Gynecomastia is a medical term for the enlargement of the mammary glands in men and boys. It appears in many men, without originating from a disease and is completely insignificant, this is more common at an advanced age. It can occur in puberty and in newborns due to hormonal disbalances, this requires no treatment and resolves itself on its own. In many cases, gynecomastia can be a symptom of a disease, however. The growth of mammary glands is cause by a shift in the ratio of male sex hormones, testosterone, and female sex hormones, estrogen, in favor of estrogen. It can be a symptom of many serious diseases and therefore it is necessary to look for the cause, although one is found only in roughly half of the cases.
Symptoms of gynecomastia
Gynecomastia can affect one or both breasts. The enlargement can be symmetrical or asymmetrical, of varying sizes from a visible swelling to a full grown female breast. Usually the enlargement is small, painless and somewhat sensitive to the touch with the gland being either soft or stiff. Irregular and hard tissue can be a sign of a breast cancer, which is more rare in men than in women, but tends to have a worse prognosis. The main reason for this is that men seek out their doctors very late. Scales and scabs will form on the breast's skin, as well as reddening and bloody discharge which leaves stains on clothes and bedding. Lymph nodes in the armpits are affected as well, making them apparent to touch, but painless.
Causes of gynecomastia
Gynecomastia is most commonly caused by medication and is therefore a side effect of a treatment of a different disease. Certain drugs can cause gynecomastia as well, notably cannabis or amphetamines. Of the more serious causes, testicular cancer or cancer of the adrenal glands, which produce estrogen, will be looked into by a doctor. An increased amount of estrogen in body is also present during a long lasting kidney disease and during liver damage. If the amount of estrogen in body is not raised by its overproduction, the problem can lie in a low production of androgens, or male sex hormones, due to testicular issues, genetic disorders, increased function of the thyroid gland or tumors which produce compounds that inhibit testicular activity, therefore reducing the production of androgens.
Diagnostics of gynecomastia
Diagnostics of gynecomastia rely on anamnesis, physical, ultrasound, x-ray and laboraty examination. During the anamnesis the endocrinologist will focus on questions relating to childhood diseases, development during puberty, medication used, eating habits, weight gain or loss, abuse of anabolics, drugs and alcohol. During the physical exam he will evaluate the amount of body fat, size and sensitivity of breasts, underarm lymph nodes and the testicles as well. Further examinations during gynecomastia diagnosis are an ultrasound of breasts and testicles, a mammogram, the abdomen is examined to rule out changes in kidneys and liver, an x-ray, CT(computer tomography) or MRI (magnetic resonance imaging) or skull if there is a suspicion of a tumor. During the laboratory exam a sample of blood is taken and examined for hormonal levels, kidney and liver function and blood sugar levels or glycemia.
Treatment of gynecomastia
Gynecomastia with an undiscovered cause, which causes no issues requires no immediate treatment. The gland can always be removed for cosmetic reasons. If a tumor is discovered a surgical treatment is necessary. The breast is removed together with the affected lymph nodes in armpits. The treatment is followed by irradiation and hormonal or cytostatic medication. If the gynecomastia is caused by medication that can be replaced, it will be replaced. If a disease among whose symptoms is gynecomastia is discovered the treatment focuses on the disease. Certain risk factors are tied to certain diseases during which gynecomastia occurs. With male breast cancer this is a long term usage of anti-androgen therapy during prostate cancer and the use of hormonal agents. Risk factors of liver and kidney disease are repeated infections and toxic influenced of alcohol, obesity, diabetes, abuse of drugs, high blood pressure and arterial damage.
Prevention of gynecomastia
Avoiding products which can cause gynecomastia and prevention of cancerous diseases, which is mainly based on a healthy lifestyle, plenty of movement and sleep, healthy diet, limiting of smoking and drinking and avoiding harmful radiation and stress are all parts of gynecomastia prevention. Prevention is a hard work, but is the basis of a healthy life. If you believe you suffer from gynecomastia or have noticed worrisome changes, please consult your doctor as soon as possible.