WHAT IS GYNECOMASTIA?
Gynecomastia is the benign enlargement of breast tissue in males.It may occur transiently in newborns. Half or more of adolescent boys have some breast development during puberty. Gynecomastia may arise as an abnormal condition associated with disease or metabolic disorders, as a side-effect of medication, or as a result of the natural decrease of testosterone production in older males. In adolescent boys, the condition is often a source of psychological distress; however, 75% of pubertal gynecomastia cases resolve within two years of onset without treatment.
SIGNS AND SYMPTOMS
Gynecomastia may occur unilaterally or bilaterally, presenting with swollen breast tissue or breast tenderness, which may lead affected individuals to be concerned about the possibility of having breast cancer.An increase in the diameter of the areola or asymmetry of chest tissue are other possible signs of gynecomastia.
Gynecomastia is caused by excessive estrogen actions and is often the result of an increased ratio of estrogen to androgen. In approximately 25% of cases, the cause of gynecomastia is unknown.About 10%-25% of cases are estimated to result from the use of medications.This is known as non-physiologic gynecomastia. Those medications include ketoconazole, cimetidine, gonadotropin-releasing hormone analogues, human growth hormone, human chorionic gonadotropin, antiandrogens such as bicalutamide, flutamide, and spironolactone, and 5-alpha-reductase inhibitors such as finasteride or dutasteride. Medications with probable associations to gynecomastia include risperidone, calcium channel blockers such as verapamil and nifedipine, anabolic steroids,alcohol, opioids, efavirenz, alkylating agents, and omeprazole.Individuals with prostate cancer who are treated with androgen deprivation therapy may experience gynecomastia. Hyperprolactinemia has also been associated with the development of gynecomastia.
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