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- Therapeutics and Clinical Risk Management: Gynecomastia – Evaluation and Current Treatment Options
- Therapeutics and Clinical Risk Management: Gynecomastia – Evaluation and Current Treatment Options
- Indian Journal of Endocrinology and Metabolism: Gynecomastia -- Clinical Evaluation and Management
- Indian Journal of Endocrinology and Metabolism: Gynecomastia -- Clinical Evaluation and Management
- Mayo Clinic Proceedings: Gynecomastia -- Pathophysiology, Evaluation, and Management
- Mayo Clinic Proceedings: Gynecomastia -- Pathophysiology, Evaluation, and Management
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What Is Bilateral Gynecomastia?
Bilateral gynecomastia is the enlargement of both breasts in men. Gynecomastia occurs when an imbalance between the hormones estrogen and testosterone occur. Gynecomastia is not considered a serious problem although some men and boys feel discomfort in the breast tissue along with social embarrassment. This disorder can resolve itself or may require medical intervention such as medication or surgery.
Symptoms
The primary symptoms of gynecomastia are swollen breast tissue and breast tenderness. Bilateral gynecomastia suffers experience these symptoms in both breasts although it can occur on just one side. Enlargement of the breast tissue may occur unevenly between the two breasts.
Causes
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Gynecomastia has several causes. When the estrogen level in the male body is higher than the testosterone level, gynecomastia may result. This hormone imbalance may result from naturally occurring hormonal changes, medications and health disorders. Approximately 25 percent of gynecomastia cases have no known cause. Hormonal imbalances may be caused by the natural aging process, chemotherapy treatments for cancer, liver disease, anabolic steroid hormone usage, estrogen hormone exposure, dialysis, using marijuana, medical hormone treatments, radiation to the testicles and testosterone deficiency.cause:
- Hormonal imbalances may be caused by the natural aging process
- chemotherapy treatments for cancer
- liver disease
- anabolic steroid hormone usage
- estrogen hormone exposure
- dialysis
- using marijuana
- medical hormone treatments
- radiation to the testicles
- testosterone deficiency
Any of these can lead to gynecomastia 2.
- Gynecomastia has several causes.
- When the estrogen level in the male body is higher than the testosterone level, gynecomastia may result.
Diagnosis
In order to diagnosis gynecomastia, a health care provider will complete a physical health exam including questions about current medications. Other possible testing includes palpation (feeling) of the breast tissue, abdomen and genitals, blood tests such as:
- hormone levels
- mammograms
- X-rays
- CT scans
- MRIs
- ultrasounds
- biopsies
The health care provider will also determine if other conditions are present such as excess fatty tissue in the breast, abcesses or breast cancer.
Treatments
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Treatment choices vary according to the cause and amount of discomfort the patient experiences. Initially, underlying medical conditions causing gynecomastia should be evaluated and treated by a health care provider. If the condition continues to be bothersome, other treatment options include medications and surgery such as liposuction to removed excess fatty tissue and mastectomy to remove the breast gland.
Prevention
To prevent or possibly resolve bilateral gynecomastia, stop all use of recreational drugs such as marijuana and supplements meant to enhance bodybuilding such as anabolic steroids.
Related Articles
References
- Therapeutics and Clinical Risk Management: Gynecomastia – Evaluation and Current Treatment Options
- Indian Journal of Endocrinology and Metabolism: Gynecomastia -- Clinical Evaluation and Management
- Mayo Clinic Proceedings: Gynecomastia -- Pathophysiology, Evaluation, and Management
- Cuhaci N, Polat SB, Evranos B, Ersoy R, Cakir B. Gynecomastia: Clinical evaluation and management. Indian J Endocrinol Metab. 2014;18(2):150-8. doi:10.4103/2230-8210.129104
- Lemaine V, Cayci C, Simmons PS, Petty P. Gynecomastia in adolescent males. Semin Plast Surg. 2013;27(1):56-61. doi:10.1055/s-0033-1347166
- Niewoehner CB, Schorer AE. Gynaecomastia and breast cancer in men. BMJ. 2008;336(7646):709-13. doi:10.1136/bmj.39511.493391.BE
- Male Breast Cancer. MedlinePlus. Jul 11, 2019.
- Dickson G. Gynecomastia. American Family Physician. Apr 1, 2012.
- Henley DV, Lipson N, Korach KS, Bloch CA. Prepubertal gynecomastia linked to lavender and tea tree oils. N Engl J Med. 2007;356(5):479-85. doi:10.1056/NEJMoa064725
- 2016 Cosmetic Surgery National Data Bank Statistics. The American Society for Aesthetic Plastic Surgery.
- Taheri AR, Farahvash MR, Fathi HR, Ghanbarzadeh K, Faridniya B. The Satisfaction Rate among Patients and Surgeons after Periareolar Surgical Approach to Gynecomastia along with Liposuction. World J Plast Surg. 2016;5(3):287-292.
- Cuhaci, Neslihan. Gynecomastia: Clinical evaluation and management. Indian J Endocrinol Metab. 2014 Mar-Apr 18(2): 150-158. https://dx.doi.org/10.4103/2230-8210.129104
- Henley DV, et al. Prepubertal gynecomastia linked to lavender and tea tree oils. N Engl J Med. 2007 Feb 1;356(5):479-85. doi:10.1056/NEJMoa064725
- Johnson Ruth E and Murad M Hassan. Gynecomastia: Pathophysiology, Evaluation, and Management. Mayo Clin Proc. 2009 Nov; 84(11): 1010–1015. doi:10.1016/S0025-6196%2811%2960671-X
- Love Susan. "Dr. Susan Love's Breast Book." Sixth edition. Hachette Book Group; 2015.
- Niewoehner CB, Nuttal FQ. Gynecomastia in a hospitalized male population. Am J Med. 1984 Oct; 77(4):633-8. doi:10.1016/0002-9343(84)90353-x
- Taheri Ahmad Reza. The Satisfaction Rate among Patients and Surgeons after Periareolar Surgical Approach to Gynecomastia along with Liposuction. World J Plast Surg. 2016 Sep; 5(3): 287–292.
- Toorians AW, et al. Gynaecomastia linked to the intake of a herbal supplement fortified with diethylstilbestrol. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2010 Jul;27(7):917-25. doi:10.1080/19440041003660869
Writer Bio
Terri Peerenboom, R.N., began writing for Demand Studios in 2010. She specializes in health-related topics, and has written and published over 100 articles for LIVESTRONG.COM. She holds a Bachelor of Science in nursing from the University of Texas and a Master of Arts in counseling from Sam Houston State University.