Gynecomastia

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: David Perlstein, MD, MBA, FAAP
    David Perlstein, MD, MBA, FAAP

    David Perlstein, MD, MBA, FAAP

    Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

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When should I call the doctor about gynecomastia?

It is appropriate to consult a health care practitioner if a male develops gynecomastia in order to determine its cause. The health care practitioner can order tests if necessary to rule out any serious medical conditions that may be the cause of gynecomastia.

How is gynecomastia diagnosed?

The definition of gynecomastia is the presence of breast tissue greater than 0.5 cm in diameter in a male. As previously discussed, gynecomastia is the presence of true breast (glandular) tissue, generally located around the nipple. Fat deposition is not considered to be true gynecomastia.

In most cases, gynecomastia can be diagnosed by a physical examination. A careful medical history is also important, including medication and drug use. If there is a suspicion of cancer, a mammogram may be ordered by a health care practitioner. Further tests may be recommended to help establish the cause of gynecomastia in certain cases. These can include blood tests to examine liver, kidney, and thyroid function. Measurement of hormone levels in the bloodstream may also be recommended in some cases.

What is the treatment for gynecomastia?

Gynecomastia, especially in pubertal males, often goes away on its own within about six months, so observation is preferred over specific treatment in many cases. Stopping any offending medications and treatment of underlying medical conditions that cause gynecomastia are also mainstays of treatment.

Treatments are also available to specifically address the problem of gynecomastia, but data on their effectiveness are limited, and no drugs have yet been approved by the U.S. Food and Drug Administration (FDA) for treatment of gynecomastia. Medications are more effective in reducing gynecomastia in the early stages, since scarring often occurs after about 12 months. After the tissue has become scarred, medications are not likely to be effective, and surgical removal is the only possible treatment.

Medications that have been used to treat gynecomastia include:

  • Testosterone replacement has been effective in older men with low levels of testosterone, but it is not effective for men who have normal levels of the male hormone.
  • Clomiphene gynecomastia. It can be taken for up to 6 months.
  • The selective estrogen receptor modulator (SERM) tamoxifen (Nolvadex) has been shown to reduce breast volume in gynecomastia, it was not able to entirely eliminate all the breast tissue. This type of therapy is most often used for severe or painful gynecomastia.
  • Danazol is a synthetic derivative of testosterone that decreases estrogen synthesis by the testes. It works by inhibition of pituitary secretion of LH and follicle-stimulating hormone (FSH), substances that direct the sex organs to produce hormones. It is less commonly used to treat gynecomastia than other medications.
Medically Reviewed by a Doctor on 11/9/2015
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