Back تثدي الرجل Arabic Xinecomastia AST Ginekomastiya Azerbaijani Гінекамастыя Byelorussian Гинекомастия Bulgarian गाइनेकोमास्टिया Bihari Ginecomàstia Catalan Gynekomastie Czech Gynäkomastie German Ginecomastia Spanish

Gynecomastia

Gynecomastia
Adult male with significant gynecomastia
Pronunciation
SpecialtyEndocrinology, plastic surgery
Usual onsetAny age
DurationUsually up to 2 years, but can be lifelong
CausesIncreased estrogen/androgen ratio (physiologic, medications, chronic kidney disease, obesity, cirrhosis, malnutrition, certain cancers)
Diagnostic methodphysical exam, mammography (if indicated)
Differential diagnosisPseudogynecomastia, breast cancer
TreatmentLifestyle 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]

  1. ^ "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.
  2. ^ "Definition of Gynecomastia". www.merriam-webster.com. Retrieved 17 November 2020.
  3. ^ 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.
  4. ^ 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)
  5. ^ 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.
  6. ^ 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.
  7. ^ a b Cite error: The named reference Narula2014 was invoked but never defined (see the help page).
  8. ^ 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.
  9. ^ Cite error: The named reference Chau2016 was invoked but never defined (see the help page).
  10. ^ 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.
  11. ^ "Gynecomastia: Surgery, treatment, causes, and symptoms". www.medicalnewstoday.com. 11 January 2018. Retrieved 16 April 2021.
  12. ^ Dickson, Gretchen (1 April 2012). "Gynecomastia". American Family Physician. 85 (7): 716–722. ISSN 0002-838X. PMID 22534349.
  13. ^ Z. Hochberg (1 January 2007). Practical Algorithms in Pediatric Endocrinology. Karger Medical and Scientific Publishers. pp. 21–. ISBN 978-3-8055-8220-9.
  14. ^ Seth Thaller; Mimis Cohen (28 February 2013). Cosmetic Surgery After Massive Weight Loss. JP Medical Ltd. pp. 133–. ISBN 978-1-907816-28-4.
  15. ^ 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
  16. ^ Cite error: The named reference Wit2011 was invoked but never defined (see the help page).
  17. ^ Cite error: The named reference Drugs was invoked but never defined (see the help page).
  18. ^ "Plastic Surgery Statistics Report" (PDF). American Society of Plastic Surgeons. 2019. Archived from the original (PDF) on 19 February 2021.


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