gynecomastia:
- Malnutrition and re-feeding (recovery from malnutrition) have both been shown to create a hormonal environment that may lead to gynecomastia. Similarly, cirrhosis of the liver alters normal hormone metabolism and may lead to gynecomastia.
- Disorders of the male sex organs (testes) can result in decreased testosterone production and relatively high estrogen levels, leading to gynecomastia. These disorders may be genetic, such as Klinefelter's syndrome, or acquired due to trauma, infection, reduced blood flow, or aging. Testicular cancers may also secrete hormones that cause gynecomastia.
- Other conditions that are associated with an altered hormonal environment in the body and may be associated with gynecomastia are chronic renal failure and hyperthyroidism. Rarely, cancers other than testicular tumors may produce hormones that can cause gynecomastia.
What medications cause gynecomastia?
Gynecomastia can also be a side effect of a number of medications. Examples of drugs that can be associated with gynecomastia are listed below:
- spironolactone (Aldactone), a diuretic that has anti-androgenic activity
- Calcium channel blockers used to treat hypertension (such as nifedipine [Procardia and others])
- ACE inhibitor drugs for hypertension (captopril [Capoten], enalapril [Vasotec])
- Some antibiotics (for example, isoniazid, ketoconazole [Nizoral, Extina, Xolegel, Kuric], and metronidazole [Flagyl])
- Anti-ulcer drugs (such as ranitidine [Zantac], cimetidine [Tagamet], and omeprazole [Prilosec])
- Anti-androgen or estrogen therapies for prostate cancer
- methyldopa (Aldomet)
- Highly active anti-retroviral therapy (HAART) for HIV disease, which may cause fat redistribution leading to pseudogynecomastia or, in some cases, true gynecomastia
- diazepam (Valium)
- Drugs of abuse (for example, alcohol, marijuana, heroin)
- Lavender oil and tea tree oil, when used in skin-care products, have been associated with gynecomastia
It is appropriate to consult a doctor or other health care professional if you think you may be developing or have the condition.