What Are The Signs And Symptoms Of Gynecomastia?

Gynecomastia is a condition that can occur in humans, characterized from much of the breasts, which tend to resemble female ones. Gynecomastia is more common in male babies, in boys during puberty and in older men.

In most cases, gynecomastia is not a serious disease but it can be difficult to tackle the problem from a psychological point of view. As well as affect the self-confidence and cause embarrassment, some men may also feel pain in your breasts.

In most cases, gynecomastia resolves spontaneously. In over 75% of cases of pubertal gynecomastia signs and symptoms resolve within a year.

What Are The Signs And Symptoms Of Gynecomastia?

If the gynecomastia persists available treatments.

Gynecomastia is not caused by the accumulation of fat, in the context of overweight or obesity, but it is caused by the increase in glandular tissue. For this exercise, and losing weight does not help to resolve it. There are other conditions, such as pseudo-gynecomastia, in which the fatty tissue accumulates in the breasts, which is sometimes associated with overweight and obesity.

What are the signs and symptoms of gynecomastia?

Signs and symptoms of gynecomastia may also appear in one breast.

- The fabric of the mammary gland increases in volume.

- The breast takes a soft consistency.

- The areola diameter increases (the areola is the area of ​​pigmented skin surrounding the nipple).

If they are noticed: unusual and persistent bloating, breast softer to the touch, pain and / or nipple discharge is advisable to request a medical examination.

What causes gynecomastia?

- A hormonal imbalance of testosterone and estrogen.

Estrogen, the female hormone, stimulate the growth of breast tissue, while the testosterone, the male hormone, has the growth inhibitory effects of this tissue.

About 50% of male infants are born with enlarged breasts. This is because they have high levels of estrogen that come from the mother. As estrogen levels return to normal, the enlargement of the breasts disappears, usually within a few weeks. The increase in breast enlargement is more common in middle-aged and elderly males. This is because aging will always produce less testosterone. Also older men are usually more overweight, and it is known that adipose tissue produces estrogen.

- Kidney failure

- Alcohol abuse

- Liver disease

Irradiation of the testes

Klinefelter's syndrome

- Marijuana and other illegal drugs. Many studies have investigated whether there is a link between the use of cannabis and gynecomastia. Some have found an association while others have not shown any particular link.

Infection or testicular tumors

Some thyroid diseases

- Drugs, such as:

- Certain antibiotics

- Some anti-ulcer drugs

- chemotherapy

- Tricyclic antidepressants

- Diazepam (Valium) and other sedative drugs

- Anabolic steroids

- Anti-androgens (drugs commonly prescribed for prostate cancer or BPH)

- Certain heart medications, including calcium channel blockers and digoxin (Lanoxin)

In fact the majority of cases of gynecomastia charged to pharmacological side effects are based on reports or studies with a low level of evidence.

The association between the drug and gynecomastia was confirmed for: spironolactone, cimetidine, ketoconazole, hGH, estrogen, hCG, anti-androgens, GnRH analogues, 5 alpha reductase inhibitors. Drugs likely associated with gynecomastia include risperidone, verapamil, nifedipine, omeprazole, alkylating agents, for HIV drugs (efavirez), anabolic steroids, alcohol and opioids.

gynecomastia diagnosis

The doctor asks the patient what are the symptoms, any present or past illnesses, medications you are taking and the family history.

Following subjects the patient to a visit of the breasts, abdomen and genitals.

If the doctor determines that the gynecomastia is caused by a hormonal imbalance, as may be the case of puberty, the patient is asked not to worry because it is likely the problem will be resolved within a year.

If the swelling of the breast is very clear, soft, single-sided, or fixed and hard, they will be asked for further investigations, which may include a biopsy. In case of unilateral involvement physician you need to know if there is a family history of breast cancer.

The doctor will try to rule out other causes enlargement of the breasts, such as:

cyst

lipoma (benign tumor composed of fatty tissue)

mastitis (inflammation of the mammary gland)

breast cancer

pseudogynecomastia (magnification caused by fat accumulation)

hematoma (solid swelling of clotted blood)

metastases (tumor tissue from a tumor in some other seat of the body)

hamartoma (benign tumor)

Your doctor may order blood tests or a mammogram. Depending on the additional tests may be required, such as:

chest x-ray

CT, MRI

ultrasound of the testicles

biopsy

What are the treatments for gynecomastia?

If there is an underlying cause, it must be cured.

In case of side effect of a drug, this must be replaced or suspended. If therapy is in the short term, at the end of the same breast tissue will regress spontaneously.

In most cases, gynecomastia resolves spontaneously. It 'important that the patient understands it well. Adolescents are followed over time to see if the gynecomastia improves, as usually happens.

If gynecomastia is not resolved within a couple of years, due to embarrassment, pain or decrease of consistency, you may need treatment.

Medical therapy

Tamoxifen, a drug that blocks the action of estrogen in the body. E 'used for the treatment of breast cancer, but is also used to reduce the symptoms present in cases of gynecomastia. The 70% of patients treated with tamoxifen report a reduction in size of the udder, while in all cases the pain resolves.

Aromatase inhibitors, a class of drugs used for the treatment of breast and ovarian cancer. They can be used off-label to prevent or treat gynecomastia in men.

Testosterone, sometimes used in older men with gynecomastia and low testosterone levels. This treatment does not work if your testosterone levels are normal.

surgical treatment

The breast consists of two main components:

glandular tissue, compact and solid

adipose tissue, soft

The ratio of glandular tissue and fat varies from patient to patient. In patients with gynecomastia may be an excess of both tissues.

Liposuction. If there is excess adipose tissue, this can be aspirated. an incision of 3-4 mm is performed through which a small tube for suction is inserted.

Excision. It means the surgical removal of the tissue. If gynecomastia consists mainly by the increase in glandular tissue, this will have to be removed. The intervention hesitate in a scar, usually at the edge of the areola.

In some cases it may be required either liposuction that the excision.

After surgery the breast may appear bruised and swollen, leaving hardly perceive the effectiveness of the treatment. The doctor may advise the patient to wear an elastic compression bandage for a couple of weeks to promote healing.

After about 6 weeks the patient can fully resume its activities.

The surgery complications are rare and can include insufficient removal of tissue, an irregular contour of the breast, a reduction in nipple sensation, hematoma formation.