Gynecomastia

Gynecomastia is an increase in glandular tissue (mammary gland) of the breasts in men.

It can affect one or both breasts and can be caused by hormonal imbalances, medications, or other medical conditions. However, in most cases, no cause or disease is found.

Causes may include:

– Hormonal imbalances (increased estrogen or decreased testosterone).

– Taking medication (antidepressants, steroids, etc.).

– Diseases (cirrhosis, hyperthyroidism).

– Substance use (alcohol, marijuana, anabolic steroids).

• Gynecomastia is common in adolescents and older men. We can even consider it physiological at these ages.
• Many drugs, so-called natural products, doping products, food supplements, and toxins must be investigated.
• Dr. Smarrito Your doctor will prescribe an endocrine assessment, primarily based on a blood test. The basic assessment includes studies of kidney, liver, and thyroid function, as well as LH, beta-HCG, estradiol, and total testosterone levels.
• In most cases, no cause is found; this is idiopathic gynecomastia. This is the most frequent clinical presentation.
• When gynecomastia is less than 6 months old, drug treatment can cause the breast mass to regress; beyond that, it becomes fibrous and requires surgical intervention.

At what age does gynecomastia typically occur?

Gynecomastia can occur at various ages:

– Newborn

– Puberty: common in adolescents due to hormonal changes.

– Adulthood: can develop at any age, often due to illness or treatment.

– Senescence: evolution towards fibrosed tissue.

Gynecomastia can be associated with breast tenderness or pain, but in many cases, it does not cause discomfort. Often, it is the weight that leads to this painful sensation.

In cases of significant pain, a consultation is necessary to rule out breast cancer in men.

The diagnosis is usually established by:

– A physical examination during a consultation.

– A medical questionnaire.

– Imaging examinations (ultrasound or mammography).

– Blood tests to assess hormone levels.

In practice, with my experience, I make the diagnosis by pinching the breast.

On average, you need to stop exercising for 15 days, except for athletes with a high level of training. I can also adapt the training program depending on the patient and the surgery performed.

Treatment options include:

– Therapeutic abstention and monitoring (in the case of benign gynecomastia).

– Lifestyle changes (weight loss, alcohol reduction).

– Medications (anti-androgens or aromatase inhibitors).

– Surgery in cases that have not regressed in 6 months. Liposuction and/or incision for gland removal.

Yes, in some adolescents, gynecomastia can disappear without treatment in a few months.

The risks of surgery include:

- Infection.

– Bleeding.

– Scars.

– Breast asymmetry.

– Skin laxity in the absence of associated Bodytitis.

Although gynecomastia is usually benign, it can sometimes be associated with testicular tumors or other cancers, including breast cancer. A medical evaluation is essential. Pay particular attention to asymmetrical cases, which are more suspicious.

No, in my career, I discovered two cases of cancer during histological analysis under a microscope, with normal mammograms. These were multifocal, minimally invasive tumors.

Only microscopic (histological) examination is reliable for ruling out the diagnosis. This examination is covered by health insurance.

Preventing gynecomastia may include:

– Maintain a healthy weight.

– Limit alcohol and drug consumption.

– Avoid medications known to cause gynecomastia.

Gynecomastia involves an increase in glandular tissue, while lipomastia refers to an accumulation of fat in the breast area without an increase in glandular tissue.

Yes, children can develop gynecomastia, often linked to hormonal changes.

Gynecomastia can lead to emotional distress, low self-esteem, and anxiety or depression. It is important to consult a healthcare professional for support if needed.

Many teenagers no longer dare to go swimming or wear tight clothes. Often, obesity is a refuge to camouflage gynecomastia.

Throughout my career, I have literally saved teenagers who were psychologically devastated because of their breasts. This phenomenon is exacerbated by social media.

Doping, particularly the use of anabolic steroids, is often associated with gynecomastia.

These substances can cause hormonal imbalances, increasing estrogen levels in the body, which can lead to excessive development of mammary glandular tissue in men.

Athletes and bodybuilders using these products are more likely to develop this condition.