Gynecomastia

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

It can affect one or both breasts and can be caused by hormonal imbalances, medications, or other medical conditions. But, 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 researched.
• Dr. Smarrito will prescribe an endocrine assessment mainly based on a blood test. The basic assessment combines studies of renal, hepatic, thyroid functions, as well as LH, B-HCG, estradiol and total testosterone.
• In most cases, no cause is found, it is idiopathic gynecomastia. This is the most frequent clinical case.
• When gynecomastia is less than 6 months old, drug treatment can cause the breast mass to regress; beyond that, it becomes fibrous and requires surgery.

At what age does gynecomastia usually 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: ovulation towards fibrotic tissue.

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

In case of significant pain, you should consult a doctor to rule out breast cancer in men.

The diagnosis is generally established by:

– A physical examination during consultation.

– A medical questionnaire.

– Imaging tests (ultrasound or mammogram).

– Blood tests to assess hormone levels.

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

On average, you have to stop sport for 15 days, except for athletes with a high level of training. I can also adapt the training 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, reducing alcohol).

– Medications (anti-androgens or aromatase inhibitors).

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

Yes, in some adolescents, gynecomastia can go away without treatment within a few months.

Risks of surgery include:

- Infection.

– Bleeding.

– Scars.

– Asymmetry of the breasts.

– Skin sagging in the absence of associated Bodytitis.

Although gynecomastia is generally benign, it can sometimes be associated with testicular tumors or other carcinomas including breast. A medical evaluation is essential. Beware of asymmetrical cases which are more suspicious.

No, in my career I have discovered 2 cases of cancer at the time of histological analysis under the microscope, with normal mammograms. These were minimally invasive multifocal tumors.

Only microscopic examination (histological) is reliable to rule out the diagnosis. This examination is reimbursed by insurance funds.

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 issues with 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 clothing. Often obesity is a refuge to camouflage gynecomastia.

Throughout my career, I have literally saved teenagers who were psychologically sinking because of their breasts. This phenomenon is accentuated by social networks.

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 breast glandular tissue in men.

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