Gynecomastia in men - Causes, Symptoms and Treatment .MF .
Gynecomastia - the increase of breast tissue in men.
Causes of gynecomastia
Gynecomastia occurs in men as a result of hormonal disorders in which the levels of estrogen (female sex hormone) is increased compared to the level of androgens (hormones muzhskihpolovyh).
Gynecomastia can occur in healthy boys in the neonatal period, adolescence, old age.This is called physiological gynecomastia.Physiological gynecomastia usually disappears on its own.
have 60-80% of newborns marked swelling of the breast, this is due to the action of estrogen mother received the body of the child in utero.Usually disappears on its own within 2-4 weeks.
pubertal gynecomastia occurs in 30-60% of boys 12-14 years, in most cases, double-sided, sometimes accompanied by discharge from the nipples, caused by temporary changes in hormone levels.As a rule, such gynecomastia regress within 12-24 months.Sometimes gynecomastia, which develops during puberty, persists for more than two years, and it is called persistent pubertal
gynecomastia in the elderly in men 50-80 years of age due to a decrease in testosterone levels and the prevalence of female sex hormones.
However, in some cases, gynecomastia in men can be a symptom of serious illness.First of all, gynecomastia cause diseases of male genital organs (testicles), accompanied by a decrease in testosterone production.They may be innate: Klinefelter syndrome, anorchidism (absence of one or both testes), testosterone synthesis defects.It acquired pathology of the male reproductive system include trauma, infections (mumps, orchitis), decreased blood flow, testicular cancer.
cause of gynecomastia in men may be to increase the production of estrogen in some testicular tumors, horionkartsinoma, bronchogenic lung cancer, true hermaphroditism, feminizing adrenal tumor (adenoma or carcinoma)
Sometimes gynecomastia is a symptom of diseases of internal organs, endocrine glands.For example, gynecomastia can accompany chronic renal failure, hyperthyroidism (increased thyroid function), hyperprolactinemia (increased prolactin levels as a result of pituitary disease), malnutrition, starvation, cirrhosis, obesity (available aromatase enzyme in fat tissue, which promotes the conversion of testosterone into estrogen).
Gynecomastia can also be a side effect of certain drugs:
- Spironolactone (Veroshpiron) - a diuretic, which has anti-androgen activity;
- Calcium channel blockers - used to treat hypertension, ischemic heart disease (nifedipine, amlodipine, verapamil);
- Angiotensin converting enzyme inhibitors - drugs for the treatment of hypertension and congestive heart failure (captopril (Capoten), enalapril (Enap, ednit), lisinopril (Diroton);
- some antibiotics and antifungal drugs (isoniazid, ketoconazole (Nizoral), metronidazole (Trichopolum, Metrid);
- anti-ulcer drug (ranitidine (Zantac), cimetidine, omeprazole (Omez);
- hormonal treatments for prostate cancer;
- methyldopa (dopegit) - antihypertensive drug;
- antiretroviral therapy for HIV infection;
- digoxin - a cardiac glycoside, appointed in heart failure;
- diazepam (Relanium Seduxen) - tranquillizer;
- drugs (eg, alcohol, marijuana, heroin);.
- lavender oil and tea tree oil
sometimes cause gynecomastiaidentify fails, then called idiopathic gynecomastia.
symptoms of gynecomastia in men
main symptom of gynecomastia is the increase in the male breast.The increase is based gynecomastia glandular and fatty tissue are not.Breast augmentation by fat tissue in obese men called pseudogynecomastia.
As a rule, bilateral gynecomastia, approximately one third of cases can be one-sided.Sometimes detected discharge from the nipple, similar to colostrum.The increase may be more than one side, even if both parties involved.Soreness is usually absent, but may present discomfort, increased sensitivity in the mammary gland.
unilateral gynecomastia in men
Bilateral gynecomastia in men (left) and the gland is normal (right)
Gynecomastia is usually associated with normal sexual potency, in addition to gynecomastia caused by excessive production of estrogen and testosterone decline.At higher levels of estrogen can occur decline and lack of libido.
should immediately seek medical attention if symptoms characteristic of malignancy: one-sided gynecomastia, firm, dense texture formation, skin changes in the breast, increasing the axillary lymph nodes.It is also an urgent medical evaluation for gynecomastia is necessary with the involvement of the testes (change shape, swelling, swelling of the testicles), with signs hyperestrogenism.Symptoms hyperestrogenism include voice changes (increased tone), loss of hair on the face (beard and mustache), emotional disorders such as tearfulness, irritability, and decreased libido.
diagnosis of gynecomastia
preliminary diagnosis is made by palpation (palpation) of breast tissue, the axillary lymph nodes.
uses ultrasound breast, axillary lymph nodes, less mammography and breast biopsy to confirm the diagnosis, detection of breast cancer.
Laboratory studies should include a definition of levels of testosterone, estradiol, luteinizing hormone (LH), thyroid stimulating hormone (TSH), prolactin, and human chorionic gonadotropin (hCG).With increasing levels of estradiol and hCG studies to exclude malignancy should be implemented immediately!
If necessary, appoint men as ultrasound of the testes, adrenal computed tomography to rule out a tumor.
often need help therapist, endocrinologist, urologist, oncologist surgeon, neurologist.
Treatment of Gynecomastia in men
The treatment of gynecomastia depends on the reason she was summoned.Physiological gynecomastia newborns in most cases does not require treatment, it disappears on its own.
gynecomastia, especially in puberty, often self undergoes reverse development for about six months.Therefore, in the absence of signs of malignancy in many cases preferable to observation.If within 6 months there is no positive dynamics is usually given drug therapy.
Drugs used to treat gynecomastia, appointed only physician!
Independent uncontrolled intake of these drugs without establishing the exact cause of gynecomastia may lead to aggravation of gynecomastia, the progression of the disease or severe side effects.
Testosterone - prescribed to patients with low levels of testosterone to elderly men, in patients with normal levels of testosterone are generally ineffective.
Clomiphene - an anti-estrogen, is often used to treat gynecomastia.
Tamoxifen (Nolvadex) - a selective estrogen receptor modulator - is most often used for severe and painful form of gynecomastia.
Danazol is a synthetic derivative of testosterone, decreases estrogen synthesis in the testes, is used to treat gynecomastia is much less than other medications.
When gynecomastia caused by taking drugs, the question of replacing the drug or reducing the dose.
Gynecomastia caused by diseases of internal or endocrine organs, requires treatment of the underlying disease.
If diagnosed malignant process, requires emergency surgery.
Surgical treatment of gynecomastia
Reduction mammoplasty (breast reduction surgery) is used in severe cases of gynecomastia, the current long-term (over 1 year), subjected to scarring of gynecomastia, or in cases where drug treatment has been ineffective.
Gynecomastia, the existing more than 12 months, may be subject to scarring (fibrosis), which greatly complicates the medication.
Another complication of gynecomastia are psychological consequences, often they occur in adolescents, if breast augmentation is the cause of inferiority complexes.
Prevention of gynecomastia is the prevention of diseases that can cause it, careful monitoring of medication, keeping their side effects.Prevention of physiological forms of gynecomastia exists.
forecast for gynecomastia
Physiological gynecomastia infants and adolescents usually has a favorable course, it disappears without treatment.
Exodus with symptomatic gynecomastia depends on the cause of the disease.In severe cases or cases of breast scarring due to the duration of the process, the lack of adequate treatment, surgical methods, in most cases, can help restore normal appearance chest.
endocrinologist Faizulin NM