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| Male Gynecomastia |
Last updated: Nov 05, 2009 |
Conditions that suggest it | Contributing risk factors | Recommendations
Conditions that suggest Male Gynecomastia: | |  | | | | Symptoms - Glandular | Counter-indicators:
Absence of gynecomastia |
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Risk factors for Male Gynecomastia: | |  | | | | Hormones | Low Testosterone Level | The basic mechanisms of gynecomastia are a decrease in androgen production, an absolute increase in estrogen production, and an increased availability of estrogen precursors for peripheral conversion to estradiol. |
| Symptoms - Glandular |
History of gynecomastia |
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Recommendations for Male Gynecomastia: | |  | | | | Diet | Alcohol Avoidance | Several studies indicate a potential role for prolactin and estrogen in the pathogenesis for feminization. Male alcoholic patients frequently show evidence of feminization that is manifested by gynecomastia, spider angiomata, palmar erytherma and changes in body hair patterns. Alcoholic men show a positive association between the presence of clinically apparent gynecomastia and elevated circulating levels of prolactin. The gynecomastia found in alcoholic patients is characterized by a proliferation of the stroma and ducts that are known to be estrogen-positive. |
| Hormone |
Estrogen-balancing Medications | Males with gynecomastia often have an elevation of plasma levels of estrogen which is believed to be due to peripheral conversion of weak adrenal androgens to estrogen. |
Testosterone | Gynecomastia is a common condition in athletes who use steroids or testosterone to build muscle. The condition is caused by the aromatization of testosterone into estrogens. Gynecomastia may be avoided through the use of dihydrotestosterone instead of other forms of testosterone. It can actually even be applied as a treatment for gynecomastia. A further advantage of dihydrotestosterone is that increased levels of the hormone are correlated to increased sex drive and increased sexual function. |
Not recommended:
Melatonin | One case of painful gynecomastia has been reported involving a 56 year old man who had been suffering from amyotrophic lateral sclerosis and was taking 1 to 2mg melatonin per day over a 1 1/2 year period. As the gynecomastia disappeared after melatonin use was discontinued, it was suspected that the melatonin caused this side effect. |
| Lab Tests/Rule-Outs |
Test / Monitor Hormone levels | Estradiol is the growth hormone of the breast, and an excess of estradiol leads to the proliferation of breast tissue. Under normal circumstances, most estradiol in men is derived from the peripheral conversion of testosterone and adrenal estrone. The basic mechanisms of gynecomastia are a decrease in androgen production, an absolute increase in estrogen production, and an increased availability of estrogen precursors for peripheral conversion to estradiol. |
| Surgery/Invasive |
Surgery | Often no cause is found for the disorder and the gynecomastia may not resolve on it's own. In these cases, surgery is frequently the best solution. |
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KEY |  | Strong or generally accepted link |  |  | Very strongly or absolutely counter-indicative |  |  | May do some good |  |  | Likely to help |  |  | Highly recommended |  |  | May have adverse consequences |
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